Earning equal treatment is pretty difficult for a group of people when their core identity is literally identified as a mental illness, which was exactly the situation for gay Americans in 1973. It was on this date 41 years ago that the American Psychiatric Association made a giant stride toward removing that stigma with a unanimous vote by its board of directors to de-list homosexuality as a mental illness on December 15, 1973. The vote resulted in homosexuality being removed as a diagnostic category from the second edition of the Diagnostic and Statistical Manual of Mental Disorders (or DSM-II).

The science behind viewing all gay people as mentally ill had always been weak. The classification was based more on societal norms after the Victorian era. If something was defined as a sin and a crime, then someone would obviously have to be mentally ill to do it! Long before the APA’s historic vote, there were cracks in this consensus among mental health practitioners. Freud said in 1935 that “Homosexuality is assuredly no advantage, but it is nothing to be ashamed of, no vice, no degradation, [and] it cannot be classified as an illness.”

Work by Alfred Kinsey and Evelyn Hooker also poked holes in the traditional line of thought what would prove fatal through their work in the 1940s and 1950s. Kinsey found that same-sex attraction was much more common than had been previously assumed, while Hooker administered a series of psychological exams to groups of straight and gay men, with the result showing no difference between their psychological profiles.

And then there was the anonymous doctor who appeared before the APA board in a heavy disguise to give his testimony about his life as a gay psychiatrist in 1972. John Fryer came out later, but he took advantage of his relationship with a drama student at the time to appear before the APA in a mask and oversized outfit. “I had been thrown out of a residency because I was gay; I had lost a job because I was gay,” he later recalled. The anonymous Fryer made a simple argument: As a gay man in a field where his colleagues would have regarded his true identity as a sickness, he was forced to be even more mentally healthy than most psychiatrists. He also provided written statements from other gay psychiatrists.

There was no saving the DSM category of homosexuality by then, and it was struck down by a 13-0 vote on this date in 1973. Due to the political climate at the time, many psychiatrists still wanted the option to diagnose their gay patients with something. As a compromise, “sexual orientation disorder” was inserted into the DSM, followed by “ego-dystonic homosexuality,” which noted that many gay people were distressed about their orientation and wished to change it. Those categories have since been removed, and the only artifact of the old diagnosis in the DSM is a diagnosis of “sexual disorder not otherwise specified,” which notes that some people can experience mental anguish about their sexual orientation.

Gay-rights activist Barbara Gittings (seen on the left staffing a booth at the APA convention in 1972) explained how consequential the APA vote was this way: “The sickness label was an albatross around the neck of our early gay rights groups — it infected all our work on other issues. Anything we said on our behalf could be dismissed as ‘That’s just your sickness talking.’”

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