
St. Elizabeths Hospital for the Insane was supposed to help straighten Thomas H. Tattersall out, but by all appearances, it put him through a world of pain.
Tattersall was admitted to the federal hospital in Southeast D.C. in the mid-1950s, after he had been forced out of his job at the U.S. Department of Commerce. Bureaucrats in the Eisenhower administration learned that Tattersall, a married man with a history of mental illness, was what was then pejoratively labelled a “self-admitted homosexual.” He was gay, in other words—and needed to be cured of it.
So off he went to the country’s first federally operated psychiatric facility, established a century earlier by an act of Congress at the urging of reformers Dorothea Dix and Thomas Miller. They championed humane treatment for the mentally ill who lived in the area, and who previously had been sent to prisons and almshouses that offered little if any therapeutic care, much less dignity.
The facility, originally known as the “Government Hospital for the Insane,” started going by its Victorian moniker because Civil War soldiers were embarrassed to tell their families that they were recovering at a mental institution. In letters, they called it “St. Elizabeths,” the name of the land-tract that the site’s 17th-century owner had patented. Congress renamed the hospital as such in 1916 and—in an apparent surrender to colonial-era orthography—the apostrophe has been missing ever since.
But Tattersall’s experience of St. Elizabeths has survived in the historical record. Ousted from his job, the civil servant was certified “insane” and received a battery of “insulin shock therapy” sessions by injection. Over the course of weeks, Tattersall endured insulin-induced comas that St. Elizabeths caregivers believed would heal him.
This method, among others, was a treatment for his mental illness, which physicians of that era believed included his homosexuality. Being gay—anything but straight and cisgender, really—was deemed a disease.
The U.S. government subscribed to that theory, too. Investigators for the U.S. Civil Service Commission, an agency that vetted federal employees, used Tattersall as an informant, even while describing him as “mentally deranged” in interrogation papers. The investigators sought to ferret out homosexuals, or suspected homosexuals, from the government.
In this post-war period of American supremacy, officials believed that LGBTQ people who worked for the federal government could be blackmailed and therefore were a threat to national security. They also believed that LGBTQ people would disgust their co-workers and were not suitable for civil service. The resulting policy objective was simple: The more that officials could prevent LGBTQ people from corrupting the moral fiber of the federal government, the better.
Thomas H. Tattersall became a vessel for that goal—in between receiving insulin treatments that rendered him zombie-like. In an affidavit he gave to the CSC in 1955, he named dozens of men and women as LGBTQ based on photos investigators had shown him and personal encounters. In one instance, he identified employees across 22 federal agencies. In another, he chatted on the phone with a friend at the U.S. Interior Department while an investigator monitored the call.
The investigator wrote in a report that Tattersall and his friend had used “various homosexual terms,” recounts University of South Florida professor David Johnson in his 2004 book on the persecution of queer Americans during the Cold War, The Lavender Scare. The “tone of the conversation” and the friend’s “tone of voice” were “definitely homosexual,” the agent concluded.

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Today the St. Elizabeths campus looks like the specter of a once-bustling fortress within a city. Dozens of red-brick buildings, designed in the Italian Renaissance style, dot the landscape, a bifurcated site on either side of Martin Luther King Jr. Avenue SE. Wide windows, overgrowth, and rust cover their façades. The main building is a shell of its former self, gutted in 2016.
The site will look radically different in a few years. Already, two modern event spaces grace the campus: the R.I.S.E. Demonstration Center, housed in St. Elizabeths’ erstwhile chapel, and Gateway DC, a low-lying pavilion that resembles the wing of a starship that crashed to Earth.
The hospital itself, currently managed by D.C.’s Department of Behavioral Health, is a 450,000-square-foot facility with enclosed courtyards and a large green roof. It serves about 300 patients and runs a residency program. But the 163-year-old campus is long past its heyday of serving more than 8,000 patients across 300-plus acres in the 1950s.
As St. Elizabeths’ operations have dwindled, so has the hospital’s benighted history for LGBTQ patients like Tattersall. The campus’ name now signals forward-looking real estate development, with D.C.’s construction boom barreling east of the Anacostia River.
The District and private developers have set their sights on massive growth at the campus. The land is slated for a practice arena for the Washington Wizards, thousands of housing units, and a complex for the U.S. Department of Homeland Security. Plans for this kind of overhaul have been in the works for more than a decade: A 2008 redevelopment framework by the District called St. Elizabeths “arguably the most famous mental hospital in the United States.”
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Some of the darkest realities of St. Elizabeths’ fame are still largely hidden. But two local residents who describe themselves as “archive activists” want to change that for the institution’s LGBTQ history.
Charles Francis and Pate Felts stumbled across a curious omission last year that sparked their interest in St. Elizabeths. While touring the National Building Museum’s 2017 exhibit on the institution, Architecture of an Asylum, the men noticed there were practically no materials on the queer patients whom St. Elizabeths had treated as supposed “perverts.”
