Social Movements Final Paper

Collective Action against Non-Governmental Institutions: A Case Study from the Lesbian and Gay Movement, 1970-1973 Rowan Hildebrand-Chupp 5/8/09 Soc 280 Introduction The American Psychiatric Association (APA) had considered homosexuality a mental disorder since the first edition of the Diagnostic and Statistical Manual of Mental Disorders was published in 1952. In the early 70s, gay liberation movement chose to attack the APA's stance on homosexuality. This case is a clear example of a social movement that specifically targeted the cultural status of homosexuality, instead of its political status. In order to engage in collective action and achieve successes against the political system, activists needed to attack the institutions that exercised heavy control over the stigmatization of their identity. During the 1940s and 50s the medical model of homosexuality replaced the religious one as the primary justification for the government’s discriminatory policies toward homosexuality. By painting gay men and lesbians as “pathological,” the APA enabled and provided part of the symbolic basis for oppression based on sexual orientation. But the medical model also planted the seeds of revolt: homosexuality was no longer a passing sin, but rather a problem rooted deeply within the individual. In this way, sexual orientation became an identity that individuals could

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gather around, work through, and, ultimately, defend (D'Emilio 1998:15-19). In the midst of their own "tripartite system of domination" maintained by medical, religious, and legal authorities, gay activists realized that in order to achieve political victories they would need to win some cultural ones (D'Emilo 1998:129; Morris 1986:1-4). The APA’s classification of homosexuality as a disorder was on the top of that list. But activism against the APA also satisfied the gay power activists’ desire to attack society’s institutions, and it fit within the multi-faceted project of the New Left (Armstrong 2002:56-61). Activists understood that cultural and political institutions work together to enforce systems of oppression, and that all institutions have both material and symbolic impacts. But if this discrimination was so institutionalized, then why did it only take a few years for the American Psychiatric Association to reverse its position on homosexuality? The removal of homosexuality from the DSM provided important benefits to gay activists, and it also brings up interesting theoretical questions about how collective action works. Although in this case there were certainly some mechanisms in place that are described in the standard models for collective action, activism against a professional organization like the APA might not necessarily display the same mechanisms as collective action against the state. The period from the late 60s to the early 70s was a transformative one, during

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which the organizational logics of both the lesbian and gay organizations and the APA were changing. This case study will show that the multiple political logics of the gay liberation movement were particularly suited to exploit the conflicting institutional logics within the APA. Literature Review Political process theory states that broad socioeconomic processes lead to mobilizing structures, political opportunities, and cognitive liberation and that these three factors are required for the emergence of a social movement (McAdam 1999). Mobilizing structures are comprised of organizations and "organizations of organizations" (Morris 1986:24) that can rally the mass base, disseminate information about tactics and successes, and coordinate collective action. Political opportunities are elements present within the political system that make the government susceptible to change or influence. These elements can range from a division within the elite to the presence of successful challengers to the political system (Tarrow 1998:77-80). Mobilizing structures and political opportunities are created by gradual, widespread socioeconomic processes, such as migration or industrialization. The combination of political opportunities and the mobilizing structures leads to cognitive liberation, wherein actors come to believe both that the current system is illegitimate and that they have the ability to change it. These three factors, in turn,

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lead to the emergence of a social movement. This model is valuable in that it combines analyses that focus on indigenous organizational strength and those that focus on the influence of political elites. On the other hand, this model works on some basic assumptions that limit its analytic usefulness when studying cases such as the removal of homosexuality from the DSM. Political process theory (PPT) privileges collective action against the state, and it focuses on struggles that address economic and political inequality and that attempt to change state policy (Armstrong 2002:6). According to PPT, cultural change only arises out of political and economic change, and so it cannot fully account for collective action that is directed against non-governmental institutions. Those struggles are labeled as "cultural" and "expressive" rather than "political" and "instrumental" (Bernstein 1997:533). PPT accounts for the cultural factors within social movements by framing them as "solidary incentives" that attempt to solve the free rider problem instead of weighing them equally alongside the political factors (Friedman and McAdam 1992). Solidary incentives provide actors with motivation to engage in activism and be a part of social movement organizations, even though it is easier to let other people do the work. According to this model, identity serves as a solidary incentive, because it encourages individuals who match that identity to engage in activism when they normally would not. The multi-institutional political approach (MIP) sees society as a

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collection of institutions that each operate within their own organizational field and have their own institutional logics (Armstrong and Bernstein 2008). Instead of viewing the state as the only worthy target of collective action, this approach focuses on the patchwork of institutions that collectively determine how actors will be categorized and how those categorizations will influence the allocation of resources. An analysis using this model does not look for broad social processes, but rather looks at how mechanisms within each institution influence its responsiveness to collective action. Instead of classifying movements as either cultural or political, the MIP examines how symbolic and material goals are inextricably intertwined (Friedland and Alford 1991). Instead of focusing on how social movements achieve change, this perspective tends to focus on why social movements achieve change – why activists choose certain tactics or goals over others and why institutions maintain or lose control over symbolic and material resources. MIP is particularly useful in this case, because it can be used to analyze struggles that are against non-governmental institutions and because MIP works from the assumption that cultural and political change are linked. An analysis using this model will focus on how the organizational logic of the lesbian and gay movement in the early 70s interacted with the organizational logic of the American Psychiatric Association at that time. However, MIP does not see institutions as

