Social Activist, Former APA President Alfred Freedman Dead at 94

Psychiatrist Instrumental in Removing Homosexuality as a Mental Disorder

Fran Lowry

April 25, 2011

April 25, 2011 — Alfred M. Freedman, MD, who served as the 102nd president of the American Psychiatric Association (APA) from 1973 to 1974 and was instrumental in removing homosexuality from the official Diagnostic and Statistical Manual of Mental Disorders (Second Edition) as a designated psychiatric disorder, has died in Manhattan at the age of 94 years.

In a statement released by the APA, James H. Scully Jr., medical director and chief executive officer of the APA, said Dr. Freedman "helped lead important changes for psychiatry and the APA as well as our entire society as he helped to end discrimination against gays and lesbians nearly 40 years ago."

Dr. Freedman, who was active on the APA board as a past-president well into his 90s, became president as a petition candidate by the slimmest of margins.

Dr. Alfred Freedman. Courtesy New York Medical College

In an interview with Michael Blumenfield, MD, The Sidney E. Frank Distinguished Professor of Psychiatry at New York Medical College, Valhalla, that appeared in the Journal of Gay & Lesbian Mental Health in 2009, Dr. Freedman described the unusual circumstances that led to his election.

"The Committee of Concerned Psychiatrists approached me to be the petition candidate for the election. I declined at first, but finally, in December, feeling sure that I would be defeated, I accepted the nomination and was elected with a margin of 3 votes out of 20,000!"

Tumultuous Times

The years preceding his election were a time of social turmoil and desire for change. Two of the major issues of the day were the Vietnam War and the debate over removing homosexuality as a disease. The APA members were deeply divided about both issues.

"From the end of World War II until into the 1970s, the APA had been run by a clique; the nominating committee would present a slate with single candidates for each office who would automatically be elected. It was known as an old boy’s club and there was great resentment. That group resisted any change or reform in regards to the Vietnam War, or to sexuality, or to a number of other issues of the day," Dr. Freedman recalled in the interview.

As soon as he took office, Dr. Freedman supported a resolution, which was drafted by psychiatrist Robert L. Spitzer, of Columbia University, to remove homosexuality from the list of mental disorders. The resolution was passed on December 15, 1973, by a vote of 13 to 0, with 2 abstentions.

By then, the APA board had many newly elected members who were committed to reform and supportive of Dr. Spitzer’s resolution. "So the 1973 election was very important because the board of the previous year would never have supported the declassification of homosexuality," Dr. Freedman noted.

Jack Drescher, MD, distinguished fellow of the APA, president of the Group for the Advancement of Psychiatry, and a psychiatrist and psychoanalyst in Manhattan, told Medscape Medical News that this reform represented a major cultural shift.

"It took the social debate on sexuality and its meanings out of the realm of medicine and psychiatry and forced the discussion eventually, not right away, about how modern society should act [toward] and treat gay people," Dr. Drescher said.

Today, the results of that 1973 decision are evident around the world, as all religious denominations debate how to respond to the needs of gay people and whether they should have equal rights.

"That is the major long-term consequence of that decision in 1973. Dr. Freedman clearly had a role to play in that decision, but there were others involved as well," Dr. Drescher said.

Advocate for Political Prisoners

Removing homosexuality from the list of mental disorders was one of the highlights of his career, but there were others.

While he was APA president, Dr. Freedman led a delegation to the Soviet Union at a regional meeting of the World Psychiatric Association to raise the question of psychiatric abuse and to interview political dissidents who had been inappropriately hospitalized for political reasons.

Dr. Freedman continued to take an interest in social issues, speaking out against the interrogation of prisoners and the role of psychiatrists in executions. He also took a stand against psychiatrists participating in the interrogation of detainees at Guantanomo and Abu Ghraib.

Alfred Mordecai Freedman was born on January 7, 1917, in Albany, New York. His parents were immigrants from Poland who worked long hours in a small family store to send all their children to college and 2 of them to medical school.

Dr. Freedman won scholarships to Cornell University, where he earned a bachelor’s degree. After being rejected from numerous medical schools, he was finally accepted at the University of Minnesota, where he got his MD degree in 1941.

He began in internship at Harlem Hospital, where he became aware of the problems and challenges of providing medical care to neglected populations, but cut his stint as an intern short after Pearl Harbor, when he enlisted in the US Army.

He was discharged from the US Army in 1946 and began training in pathology at Mt Sinai Hospital in New York City. He did his psychiatry residency at Bellevue Hospital in July 1948, where he became a senior child psychiatrist. Later, he became the first full-time chairman of the Department of Psychiatry at New York Medical College in Valhalla and was director of psychiatry at Metropolitan Hospital, also in Valhalla.

He also coedited the Comprehensive Textbook of Psychiatry with Harold I. Kaplan, MD, which is now in its ninth edition.

Loved by Students

Dr. Freedman is survived by his wife, Marcia, his 2 sons, Dan and Paul, and 2 grandchildren.

In his April 24, 2011, blog, Psychiatry Talk, Dr. Blumenfield called Dr. Freedman, “A gentle giant in American psychiatry.

"The residents always loved him, and he was a role model for every young psychiatrist who trained at any of the hospitals which were part of the New York Medical College consortium," Dr. Blumenfield said.

In addition to his family, Dr. Freedman leaves behind "innumerable colleagues whose careers were greatly influenced by him as well as a mental health community with untold numbers of patients, most of whom will never know how his career has led to improvements in their care," Dr. Blumenfield writes.

An Interview with Alfred M. Freedman, MD. Journal of Gay & Lesbian Mental Health. 2009;13:62-68.

Psychiatry Talk by Michael Blumenfield, MD. A blog for everyone interested in mental health issues.

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