Psychiatr News September 16, 2005
Volume 40, Number 18, page 3
© 2005 American Psychiatric Association
Psychiatry and Legal Recognition Of Same-Sex Civil Marriage
Steven S. Sharfstein, M.D.
I have been asked by a
number of concerned APA members why psychiatry should enter into the current
debate on the legalization of same-sex marriage. A few have resigned, on the
grounds that as a scientific and medical professional society, APA should not
be commenting on this issue. To quote one disgruntled member, "I feel
that APA has truly lost sight of its mission as a MEDICAL organization, led by
PHYSICIANS, whose principles should be guided only by SCIENCE and what is in
the best interest of those with mental illness."
The topic of same-sex marriage hits a sensitive nerve for many in our
society. The easy response to such sensitivity is to withdraw. But what the
Assembly concluded, and the Board of Trustees agreed, is that the psychiatric
profession should not stand back simply because an area is controversial.
Rather, we serve society by providing our expert understanding of the science
involved and also our judgment on its implications for civil rights.
Homosexuality was part of our diagnostic nomenclature until 1973, when the
Board of Trustees removed it from the DSM. This change was supported
by the membership when a referendum to overturn the Board's decision was
defeated in 1974. Since then, research on the nature of homosexuality has
uncovered its strong links to genetics and biology. As the science has
advanced, so have APA's actions. In 2000 APA endorsed the concept of same-sex
civil unions. This year, by action of the Assembly in May and the Board in
July, we endorsed legal recognition of same-sex civil marriage
(Psychiatric News, June 17, August 19).
APA's action to support legal recognition of same-sex civil marriage is
based fundamentally on the research evidence. Many studies have now
established that marriage is associated with clear benefits, including better
mental and physical health. It is a stabilizing force in our society that
enables individuals to make public their commitment to each other and receive
acceptance and support from others. Further, research indicates that same-sex
partners have the same capacity to form long-term relationships as do
heterosexual individuals. To deny this recognition increases the stigma and
related distress often experienced by gay and lesbian individuals in other
facets of community life.
Against such compelling evidence, opponents of gay marriage cite religious
faith and an ideological belief that the institution of marriage is threatened
when same-sex partners can participate. In our civil society, which respects
freedom of speech, all views should be heard; however, one strain of religious
thought (among many) is an inappropriate basis for the official position of
APA. APA's position deals with same-sex civil marriage only. And APA
has concluded that fears about the future of society have no basis in
evidence.
Clarifying the science is just one task of APA. Another is to be true to
its implications. The biological basis of sexuality has important implications
for civil rights. Gays, lesbians, bisexuals, and transgendered individuals are
citizens who deserve the rights and benefits of full participation in
society.
Their children deserve fair treatment as well. Measures to improve the
mental health of parents have a definite, positive impact on the children in
the family. It stands to reason that these children would feel more accepted
in the community knowing that their parents are legally married. Marriage also
offers more legal options in the case of divorce, such as joint custody and
visitation. APA's endorsement of same-sex marriage is a recognition that
science can forge a path toward a more decent society.
Although APA is the first medical society to endorse the legalization of
same-sex civil marriage, we have been preceded by the American Psychoanalytic
Association, American Psychological Association, and National Association of
Social Workers.
Gaining legal status for same-sex civil marriage is an uphill battle. At
the state level, debate over whether same-sex marriage should be legalized has
created great heat, loss of civility, and controversy. Thirty-seven states
have enacted so-called Defense of Marriage Acts, which ban same-sex marriage,
and other states have similar legislation pending. Only one state,
Massachusetts, explicitly allows same-sex marriage and only for residents of
that state.
The international scene is more promising. Recently Canada and Spain
legalized same-sex civil marriage, and Belgium and the Netherlands have
similar provisions.
Marriage by gay and lesbian partners arouses irrational prejudice and fear,
but as psychiatrists, we must take a stand on issues that have a clear impact
on the mental health of our patients and of persons in the community at large.
As an organization, we seek also to promote human rights and freedom from
discrimination. Psychiatry leads the way for the rest of medicine on this
important issue.
The APA position statement "Support of Legal Recognition of
Same-Sex Civil Marriage" is posted on APA's Web site at
<www.psych.org/edu/other_res/lib_archives/archives/200502.pdf>.
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