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solitary, vulnerable entities; instead, all institutions interact with each other and maintain specific material and symbolic orders that social movements struggle against. Therefore, one possible problem with this approach is that the same processes that work within governmental institutions will also work within other institutions. If political opportunities and mobilizing structures play the same role in struggles with the APA as with the state, then the different institutional fields are ultimately unimportant for predicting movement outcomes. Alternatively, political process theory may more adequately explain how social movements emerge, maintain themselves, and decline, while a multi-institutional political approach might be more useful when analyzing how social movements interact with a variety of institutions in order to gain symbolic and material concessions. Karen Armstrong uses organizational field theory in her book, Forging Gay Identities, in order to explain how the political logics of the lesbian and gay movement shifted over time (2002). She argues that the interest group logic of the homophile movement was combined with the redistributive and identity politics of the New Left within the gay liberation movement. When the New Left collapsed, the lesbian and gay movement’s organizational field crystallized around the political logic of identity, which encourages each activist to express their gay identity in whatever way they desire. Through this selfexpression, identity politics build a diverse coalition of interests unified

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around one identity but comprised of many different ways of approaching that identity. In this case, the resulting stance supported both cultural and political goals and tactics by allowing the gay rights activists to pursue rights within the political system while gay pride activists sought to build and maintain their collective identity in the face of cultural discrimination. Armstrong’s theory provides a framework for looking at how the internal logics – “the rules of the game” – (2002:9) changed within the gay movement during the same time that activists were targeting the American Psychiatric Association’s stance on homosexuality. According to Armstrong, from 1968 to 1971 there were several different political logics competing within the lesbian and gay movement. This period of instability and the crystallization that followed it may help explain the changes in the tactics used by activists against the APA. The main limitation of Armstrong’s analysis is her overgeneralization of the influence of these political logics. She is unable to account for why some gay activists occasionally rebuked the importance of identity well after the field had crystallized. Fortunately, this case study involves the very historical periods where her analysis is most useful. Mary Bernstein’s work on identity looks at how the factors described by political process theory influence the way that actors tactically use identity depending on their goals (1997, 2003). Bernstein tries to avoid the essentialist categorization of movements as either

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“expressive” (as described by new social movement theory) or “instrumental” (as described by political process theory). In order to do this, she breaks down the tactics and goals of movements. She divides the strategic use of identity into two categories: identity for education and identity for critique (Bernstein 1997:538). The former refers to efforts to place an identity within the mainstream, to accommodate the viewpoints of others, and to educate them about that identity. The latter refers to tactics that place an identity outside of the mainstream, to criticize the dominant norms and point to that identity as the ideal. Generally, identity for education is used when actors have more mobilizing structures and access to the polity, and identity for critique is used when actors have little organizational strength or political opportunity. However, the influence of the political system is mediated by the varying importance actors place on political, cultural, or mobilization goals. Goals, tactics, and political factors do not relate on a one-to-one basis: one set of political factors will not necessarily force activists to adopt one set of goals and tactics, and the goals of activists do not necessarily determine their tactics or vice versa. In the presence of political opportunities, activists may nevertheless seek other goals and refuse to deploy identity tactically. Alternatively, a moral shock that highlights the lack of political opportunities can lead to mobilization and a focus on cultural goals and tactics that are less politically successful (Bernstein 2003).

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Bernstein’s loose framework provides a useful way to look at how political and organizational factors influence the goals and tactics of social movement actors. It bridges the gap between the political logics that Armstrong specifies and the mechanisms in political process theory. The interest group logic of the homophile movement can be roughly thought of as a combination of identity for education and political goals. The political logic of the gay liberation movement is the combination of identity for critique and a variety of cultural, political, and mobilization goals. MIP takes this framework and adds another dimension to it: namely, the idea that in non-governmental struggles there may be other sets of opportunities at work. However, cultural/symbolic institutions and political/material institutions influence each other, and so these distinctions may depend on the perceptions of movement actors themselves. Any use of Bernstein’s framework must keep in mind that she simultaneously differentiates goals and tactics along political and cultural lines while acknowledging that the political order and the cultural order are ultimately inseparable (1997:559). My analysis will investigate the relative usefulness of political process theory and a multi-institutional political approach. In order to do this, I use Bernstein’s concept of identity deployment in order to look at how the activists' tactics adapted based on their relationship to the APA. I will also use Armstrong’s organizational field approach to

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study the importance of the contrasting political logics within the lesbian and gay movement. My case study will assess whether the factors described by political process theory or an analysis of the institutional and organizational logics within the case will be more useful in explaining the outcome. In order for political process theory to still be useful in cases of activism against non-governmental institutions, factors analogous to the ones that are delineated by political process theory (political opportunity, etc.) must be present. If a multi-institutional political approach is more useful, then the factors that differentiate institutions (i.e. institutional logics) will more fully explain the end result. Case Study Background: the lesbian and gay movement, 1950s-1960s The psychiatric establishment had been the focus of members of the lesbian and gay movement since the 1950s, but their relationship shifted as the goals and tactics of the movement changed. In the 50s, the homophile organizations tried to distance themselves from any sort of gay identity by choosing cryptic names like “The Mattachine Society” and “The Daughters of Bilitis,” and they refused to lobby directly. Instead they focused on persuading influential professionals (psychiatrists, lawyers, etc.) to be more accepting in hopes that the professionals would, in turn, spread their message of tolerance towards homosexuals. They did not engage in collective action; instead, they

