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There was a time, not so long ago, when the terms 'homosexuality', 'lesbianism', 'bisexuality', 'transsexuality', and 'intersexuality' were not part of our language at all. Therefore, they were not identities as they are now. When did this change occur? Why do we talk about homosexuals, for example? The journey from 'sodomy' to 'homosexuality' as an identity has been long, arduous, and deliberate.

Sexuality is under social scrutiny in biopolitical regimes, where life is controlled by knowledge and intervened upon by power. It functions as a control mechanism, a means of managing life. The idea of ​​'degeneration' emerged in the 19th century, within these types of societies. Certain authorized professions, including psychiatry, categorized and codified sexualities they considered deviant . They also maintained that degenerates could only produce more degenerates. Thus, the monogamous nuclear family, and especially the mother, was expected to guarantee normative sexuality and prevent deviations, which were ultimately seen as a disease for society as a whole.

In this context, the discipline of psychiatry begins to produce pathological sexualities and gender identities. Thus, it contributes to constructing the sex-gender-sexuality system itself by generating what would be its exterior: the incoherent. This means that dissent from the sex-gender-sexuality system is configured as mental illness by psychiatric knowledge-power. That is to say, sexual dissidence (whether orientation, identity, or deviant subjectivity) is constructed within psychiatry. This does not mean that the practices we now codify as dissident did not exist before. Previously, they were just that: practices, not identities that permeated the entire subjectivity and lives of the degenerates.

Fix subjects

The word homosexuality originated as a psychiatric category. Previously, what we understand today as homosexual was not a homosexual in terms of identity, but rather a person who practiced sodomy. In the 19th century, when the physician Ambroise Tardieu conceptualized this pathology, he codified it as pederasty, in addition to sodomy. This was subsequently adopted by medicine, the justice system, and other institutional bodies. Social dangerousness and homosexuality went hand in hand. For this reason, and because of the social degeneration they represent, the direct use of technologies of power was deemed necessary to control and eliminate this evil. In her book *How to Bring Your Kids Up Gay* , Eve Kosofsky Sedgwick , a pioneering author and key figure in queer theory, argues that psychiatry seeks ways to contain dissenting subjects within its sphere of influence, while somehow washing its hands of the matter.

Homosexuals, but very masculine

Labels like 'homosexual' are removed from lists of pathologies, but a way is sought to seize upon 'homosexuality' and intervene in it nonetheless. Homosexuality will not be a pathology as long as the gay man in question is masculine and fulfills the imperatives of masculine norms. Except, of course, for heterosexuality. This is what she refers to as homonormativity. She says that, in this way, by renouncing the pathologization of homosexual lives that comply with the rest of the social imperatives, the sex-gender system is consolidated. That is, gender is naturalized, and non-compliance with the norms of that system is understood as pathological. The explicit pathologization of dissident sexual orientation is abandoned in exchange for pathologizing dissident gender identity.

New pathology: trans identity

The third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM), published in 1973, removed homosexuality (now defined as sexual and/or emotional attraction between men) from its list of mental illnesses. However, it introduced "gender identity disorder in childhood." Thus, non-normative sexual orientation was depathologized while simultaneously linking this form of desire to gender non-normativity. It was in this same edition of the DSM that transsexuality was added to the list of pathologies.

Anatomy as normality

Trans issues remain largely within the purview of psychiatry, even though the latest edition of the DSM, the fifth, no longer includes "transsexuality" as a disorder. Instead, it pathologizes the suffering experienced by some trans people as a result of the violence inherent in the sex/gender norm, through the concept of "gender dysphoria." This implies that dysphoria can be pathologized and medicalized, rather than addressed from a socio-psychological perspective.

Although I have only discussed the terms 'homosexual' and 'transsexual,' the other subjectivities that today comprise the LGBTI+ acronym and/or queer were also originally addressed by psychiatry and, failing that, by other areas of medicine. Interestingly, the concept of 'bisexual' is incorporated into this bioanatomical framework to refer to intersex realities. And, while this could be explored much further, we know that it then legitimizes intervention on bodies and lives that simply do not fit into its sex-gender-sexuality system, into its normative corporealities.

The dissidents

Psychiatry has medicalized, and continues to medicalize, women who do not conform to the imperatives of femininity, undisciplined and idle workers, migrants, and any dissident life in the various senses that the word can take. I have decided to speak of dissident subjectivities within the sex-gender-sexuality system because these, specifically, are initially produced within psychiatry itself as identity situations. 

That is why queer , in my view, can be fertile ground for responding to the original pathologization of the LGBTI+ community, provided it has a sound, mad approach and is careful not to fall into sanity . Queerness , in its abject dimension, needs not only anti-psychiatric politics, but also a mad perspective. Today, the LGBTI+ community continues to be tied to psychiatry through more subtle mechanisms that pathologize and transform into biological fictions the various types of suffering that result from the violence of the norm.

If psychiatric knowledge-power uses LGBTI+ to safeguard normative genders and to uphold the biological paradigm of mental illness, queerness has the mission of politicizing its abjection and reclaiming itself as mad, resisting the bioscientific paradigm of psychiatry and generating community alternatives to the medicalization of difference.