the ICD-10 in 1990, and was removed from the ICD-11 in 2019. Origins: DSM-III The decision to include ego-dystonic homosexuality in the DSM-III came after years of debate and controversy between two competing schools of thought within the psychiatry field: the view that homosexuality was a pathological condition and the view that homosexuality was a normal variation of sexuality. Scientific evidence increasingly challenged the assumption that homosexuality was a disorder, yet many within the psychiatry field adamantly believed it was. In 1973, after extensive organizing by gay rights activists, a compromise had been reached of removing homosexuality from the DSM and replacing it with "sexual orientation disturbance," a diagnostic category that could be applied to people with same-sex attractions "who are either disturbed by, in conflict with, or wish to change their sexual orientation. The American Psychiatric Association's (APA) board of trustees voted unanimously in December 1973 in favor of this compromise, and in 1974 the seventh printing of the DSM-II in 1974 included "sexual orientation disturbance" in place of "homosexuality" and a note that homosexuality "by itself does not constitute a psychiatric disorder." That same year, a task force was appointed to develop the DSM-III, led by Robert Spitzer, the psychiatrist who had originally drafted the proposal to replace homosexuality with sexual orientation disturbance. Spitzer felt that it was important to take "a middle position regarding the pathological status of homosexuality"; nine members of the task force agreed with him and five disagreed, leading to a deadlock. Classifications of "homodysphilia," "dyshomophilia," and "homosexual conflict disorder" were discussed, until finally, the invented term "ego-dystonic homosexuality" was proposed, along with a barely perceptible conceptual shift: instead of distress about being homosexual, the new classification was about a desire to be heterosexual and distress at one's inability to achieve that desire. A proposal to include additional information such as a note about how internalized homophobia can be a contributing factor eventually swayed enough critics; others, including Richard Green and Richard Pillard, remained opposed to including homosexuality in the DSM in any form, but they were eventually overruled. The diagnostic criteria listed in the DSM-III for ego-dystonic homosexuality were: Removal from the DSM Leading up to the publication of the DSM-III-R, it had become clear to more and more people that the inclusion of "sexual orientation disturbance" and later "ego-dystonic homosexuality" in the DSM was the result of political compromises rather than scientific