According to the museum, the exhibit focused on “the story of St. Elizabeths’ change over time, evolving theories of how to care for the mentally ill, and the later reconfiguration of the campus as a federal workplace and mixed-use urban development.” Francis and Felts say Asylum included some items that addressed the experiences of specific identity groups at the hospital, like African and Native Americans—just not queer people.
“The exhibit was de-gayed,” says Francis. “We did see one wisp of a mention of homosexuality, though, in a diagram entitled ‘Alcoholic Woman No. 2.’” The diagram showed circles of Freudian maladies that a St. Elizabeths patient supposedly suffered from, including homosexual tendencies.
Sarah Leavitt, a curator at the museum, says the exhibit described homosexuality as “one major reason people ended up at St. Elizabeths,” but notes that the exhibit was primarily about the design of the hospital. “It certainly was not comprehensive,” she says. “We tried to include a lot, but if museums do anything, they should encourage people to explore more on their own.”
Unsatisfied, Francis and Felts set about finding the stories of LGBTQ patients at St. Elizabeths. The two men have been researching gay history for years as members of the Mattachine Society of Washington, D.C., a nonprofit founded in 2011 and named after a precursor group created in 1950 by late gay activist Frank Kameny.
“Most people who retire get into genealogy. We got into LGBT political history,” says Francis. They call their mission “Vergangenheitsbewältigung,” a German word that means “the struggle to come to terms with the past.” (It typically comes up in discussions about Nazi Germany and historical memory.) The compound word featured in the title of a 2017 article Francis and Felts authored in QED—a queer journal published by Michigan State University Press—that laid out Tattersall’s story and their own enterprise.
Francis is a Texas native and former public-relations professional who worked for major clients including David Rockefeller, Citicorp, and ExxonMobil. He was a close friend of Kameny’s and co-founded the Kameny Papers Project, which is dedicated to preserving the civil astronomer’s legacy. Kameny was fired from the federal government for being gay and spent his life battling against discrimination.
Felts is Mattachine’s chief financial officer and was born in rural Virginia. He worked as CFO at a consultancy in D.C. and chief of staff to former Arkansas Sen. David Pryor.
They faced a colossal task in researching St. Elizabeths.
In many cases, the experiences of the hospital’s queer patients have been erased—lives forgotten in the flow of time and eclipsed by the institution’s more famous residents, like poet Ezra Pound, would-be Reagan assassin John Hinckley Jr., and actress Mary Fuller.
Still, available records suggest hundreds, if not thousands, of LGBTQ Americans have stayed at St. Elizabeths since its opening in 1855. It is unknown exactly how many were committed on account of their sexual orientation or gender identity. No centralized list was kept, and countless patient records have been destroyed or lost. A museum that opened at the campus in 1981 began shipping off its holdings in the mid-1990s as the hospital waned.
The documents that still exist are a paper diaspora, spread across various archives maintained by government agencies, university libraries, and, researchers hope, private citizens.
Francis and Felts had their first major breakthrough last August when they visited the Jean-Nickolaus Tretter Collection in Gay, Lesbian, Bisexual, and Transgender Studies at the University of Minnesota. The archives hold the papers of Benjamin Karpman, who served as senior psychiatrist at St. Elizabeths from the 1920s to the 1960s. Francis and Felts went through 21 boxes of materials, writing notes as they went. (Visitors cannot take photos.)
Born in Russia, Karpman studied psychoanalysis in Minnesota. At St. Elizabeths, he practiced on homosexuals committed by judges, and served as a federal expert on complications of sex and gender. In 1948, according to documents the Mattachine Society has reviewed, he told the Post Office Department—in testimony about obscenity in the mail system—that “90 percent of the cases at St. Elizabeths have many problems centered on some sexual difficulty.”
Six years later, Karpman mused on the challenge that homosexuality represented. “Chasing all of the homosexuals out of one city (even assuming such a thing were possible) would not solve the problem of homosexuality, any more than chasing all of the thieves out of one city would solve the problem of dishonesty,” he explained. “Psychiatry should take time out from discussing homsexuality as an individual ‘disease’ and offer a constructive plan for dealing with it as a social problem.”
The Karpman papers include about 77,000 pages of records—dream analysis, his essays, and patients’ personal writings, among other items. They shed light on the treatment LGBTQ people received at St. Elizabeths and the theories behind that treatment.
“Karpman was not unusual in his efforts to treat and cure people of homoxesuality and what he called ‘trasnvestism,’” says Regina Kunzel, who leads Princeton University’s program in gender and sexuality and curated the Karpman papers while at the University of Minnesota. “He’s less of a dogmatic psychoanalyst than many people practicing at the time and he was a very strong critic of the criminalization of homosexuality. He doesn’t really use the language of disease, but he does use the language of arrested development.”