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held meetings and published periodicals. They used their identity for education, as they encouraged homosexuals to dress and act conservatively and tried to present themselves as typical members of society. Activists downplayed the sexual aspect of their identity with the word “homophile" instead of "homosexual," and some activists even claimed that being homosexual did not necessarily involve having sex with other members of the same sex. Ultimately, the homophile movement in the 1950s refused to take strong stances and merely pleaded for tolerance (D'Emilio 1998). The attitude of homophile activists about the psychiatric establishment at this time was mixed and agnostic. On the one hand, some activists wanted psychiatrists to speak more tolerantly about homosexuals, but on the other hand, many activists actually agreed with the medical model and thought that homosexuality was an illness that needed to be cured, or at least prevented (Minton 2002:246-250). Psychiatrists on both sides gave lectures at meetings of various homophile organizations and published papers in homophile periodicals. The periodicals generally took an impartial stance and believed that the scientific process would play itself out in their favor. Most homophile activists at this time believed that psychiatrists knew more about homosexuality than they did, and they deferred to the knowledge of the experts. Of course, they were always eager to help those who were interested in publishing studies that went against the

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psychiatric orthodoxy at this time. Evelyn Hooker’s groundbreaking research used the Mattachine Society in order to recruit gay participants, and in 1957 the Mattachine Review published her article: the first to study a group of homosexuals who were not in therapy, prison, or institutionalized. She found that there was no difference between homosexuals and heterosexuals on various projective tests that measure pathology, and when she submitted the results to experts in assessing those tests, the experts were no better than chance at determining which of the participants were gay (Minton 2002:247-249). In the first half of the 1960s, the homophile organizations became more militant, as the political opportunity represented by the civil rights movement proved that direct action could be effective. One of the leaders of this transition was Franklin Kameny, who started a chapter of the Mattachine Society in Washington D.C. in 1961. He had lost his government job because he was gay, and he had fought his firing in court for several years with no success (D'Emilio 1998:150151). The Washington Mattachine Society wrote letters to congressmen, had meetings with public officials about the government’s discriminatory policies, and fought legally for homosexual rights. In 1963, the Washington Mattachine Society joined with other homophile groups on the east coast to form ECHO, the militant wing of the homophile movement. In 1965, Kameny and his

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small group of activists even picketed in front of the White House, something that would have been unthinkable ten years before because of the homophile movement's secrecy and its refusal to engage in direct politics (D'Emilio 1998:164-165). The homophile movement not only shifted to NAACP-style tactics, but they also shifted their goals. Talking to many governmental officials made Frank Kameny realize that the labeling of homosexuality as a disorder impaired his group's ability to achieve political victories. In a speech to the New York Mattachine Society in 1964, he said, "The entire homophile movement... is going to stand or fall upon the question of whether homosexuality is a sickness, and upon our taking a firm stand on it" (Minton 2002:245). He saw that classification as “the major supportive factor currently behind the negative attitude of society at large" (Minton 2002:244). The conflict within the movement over the medical model came to a head in 1965, when the New York Mattachine Society’s elections favored the militant activists. Now, the homophile activists saw themselves as the experts on homosexuality, and they believed that the burden of proof was on the psychiatrists to show that homosexuality was actually a disorder. The tide had turned against those who still embraced the medical model, and in 1965 Kameny’s chapter of the Mattachine Society officially declared a resolution against the “sickness model" (Clendinen and Nagourney 1999:202).

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However, direct action was not taken against the psychiatric establishment until the rise of gay liberation. As the homophile movement was overtaken by the politics of the New Left, the activists became more confrontational, and the movement was quickly radicalized. In 1968, NACHO, the North American Conference of Homophile Organizations, adopted the slogan of “Gay is Good" and sought to take pride in their identity. This slogan was intentionally modeled off of the black power slogan "Black is Beautiful" (Minton 2002:253). That year activists at Columbia University picketed a panel discussion on homosexuality, and, as the American Medical Association held a conference in San Francisco, activists held a press conference protesting the stigmatizing views of one psychoanalyst, Charles Socarides. The Gay Liberation Front formed a few weeks after the Stonewall riots on June 27th, 1969, and it had a revolutionary agenda centered on the abolishment of existing social institutions in order to achieve sexual liberation. The Gay Activists Alliance formed in fall 1969 out of the Gay Liberation Front due to disagreements about whether or not the movement should ally with the Black Panthers. The members of the GAA wanted to focus their energies on gay liberation and did not want a revolution by any means necessary, but they still used some of the confrontational tactics of the GLF (Armstrong 2002:87-88). Gay liberationists, particularly the gay pride activists, pioneered the use of "zaps," a confrontational tactic where activists approach

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officials and question them loudly and directly about their stances on homosexuality. This tactic was used heavily in the struggle to remove homosexuality from the DSM, because it was particularly useful when activists wanted to increase their visibility and make themselves heard. According to Elizabeth Armstrong, "The GAA staged highly successful cultural zaps. The GAA, tailored to the 'hip homosexual mainstream,' was 'activist but nonviolent, imaginative, cool, and very successful'" (Armstrong 2002:92). Zaps represented a compromise between the more radical sectors of the gay liberation movement and those who wished to remain nonviolent and focus on gay identity specifically. This tactic was popular because it was immediately gratifying and it yielded results (Armstrong 2002:74). The transitions that occurred from the homophile movement in the 1950s to the gay liberation movement in the late 1960s had a crucial impact on the stance of gay activists against the psychiatric establishment. This transformation led to organizations that were more inclusive and more suited to mobilizing activists. The dominant form of identity deployment shifted from educating the psychiatrists about homosexuality and apologizing for their homosexuality to critiquing psychiatry and presenting homosexuality as "moral, in a positive and real sense, and... right, good, and desirable" (D'Emilio 1998:153). The goal also changed – while some gay power activists wanted revolution and a complete restructuring of society, gay pride activists wanted to

