Sexual orientation disturbance (homosexuality; SOD) is the little-known and short-lived diagnostic classification that replaced homosexuality when it was removed from the Diagnostic and Statistical Manual of Mental Disorders second edition: (DSM-II; 7th printing). The famous 1973 vote by the American Psychiatric Association (APA), depicted as a monumental shift in psychiatric thinking, was in actuality a vote to replace the homosexuality diagnosis with SOD. The popular perception is that the vote affirmed the legitimacy of homosexuality as a sexual orientation, rejecting previous conceptualizations of homosexuality as a manifestation of mental illness or evidence of incomplete psychosexual development. The cultural implications of the vote were enormous.

However, the SOD diagnosis, while a step toward depathologization, fell far short of recognizing homosexuality as a valid sexual orientation. Indeed, widespread ...