Homosexuality is assuredly no advantage, but it is nothing to be ashamed of, no vice, no degradation, it cannot be classified as an illness; we consider it to be a variation of the sexual function, produced by a certain arrest of the sexual development. It is a great injustice to persecute homosexuality as a crime—and a cruelty too.1

Sigmund Freud

In the 20th century, doctors were repeatedly accomplices in state repression, brutality, and genocide. The most notorious examples of medical complicity in state abuse are the Nazi doctors who participated in genocide and the Japanese doctors who practised biological warfare.2 Included among the former were psychiatrists, who in carrying out Hitler's euthanasia programme on their patients seem to have been in a state of complete moral disarray.

Involvement of psychiatrists in state repression has if anything escalated since 1945, the most extensive example being the use of psychiatric treatment for suppression of dissenters in the Soviet Union. Similar practices arose in other east European states, China, and …