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develop a positive gay identity, and gay rights activists still wanted to achieve political successes in this new phase of the lesbian and gay movement. At least at first, the actions that gay activists took against the American Psychiatric Association fit within each of these political logics. The tactics of the gay liberationists were more direct and confrontational and used public displays of anger and identity. However, there was also an older set of militant homophile activists who saw psychiatry as an important target, and they would prove useful for negotiating with the APA. Background: the American Psychiatric Association, 1950s1960s At the same time, the American Psychiatric Association had been going through its own shifts; it was changing "from a private-practicecentered, psychoanalytically based profession to a research-oriented, university-dominated discipline" (Kutchins and Kirk 1997:64). When insurance companies and Medicaid began to cover psychotherapy in the mid 1960s, they became frustrated with the lack of accountability within the psychiatric establishment. Most psychotherapy at this time was based in the psychoanalytic tradition, and its effects were not backed empirically. The federal government and the insurance companies pushed for the APA to establish more stringent restrictions on diagnostic categories and on empirically valid treatments. In addition, deinstitutionalization – the trend towards releasing psychiatric

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patients from long-term care within mental health hospitals – highlighted the inefficacy and limited usefulness of psychoanalytic therapy. Psychoanalysts were often unwilling or unable to help patients who were severely disordered (Mayes and Horwitz 2003). “Researchoriented psychiatrists insisted that the discipline needed to expand scientific research on mental disorders, increase diagnostic reliability among clinicians, and more clearly demarcate different mental disorders" (Mayes and Horwitz 2003:256), but a psychiatric establishment that was governed by the practical experience of psychoanalysts could not pursue those goals. Finally, psychiatrists were under attack from psychologists, social workers, and other mental health professionals because they charged more for the same therapies that not been proven useful. Insurance companies and the federal government supported the expansion of psychotherapy's domain to include other, non-medical mental health professionals. The medical model of homosexuality was a locus for this conflict. Psychoanalytic thinkers such as Irving Bieber and Charles Socarides were the primary proponents of the medical model at this time. They staked their careers on research that studied the pathology of homosexuals. More generally, the presence of homosexuality in the DSM was one sign of psychoanalysis’ influence within the APA, and psychoanalysts were the strongest defenders of its status as a disorder. At the same time, the liberal climate of the 60s had placed

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liberal psychiatrists in many of the positions of power within the APA. Judd Marmor, a psychoanalyst who went against the medical model, saw that psychoanalysis was not very effective in treating his homosexual patients, and he began to encourage them to accept their homosexuality (Kutchins and Kirk 1997:63-64). He would later lead the charge within the APA against homosexuality's classification as a disorder. Although previous studies – such as Hooker’s 1957 study and Alfred Kinsey’s earlier research on the prevalence of homosexuality – had undermined the medical model, defenders brushed aside those studies in the face of the large number of studies they had produced that assumed homosexuality was a disorder. Although these shifts had created cracks within the APA, the idea of homosexuality as a disorder was still thoroughly institutionalized. Clinicians saw themselves as acting rationally and morally to help cure their intrinsically sick homosexual patients. This institutionalized view of pathology was self-sustaining because its believers saw themselves as "logical and right" when they treated homosexuals (Berger and Luckmann 1966). Before the gay activists targeted the APA, over 90-95 percent of its members agreed with the medical model (Glass 2002). After all, many of the people who worked as clinicians at this time were psychoanalysts, and the psychologists who used other perspectives were often focused on research and teaching in other areas. The stage was set for activists to claim a dramatic victory, but in many ways

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neither the members of the APA themselves nor the activists realized the full extent of the struggle between the institutional logics of research and treatment, empiricism and psychoanalysis. A divided elite is a classic example of a political opportunity, according to political process theory. But in this case, the division was more than an academic division. Two political elites that have different policy approaches may disagree about how things should be done, but divided elites in countries with relatively open political systems generally still agree on basic institutional logics (i.e. that the government should be elected by people, that each political official has special interests they are accountable to, etc.). In this case, however, the divisions within the APA were not only about academic divisions on the status of homosexuality – they were institutional divisions about the implicit framework organizing and giving meaning to the members of the APA. Though gay activists knew that there was not a total consensus about homosexuality within the APA, they did not realize that the conflicts within the APA went far deeper than some academic disagreement about diagnostic classification. An institution divided by opposing logics, therefore, may not appear to be weak, because the conflict is based on implicit rules that actors outside of the institution are unaware of. But when an event triggers that division and forces a decision in favor of one logic or the other, the opposition of

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institutional logics can further the aims of activists seeking to make change within an organization. “Institutional opportunities” (if they exist) differ from political opportunities in that they do not necessarily signal to potential activists that they will achieve success. The struggle to remove homosexuality from the DSM: 19701973 In May 1970, the American Psychiatric Association held its annual conference in San Francisco, where the Gay Liberation Front swelled with radical activists who were also involved in antiwar demonstrations and the black power movement. They seized the opportunity to make some noise. At a lecture given by one of the most infamous psychoanalysts, Irving Bieber, activists yelled, insulted, and cursed at him, preventing him from giving his lecture. When one researcher attempted to present his paper on using aversive conditioning to treat homosexuality, activists yelled at him and asked him, “Where did you take your residency? Auschwitz?” (Clendinen and Nagourney 1999:201). They forced the meeting to be adjourned, much to the ire of the psychiatrists present. After this disruption, one psychiatrist sympathetic to their cause, Kent Robinson, talked to one of the organizers of the protest, Larry Littlejohn. Littlejohn told him that that they wanted to present a panel at the next APA convention. Kent Robinson told John Ewing, the chair of the Program Committee, that the activists would disrupt the entire convention next time if they did not

