Is being gay a mental illness?

Medicine calls something a disorder when it impairs a person’s functioning, or causes distress that can’t be explained by outside pressure. Sexual orientation fails both tests. What actually hurts many LGBTQ+ people is stigma, rejection and pressure — not the orientation itself. Once you see that, the question mostly answers itself — and the answer isn’t a recent or “Western” opinion, but a conclusion the world’s psychiatric mainstream reached decades ago.

A timeline, not a single event

Depathologization wasn’t a single event; it’s a clear timeline:

• 1973: after a systematic review of the evidence, the American Psychiatric Association removed homosexuality from the DSM.
• 1990: the World Health Organization removed it from the International Classification of Diseases — the date now commemorated every May 17 as the International Day Against Homophobia.
• 2019: the World Health Assembly adopted ICD-11 (in effect since 2022), which not only upheld that conclusion but also moved trans-related categories out of the mental disorders chapter entirely.

Open any mainstream diagnostic manual today and you will not find “homosexuality” listed as a condition.

A detail readers outside China often miss

A common claim in Chinese families is that depathologization is “a foreign idea.” It isn’t. In 2001, the Chinese Society of Psychiatry published the third edition of China’s own diagnostic standard, CCMD-3, which stopped classifying homosexuality as a disorder. China’s official psychiatric standard settled this question more than two decades ago.

It’s true that a few outdated textbooks still contain pathologizing language — students have even gone to court over it. But that tells you which side is out of date: the printed pages, not the people.

If this question is causing you pain

• The pain is real — but it’s worth asking where it comes from. Is the orientation itself hurting you, or is it how people around you react to it? Medicine has nothing to cure in the first case; the second is a pressure worth naming and addressing. We unpack this idea of minority stress in our mental health explainer.
• If someone is urging “treatment” to change your orientation, read our piece on conversion practices first — that is not medicine, it is harm.
• And if things feel heavy right now, here are places you can reach out to today. You don’t need to be cured. You do deserve support.