Electric shock treatment, hypnosis, nausea-inducing medication and psychoanalysis were among the “treatments” medicine offered for homosexuality as recently as 30 years ago.
Attempts to cure homosexuality are no longer part of mainstream medical practice, which is perhaps why the case of a Sydney doctor created international headlines last week.
Dr Mark Craddock was reprimanded and banned from practising as a GP as a result of his treatment of an 18-year-old patient who consulted the doctor about his homosexuality.
Craddock, who graduated from the University of Sydney in 1960, had prescribed the anti-androgen medication, cyproterone acetate (Cyprostat), which is used to treat prostate cancer and to reduce sex drive in cases of sexual deviation, such as paedophilia.
Both patient and doctor were at the time members of the Exclusive Brethren religious organisation. As the patient later wrote in his letter of complaint: “I came out as gay … at 18 years of age, and was informed by a [church] leader that ‘there’s medication you can go on for these things’. He recommended that I speak to Dr Craddock on the matter with a view to my being placed on medication to ‘help’ me with my ‘problem’.”
The Professional Standards Committee inquiry said it was not alleged that the doctor’s religious beliefs had influenced his prescribing in this case but found the prescription of cyproterone acetate was not clinically indicated in a healthy young man and that the doctor had failed to take a history, physically examine the patient, or refer him for counselling.
Dr Craddock, who will be able to continue his practice as a radiologist but not as a GP, acknowledged his conduct constituted unsatisfactory professional conduct and said he had since undertaken further training, including a module in sexual health.
Although in some ways it seems like a strange throw back to another era, the case was a reminder of just how recent the shift in medical attitudes to different sexual orientations really is.
Homosexuality was only removed as a mental disorder from the psychiatrist’s bible, the Diagnostic and statistical manual of mental disorders (DSM), in 1973.
A generation earlier, its status as a “personality disorder” was barely contested.
A 1937 paper in the American Journal of Psychiatry presented a series of case studies of “overt homosexuality” that would almost be amusing if you weren’t aware of the myriad lives damaged or destroyed by the assumption of mental pathology.
New York psychiatrist Dr George Henry hoped his paper would add to knowledge of the causes of homosexuality, as well as providing guidance on treatment and prevention.
One of his case studies was of “a witty, humorous 28-year-old son of a prominent family” who was received in the best homes “in spite of the fact that he has an international reputation as a homosexual”.
“At any time after dinner he is likely to become a social liability because of excessive drinking”, Dr Henry noted.
In this and other cases, parents were generally held responsible for their children’s homosexual development: this young man’s father, for example, was “gentle, dreamy, idealistic, effeminate”, while his mother had a “terrific temper” and was “the most selfish person in the world”.
A large proportion of cases of homosexuality could have been prevented by eugenics as well as “the mental hygiene of the predisposed individual and his family”, Dr Henry wrote.
Because boys appeared somewhat more vulnerable than girls, parents needed to be vigilant about “undue feminine tendencies” and ensure boys were not applauded for dressing in female clothes.
Fathers should be understanding and tolerant, but virile and decisive. Mothers should be gentle, patient and passive.
As clinical recommendations, these may seem laughable to us today, but such views were orthodox medicine in their day.
It’s interesting to wonder which of the assumptions that underlie today’s clinical practice may end up looking equally bizarre to the health practitioners of the future.
Jane McCredie is a Sydney-based science and medicine writer.
Posted 10 September 2012