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receive a panel. John Ewing agreed to give them a panel in order to prevent further disruptions (Bayer 1981:103-104). This confrontation has two important theoretical implications: the mobilizing structures present in San Francisco were vital for this event to occur, but the effectiveness of this mobilization partially depended on the type of institution that they confronted. In some ways, this was an instance of collective action out of convenience – the GLF might not have chosen to fight the APA if the APA had not landed on the GLF's doorstep. The GLF used its preferred style of tactics: disruptive, theatrical, and angry. The impact of these tactics was greater because the APA did not have the same power to deal with confrontational tactics as a governmental institution would. They were successful because the APA could not react with force. Instead, the APA had to concede to the protestors in hopes that order could be restored. If the GLF stormed the U.S. Congress and tried to out-yell congressmen, the activists would have been forcibly removed. Therefore, the type of institution that is targeted has important consequences for what kinds of tactics will be successful in fighting it. In 1971, the APA held their conference in Washington D.C., home of Frank Kameny and his chapter of the Mattachine Society, which had taken a stance against psychiatry several years before gay liberation had started. As expected, there was a panel called “Lifestyles of NonPatient Homosexuals" with Frank Kameny, Larry Littlejohn (a militant

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homophile activist), Del Martin (one of the founders of the Daughters of Bilitis), Lilli Vincenz, and Jack Baker (Bayer 1981:106). This panel used identity for critique when they rejected psychiatry’s involvement in the lives of homosexuals and, in Littlejohn’s words, stated that "the homosexual lifestyle for those people who live it, is beautiful and I think it should be appreciated" (Bayer 1981:107). The confrontational tactics of the gay liberationists were still in effect, and members of the GLF and the GAA took over the highly symbolic Convocation of Fellows during the convention. Frank Kameny himself seized the microphone in the chaos and declared war on psychiatry, subverting an event that was both well attended by psychiatrists and which had ritualistic importance within the APA (Clendinen and Nagourney 1999:203-204). The conflicting political logics of the gay liberation movement in this case provided the activists with flexibility and a two-pronged strategy. The disruptive, confrontational tactics of the gay liberationist activists satisfied the political logic of identity and the conflicting goals of gay power and gay pride activists. By seizing the microphone at the Convocation of Fellows, they displayed and took pride in their identity in a public way that could not be ignored. For gay power activists, the lure of disrupting a central ritual of the APA’s convention must have been irresistible, because it enabled them to attack the APA at its symbolic core. Gay pride activists were able to build themselves up and come face to face with the psychiatrists that had stigmatized gay identity for decades. At the same time, the panel discussions expressed the more reformist, interest-group logic of the past homophile movement, albeit in a more “out and

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proud” tone. Gay pride and gay rights activists could lobby the psychiatrists in a calmer tone according to their own political logics. Although the mixed political logics of the gay liberation movement explain this strange confluence of tactics, the different institutional logics within the APA point to why those tactics worked. The fact that the activists were not completely locked out of the conference is alone impressive, considering that the activists did not stop engaging in the very tactics that the APA had sought to avoid by giving them a panel. The lack of a coherent negative response to this two-pronged strategy hints at the lack of cohesion between the institutional logics of the APA. It was so conflicted about how to deal with these activists that it could not effectively rebuke them. Alternatively, this combination of tactics may have been effective because it appealed to both sides: the sympathetic psychiatrists were swayed by the views presented on the panels, while they psychiatrists who were not sympathetic still wanted to end the chaos and have the APA’s order restored. Another possibility is that the presence of this panel alone points to the division with the APA. After all, to a psychoanalytic clinician there seems to be very little point in talking to “non-patient homosexuals.” However, an institutional logic of empiricism and science might support the proliferation of opposing points of view and the airing of disagreements. Regardless of the reason, it is clear that the APA was somehow conflicted about how to deal with the activists' strategies. There was another constituency within the APA that activists had not even been aware of: the Gay-PA, an informal, underground group of homosexual psychiatrists (Bayer 1981:110). For these psychiatrists, homosexuality’s status as a mental disorder was deeply troubling,

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because it was a constant threat to the future of their careers. To come out of the closet publicly would be professional suicide for them. However, their place as insiders within the APA meant that they had a particular type of potential leverage that the activist outsiders did not have. In a reversal of the typical resource mobilization paradigm, the insiders had less ability to create change than the outsiders because the insiders were afraid of revealing their identity. This reversal can be explained by MIP because it accounts for the institutional logics that determine how insiders and outsiders actually function within each institution. After the 1971 convention, members of the Gay-PA contacted the gay activists, and the connection between these groups became vital for the 1972 convention. At the 1972 APA convention in Dallas, Kent Robinson had successfully negotiated with the gay activists and, instead of a disruptive confrontation, there was a panel that included two sympathetic psychiatrists, two gay activists, and “Dr. H. Anonymous.” Dr. Anonymous was a gay psychiatrist who came on stage wearing a mask, a robe, and a voice-altering device in order to cover his identity. The man behind the mask, John Fryer, was a part of the Gay-PA, and he had been the only person the activists could find in the Gay-PA who was willing to sit on a panel (Minton 2002:258). Frank Kameny had at first rejected the idea of him coming on stage disguised, because it went against the prevailing political logic of identity. But Fryer was

