Dr. Richard Isay is a modern hero who opened up the world of psychoanalysis to the LGBTQ+ community. He suffered through what we would call conversion therapy today, but after realizing it didn’t help, Isay fought for psychoanalysis to better serve the queer community. 

Not only did he open the profession to gay people, but he also convinced psychoanalysts to stop treating queerness as a problem rather than an innate part of being human. And above all, he convinced the most homophobic psychological professional society to not just change its ways but become the first mental health organization to support gay marriage. 

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Isay was born in 1938 and attended college in the late 1950s. In his book Becoming Gay, Isay describes an infatuation with a fellow student, “Bob,” but felt it was just “a passing phase that would soon be replaced by an equally passionate interest in girls.” He dated women “infrequently” due to a lack of attraction and threw himself into his studies, partially as a cover for not dating. 

“Although Bob and I engaged in casual sexual play, I did not label myself ‘homosexual.’ I did view my attraction to him as a serious neurotic problem since I was uncertain that I fell into the category of those ‘normal’ adolescents who simply had occasional thoughts about other boys,” he wrote.

Isay was very interested in the mind. He knew he wanted to be an analyst since his sophomore year of college, according to the 1994 book Gay Soul: Finding the Heart of Gay Spirit and Nature by Mark Thompson. The interest wasn’t despite his concerns about his “neurosis,” but rather because of it, fearing he had “something terribly wrong.” 

It’s important to note that psychoanalysis is different than other forms of psychotherapy. The kind of therapy most people today are familiar with is based on helping the client get out of harmful thought patterns—it’s the realm of CBT and worksheets. Psychoanalysis is the realm of Freud and focuses more on reconciling conflicting desires to change. Psychology Today uses a helpful swimming metaphor to explain the difference: 

“If you have fallen into a pool or were hit hard by an ocean wave, then you will have to overcome your fear of drowning and learn how to swim. Psychotherapists can help with both. Once you see this fear for what it is (a fear, not a fact) and learn to swim, then you will be more capable of managing your life when you find yourself in water again… [but] some people need an approach that helps them face and work with the fact that, at least in part, they don’t want to learn to swim. They may be frightened of moving forward or do not want to do the hard work it would take. Some might even fight to stay where they are because it suits them in some unconscious way to be drowning.”

As part of his training, Isay started seeing an analyst himself. For the next 10 years, he was subjected to a psychoanalytic version of conversion therapy. He said his analyst had figured out the root cause of his homosexuality, and how to “cure” it: “By becoming aware of the childhood fear of my father’s rage over my closeness to my mother, I would become less frightened of the mortal consequences of my heterosexual desire.”

He even married a woman, Jane, who was a book editor with an interest in psychology; the couple had two children. In 1979, he met his future husband, artist Gordon Harrell, and a year later, he came out to Jane.

“He sat down on the bed and said, ‘I have something I need to tell you.’ He took a deep breath. ‘I’m homosexual.’ At that moment, I saw my future collapse before my eyes. I got the chills and ran to take a hot bath. It gave me time to think and warmed me, but not for long. We spent the night talking and lamenting. On the plane home, we held each other and sobbed and planned. By the time we landed, we had decided to keep his sexual orientation a secret and stay married for the sake of the children,” Jane Isay wrote in a 2011 essay for The New York Times.

While as far as his children and close family knew, he was straight, Isay became a gay activist in his professional life. Isay was involved with the American Psychoanalytic Association (APsaA), and in 1983, he courted controversy with a presentation to the organization titled “New Perspectives on Homosexuality,” where he argued against conversion therapy. He later became APsaA’s first openly gay member, leading some of his colleagues to stop referring patients to him. 

In 1986, he wrote an influential book about how psychoanalysts should handle queer patients: Being Homosexual: Gay Men and Their Development. Isay was one of the first to argue that, to paraphrase Lady Gaga, baby, we were born this way. Though the American Psychiatric Association (APA) had stopped considering homosexuality a disease in 1973, the APsaA hadn’t caught up yet, and its analysts commonly still treated being gay as a symptom of arrested development and something to be “cured.” 

In addition, the APsaA had homophobic policies. When Isay started his career, gay people couldn’t become analysts at all. Even as that changed, queer analysts were still blocked from training others or advancing in the profession, according to the BMJ. In 1991, Isay ended up threatening to sue the APsaA with the help of the ACLU. APsaA backed down, though for years there seemed to be hard feelings between the organization and Isay. In a 1996 New York Timesarticle, Isay called APsaA “one of the most prejudiced and biased institutions in the country — like the CIA, the FBI, and the military.” 

In the same article, APsaA member Dr. Roger McKinnon tried not to give Isay credit for making APsaA change its policy. 

“Yes and no. Yes, in that he has been an advocate of it. No, in that he has made pejorative depictions that exaggerate the state of affairs,” McKinnon told the Times.

In his personal life, he came out to his children and divorced Jane in 1989. He was one of the first people in New York state to have a legal same-sex marriage when he wed Harrell in 2011, according to Gay Star News. Always ahead of the curve, he was fighting for gay marriage as early as 1989, far before the issue hit the mainstream. And by 1997, the APsaA had come around, supporting same-sex marriage following Isay’s policy proposal, becoming the first mental health organization to do so. In 2019, the APsaA also became the first mental health organization to apologize for its past homophobia. 

Isay died of cancer in 2012. His passing received national coverage due to the impact he had on how the medical establishment saw gay life. Isay was proud to be gay, as he told Thompson in Gay Soul: “Being gay is an adventure because there are no guidelines for living our lives. We make them up as we go along. Sometimes I wonder what will happen when society is more accepting. Will we then become bound by convention? Life wouldn’t be as challenging. I like being a renegade.”