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constrained by the institution within which he worked, and to come on stage at all was already a serious risk for him. This panel shattered the illusion that opposition to homosexuality’s classification as a mental illness was only coming from external, political sources. Outspoken psychiatrists like Judd Marmor had already been poking holes in the psychiatric consensus about homosexuality for some time, but Dr. Anonymous’ opening words, “I am a homosexual. I am a psychiatrist" (Bayer 1981:109), showed without a doubt that psychiatrists themselves were not “immune” to homosexuality and that homosexuals could lead successful careers just like anyone else. Dr. Anonymous talked about the fear that gay psychiatrists felt, and he said that there were hundreds of gay psychiatrists attending that very conference. The power of Dr. Anonymous’ words comes from the intrinsic institutional logic within the psychiatric establishment at that time that those who treat are fundamentally different from those who are treated. Psychiatrists worked under an assumption that pathological people could not treat pathology, and so if there were many psychiatrists who were homosexual, then homosexuality must not be pathological. More generally, by breaking down the distinction between patient and clinician, Dr. Anonymous used a fundamental institutional logic of psychiatry to force psychiatrists to admit that homosexuality was not a disorder. Furthermore, the presence of well-respected

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psychiatrists on the panel prevented opponents from claiming that the pressure was entirely political and external. The debate could be framed as scientific, even though the main reason for the debate was due to the external pressure from gay activists. There were several other events in 1972 that signaled that the consensus had shifted against the medical model of homosexuality and away from the psychoanalytic institutional logic. In 1970, soon after gay liberationists had disrupted the convention that year, Charles Socarides approached the New York District Branch of the APA and asked them if he could set up a task force on sexual deviation. They agreed, but when the report was submitted to the council in May 1972, they rejected it because they said that it was too psychoanalytic (Bayer 1981:113-114). That year in the International Journal of Psychiatry position papers on both sides were published. These papers show that the debate had shifted from primarily an external struggle against disruptive activists to an internal struggle about what factors should govern the classification of mental disorders (Bayer 1981:112). However, the disruptive tactics had not disappeared entirely. At a meeting of the Association for the Advancement of Behavior Therapy, the New York GAA chapter staged a protest where they demonstrated outside the hotel while other protestors shouted down the speakers inside. The activists were protesting the aversive techniques researchers had been using in their attempt to "cure" gay men of their

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homosexuality. At this meeting, one of the leaders of the protest, Ronald Gold, happened to meet with Robert Spitzer, a member of the APA's Committee on Nomenclature. Spitzer was not sympathetic to their cause (and had been meaning to scold Gold for his group's actions), but after talking to him Spitzer agreed to arrange a meeting between the activists and the Committee on Nomenclature. He also agreed to sponsor a panel at the next convention of the APA to debate whether or not homosexuality should be classified as a mental disorder (Bayer 1981:116). He had been trained as a psychoanalyst but had spent most of his career as a professor at a university dealing with issues of diagnosis. At that meeting on February 9th, 1973, a gay psychologist appointed by the GAA, Charles Silverstein, gave a formal presentation to the Committee on Nomenclature, citing past research, including the older work of Kinsey and Hooker, and newer studies, like one by Marvin Siegelman that replicated Hooker's findings using more objective measures (Minton 2002:235). This was an example of identity being used for education, because instead of declaring war on psychiatry or decrying it from afar, the activists were using scientific studies in order to make their case. They chose a person with psychological training in order to appear more legitimate in the eyes of the committee. According to Ronald Bayer: Nothing impressed the members of the Committee on Nomenclature more than the sober and professional manner in which the homosexual case was

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presented to them. After several years of impassioned denunciations and disruptions, here, at last, was a statement that could be assimilated, analyzed, and discussed in a scientific context. (1981:120)

As the APA internalized the debate, activists knew that they needed to use their identity for education in order to sway that debate. Silverstein's presentation capitalized on the clash between institutional logics within the APA by depicting psychoanalytic theory as "a series of 'adult fairy tales'" and telling the committee that "You must choose between the undocumented theories that have unjustly harmed a great number of people and... controlled scientific studies" (Bayer 1981:119). By couching the debate as science against psychoanalysis, Silverstein made it clear to the committee (or at least to Robert Spitzer) that a victory for the gay activists would be a defeat for psychoanalysis. Silverstein also knew that the labeling of homosexuals as pathology enabled the government's discriminatory practices. He cited: the Defense Department's refusal to grant security clearance to avowed homosexuals because they suffered from a mental illness; a demand on the part of the New York Taxi Commission that a homosexual receive a psychiatric evaluation twice a year in order to assure his "fitness" to drive; the refusal of a university to grant a charter to a Gay Liberation group because the presence of such an organization on campus would not be "beneficial to the normal development of our students"; and the denial of a license to a homosexual to practice law. (Bayer 1981:118-119)

These examples made it clear to the Nomenclature Committee that their actions enabled the state to discriminate against homosexuals in many different ways. They were forced to confront the fact that they were responsible for the harsh treatment of homosexuals. In addition, Silverstein's knowledge of these cases highlights the fact that gay activists knew 28

that the legal and medical stance on homosexuality were inextricably linked. Because these institutions supported each other, the activists needed to find some way to break through this system of oppression. The psychiatric establishment was the most responsive among these interconnected institutions, and the Nomenclature Committee responded very positively to this meeting. When the New York Times reported on this meeting and declared that homosexuality would probably not stay in the DSM for much longer, psychoanalytic societies and outspoken psychoanalysts rallied against any such change. Irving Bieber and Charles Socarides organized an Ad Hoc Committee Against the Deletion of Homosexuality from DSM-II, and they tried unsuccessfully to influence leaders within the APA to "appoint a special committee, 'balanced in its composition,'" (Bayer 1981:121) to review any decision before it became official. Psychoanalytic societies passed resolutions against changing the DSM, realizing that their primacy within the APA was being threatened by this decision. When the psychoanalytic institutional logic was challenged, those who most benefited from it swiftly moved to cry foul. In the midst of this rising conflict, the 1973 Honolulu convention of the APA had no disruptive activists; instead, there was a panel entitled "Should Homosexuality Be in the APA Nomenclature?" with psychiatrists on both sides of the debate, as well as the activist Ronald Gold. Instead of activists or sympathetic psychiatrists trying to raise awareness of the problems with the diagnosis of homosexuality, this

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panel was a debate within the APA about what course of action it should take. Ronald Gold provided the voice of the activists, saying, "I'm fighting the psychiatric profession now, but I know that a false adversary situation has been drawn between psychiatry and gay liberation" (Clendinen and Nagourney 1999:214). He talked about his own mental health struggles and how the "worst thing about a psychiatric diagnosis... is that gay people believe it" (Clendinen and Nagourney 1999:213). Hundreds of psychiatrists attending applauded his speech, and the responses of the approximately one thousand psychiatrists present showed that many psychiatrists no longer supported the medical model. The transition from disruptive confrontations to reasoned debate might have been caused by the institutionalization of outsiders or by as a side effect of the field crystallization described by Elizabeth Armstrong. One explanation for this transition is that as time went on, the activists' dissent became incorporated into acceptable channels that fit in with the institutional logic of science and the scientific process. Alternatively, Armstrong believes around 1972 that the organizational field of gay activism crystallized around a political logic of identity when gay power no longer seemed realistic or relevant (Armstrong 2002:103-106). The movement as a whole became more moderate as a result, and so there was less desire among activists for overt clashes with society's institutions. Ronald Gold still stood up for

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gay identity when he said during the panel, "There are advantages to being gay. I learned that in the gay movement" (Clendinen and Nagourney 1999:214), but he was no longer screaming it from the audience like in 1970 or 1971. Later that night, Ronald Gold took Robert Spitzer to a meeting of the Gay-PA at a gay bar in Honolulu in hopes of showing him all the high-functioning homosexuals who were a part of the APA. When they realized that Spitzer was straight, they were enraged at Gold for outing all of them to a high-ranking psychiatrist. At that moment, an army psychiatrist in full uniform ran into the bar and started crying as he talked about how moved he had been by Gold's speech. Spitzer stayed and talked to the psychiatrists of the Gay-PA about their experiences and about the panel. According to some sources, it was this event that completely converted him and eventually led him to put forth a proposal that would attempt to heal the rift within the institutional logics of the APA (Glass 2002; Clendinen and Nagourney 1999:215). Other sources have focused on the influence that the past studies on homosexuality had on Spitzer’s stance (Minton 2002:260), while still others have said that Spitzer saw the rift coming and put himself into a position where he could work to heal that rift and gain power and influence within the APA (Kutchins and Kirk 1997:72). In keeping with this, Spitzer might have been trying to foster the shift from a clinicianbased, psychoanalytic institutional logic to a university-based,

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empirical institutional logic because he thought he stood to gain from such a shift. Spitzer's solution was a proposal that would remove homosexuality from the DSM and replace it with a new diagnostic category: sexual orientation disturbance. This label would be given to homosexuals who experienced distress with their sexual orientation and who wanted to be heterosexual. The logic of this proposal came from Spitzer's ideas about the definition of a mental disorder. He thought that mental disorders needed to cause subjective distress and impair general social functioning. Homosexuality could not be an illness because there were so many high-functioning homosexuals who did not find their sexual orientation to be distressing. This proposal satisfied the research-oriented institutional logic because it lent itself to a more generalizable view of mental disorders that could be investigated empirically. It also appealed to the psychoanalytic, therapy-centered institutional logic because homosexuality was still a disorder to those who wanted to treat it (Kutchins and Kirk 1997:6770). This proposal was adopted by the board of trustees on December 15th, 1973, along with a proposal that supported the end of "all public and private discrimination against homosexuals in such areas as employment, housing, public accommodation and licensing" (Clendinen and Nagourney 1999:216). Although the Committee on

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Nomenclature never actually formally accepted Spitzer's proposal, by claiming to represent that committee Spitzer was able to convince the Council on Research and Development to accept the proposal. As Spitzer moved the proposal higher and higher within the APA's bureaucracy, each group refused to go against the word of the previous one because each committee did not want to differ from the "expert advice" of the previous one. The institutional logic of the APA helped Spitzer navigate his proposal through the organization even though he did not have his own committee's approval. For his part, Franklin Kameny accepted the compromise because "Any homosexual who would rather be heterosexual would have to be crazy" (Clendinen and Nagourney 1999:215). Although some activists disliked the fact that some form of mental disorder relating to homosexuality was still in the DSM, they realized that the media coverage of the event tended to overlook this fact. For all intents and purposes, the public saw that homosexuality was no longer considered pathological. Eventually, the remaining mention of homosexuality was taken out of the DSM quietly in 1987 (Kutchins and Kirk 1997:88). Conclusion The lesbian and gay activists in this case study succeeded because of the implicit organizational and institutional logics of the gay liberation organizations and the American Psychiatric Association. The challengers used their diverse political logics and tactics to create a

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two-pronged strategy. While the confrontational gay liberationists disrupted conventions and forced the APA to listen, the previous generation of homophile activists spoke on panels and triggered a debate within the APA. By coupling identity for critique and identity for education, activists were able to swiftly bring down one of the most important pillars holding up the system of discrimination against homosexuality. Some activists appealed to psychiatrists using the new interest-group logic of equal rights, while other activists focused on the political logic of identity by being loud and proud, standing up for their identity and denouncing anyone who looked down on that expression. The success of gay activism was much more than pure numbers; in fact, many of the most successful actions were carried out by only handfuls of activists. The activists' success was determined less by their level of mobilization than by the tactical decisions of those who had been mobilized. On the other hand, the American Psychiatric Association had some traditional political opportunities: sympathetic members and a division within the elite. But those divisions were determined by conflicting institutional logics that were competing to determine whether the APA would remain a clinician-centered, theory-based organization or shift into a university-centered, research-based organization. These contradictory institutional logics were not obvious to the challengers, but they were crucial to the compromise that was

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reached and to the motivations of people like Robert Spitzer. The academic debate within the research literature was just a sign of the deeper conflict within the APA. Furthermore, the lesbian and gay activists' radical, confrontational tactics would not have been as effective if they had been directed against a different kind of institution that could respond to the disruptions with force. The institutional logics of the APA also explain why the insiders within the APA, the members of the Gay-PA, only contributed minimally to the struggle. The struggle over homosexuality in the DSM may have been the beginning of the end for the psychoanalytic, private-practice based institutional logic. Influenced by some of the same people who were involved in this debate, including Robert Spitzer, the DSM-III came out in 1980 and ended psychoanalysis’ reign over the APA. DSM-III defined disorders in a way that was designed to avoid any theoretical bias, instead focusing on lists of diagnostic symptoms. The APA now used empirical data in order to ensure the reliability of all the diagnostic categories, eliminating the vague definitions based on psychoanalytic theory in previous versions. Finally, the DSM-III became a tool that insurance companies could use to determine how treatment would be covered. The APA ceded its focus on psychotherapy as its main sphere of influence and instead focused on its role in diagnosing and prescribing medication (Mayes and Horwitz 2003). Without a doubt, the political opportunities presented by the

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tumultuous period of the late 60s and early 70s contributed to the success of gay liberationists in a general way. They had cognitive liberation in spades, and the organizational shift away from accomodationist politics provided mobilizing structures that could actually rally people together and provide a more coherent face to gay activism. But ultimately these are broad strokes that may have limited usefulness when analyzing the specific successes and failures of social movements, because they neglect the relationships between specific institutions and specific social movement organizations. In addition to expanding the range of conflict that can be studied, a multiinstitutional political approach provides a more fine-grained account of what motivates activists to seek some goals over others or use some tactics over others. In turn, this approach can study the way those goals and tactics influence and are influenced by the targeted institution. References Armstrong, Elizabeth A. 2002. Forging Gay Identities: Organizing Sexuality in San Francisco, 1950-1994. Chicago: University of Chicago Press. Armstrong, Elizabeth A. and Bernstein, Mary. 2008. "Culture, Power, and Institutions: A Multi-Institutional Politics Approach to Social Movements." Sociological Theory 26: 74-99. Bayer, Ronald. 1981. Homosexuality and American Psychiatry: The Politics of Diagnosis. New York: Basic Books. Berger, Peter L. and Luckmann, Thomas. 1966. The Social Construction of Reality: A Treatise in the Sociology of Knowledge. New York: Doubleday. Bernstein, Mary. 1997. "Celebration and Suppression: The Strategic Uses of Identity by the Lesbian and Gay Movement." The American Journal of Sociology 103: 531565. Bernstein, Mary. 2003. "Nothing Ventured, Nothing Gained? Conceptualizing Social Movement "Success" in the Lesbian and Gay Movement." Sociological

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Perspectives, 46: 353-379. Clendinen, Dudley and Nagourney, Adam. 1999. Out for Good: The Struggle to Build a Gay Rights Movement in America. New York: Simon & Schuster. D'Emilio, John. 1998. Sexual Politics, Sexual Communities: The Making of a Homosexual Minority in the United States, 1940-1970. Chicago: University of Chicago Press. Friedland, Roger and Alford, Robert R. 1991. "Bringing Society Back In: Symbols, Practices, and Institutional Contradictions." Pp. 232-263 in The New Institutionalism in Organizational Analysis, edited by W.W. Powell and P.J. DiMaggio. Chicago: University of Chicago Press. Friedman, Debra and McAdam, Doug. 1992. "Collective Identity and Activism: Networks, Choices, and the Life of a Social Movement" in Frontiers in Social Movement Theory, edited by A.D. Morris and C.M. Mueller. New Haven: Yale University Press. Glass, Ira. 2002. "81 Words." This American Life, radio program. Originally aired 1/18. http://www.thisamericanlife.org/Radio_Episode.aspx?episode=204. Kutchins, Herb and Kirk, Stuart A. 1997. Making Us Crazy: DSM: The Psychiatric Bible and the Creation of Mental Disorders. New York: Free Press. Mayes, Rick and Horwitz, Allan V. 2003. "DSM-III and the Revolution in the Classification of Mental Illness." Journal of the History of the Behavioral Sciences 41: 249-267. McAdam, Doug. 1999. Political Process and the Development of Black Insurgency, 1930-1970. Chicago: University of Chicago Press. Minton, Henry L. 2002. Departing from Deviance: A History of Homosexual Rights and Emancipatory Science in America. Chicago: University of Chicago Press. Morris, Aldon. 1986. The Origins of the Civil Rights Movement: Black Communities Organizing for Change. New York: Free Press. Tarrow, Sidney G. 1998. Power in Movement: Social Movements and Contentious Politics. New York: Cambridge University Press.

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