Under Karpman, Kunzel notes, practitioners at St. Elizabeths did not use electroshock therapy and lobotomies exclusively on LGBTQ patients, but they did rely heavily on psychoanalysis and aversion therapy to treat such patients around the 1950s and 1960s. Kunzel says queer people, like other St. Elizabeths patients, received shock treatments and lobotomies for depression or schizophrenia, which physicians thought was closely related to homosexuality. Doctors at St. Elizabeths occasionally used seclusions and restraints on patients they saw as difficult or dangerous.
Karpman worked as head of psychiatry at Howard University from the 1920s to the 1940s. He drew up at least one “questionnaire for specific types of sexual deviates,” which asked patients whether they believed “there can be a lasting emotional relationship between two homosexuals” and how it could be maintained. Francis and Felts suspect that the U.S. Civil Service Commission used Karpman’s questionnaire to sniff out LGBTQ federal employees.
The pair saw that the written assignments Karpman gave his patients were not universally well received. “At the moment, I have a fairly strong desire to throw the typewriter out of the windows, bars and all,” wrote a person in his care, per records the Mattachine Society read. Kunzel describes Karpman as “a kind of heterodox Freudian” who was “not moralizing at all about homosexuality or gender nonconformity,” but did believe that people could be “cured.”
The papers themselves have a fascinating provenance. As the MinnPost reported last year, about a decade ago the documents were “discarded in a trash bin outside St. Elizabeths … ready to be tossed in a landfill.” But an anonymous discoverer found them and, recognizing their value to LGBTQ history and familiar with the Tretter Collection, donated the papers to the University of Minnesota. “It’s amazing the Karpman Papers were saved,” Francis explains.
Kunzel says some of the people who went to St. Elizabeths in the mid-1900s had been “rounded up in gay cruising areas.” She is writing a book on what it was like for LGBTQ patients to receive treatment at the hospital, based on their accounts. “For me, that’s crucial,” Kunzel says. “We’re in another era of happiness that distorts and erases some of that history.”

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In October, at the National Archives in downtown D.C., Felts and Francis examined papers revealing how another high-ranking doctor at St. Elizabeths shaped federal attitudes toward queer people.
Winfred Overholser, the superintendent of the hospital from 1937 to 1962 and the president of American Psychiatric Association for one year, was instrumental in arguing that homosexuals should be separated from the military and undergo clinical therapy.
Overholser was a chief architect of policies that lumped LGBTQ people into a cabal of sexual degenerates (killers, rapists, voyeurs, pedophiles, homosexuals) during the period following World War II. “Some of these perverts are potentially dangerous,” Overholser said in 1947, as reported by the Evening Star newspaper. “In either event, they should be dealt with and not allowed to remain at large.”
While superintendent of St. Elizabeths, Overholser chaired a committee on neuropsychiatry for the National Research Council. In 1942, he wrote a letter to Forrest H. Harrison, a captain in the U.S. Navy, where he distinguished between a “small group” of people stuck in “the homosexual level” of psychological development who would “resort to violence to compel submission to their demands,” and another group of “homosexuals who engage in their chosen sexual activity with others of like tastes.” Members of the former group should face punishment, Overholser wrote, while those of the latter should not.
He acknowledged that “the emotional reaction of the public against homosexual activity” was “out of all proportion” with homosexuality’s actual threat to personal rights and public order,” but then recommended that gays be promptly discharged from the armed forces. “An honorable medical discharge would not serve the purpose intended,” he wrote, advising “dishonorable” or “for ineptitude” discharges instead.
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As Francis and Felts tell it, anti-LGBTQ policies took root at the federal level during J. Edgar Hoover’s tenure at the FBI. Rumored to be gay, Hoover pursued efforts to oust homosexuals from civil service, including by famously requiring FBI supervisors to “underline in green pencil the names of individuals mentioned in any report, letter, memorandum, newspaper article or other communication who are alleged to be sex deviates.”
“Sex deviates” was Hoover jargon for homosexuals. Francis and Felts says the term masked the FBI director’s obsessive animus against LGBTQ people that fed a state-sponsored “witch hunt.”
News coverage of sex crimes during this era nursed widespread panic about transgressors. In 1948, D.C.’s congressional overlords approved the Sexual Psychopath Act, which criminalized queer behavior, including oral sex, sodomy, indecent exposure, and “prostitution, or any other immoral or lewd purpose.” Overholser, the St. Elizabeths superintendent, helped draft the law.
If a person was determined to be a “sexual psychopath,” a D.C. court could send him or her to St. Elizabeths, where the person would remain until the hospital’s superintendent found that “he has sufficiently recovered so as not to be dangerous to other persons.” Dozens of people were indicted under the law, which effectively supplied a pipeline of LGBTQ people to St. Elizabeths.
But the hospital also indoctrinated medical professionals to believe queer people were damaged and needed to be fixed, the Mattachine Society’s research shows. In December, they requested more than 85 digital copies of St. Elizabeths documents at the National Museum of Health and Medicine in Silver Spring. It took them 30 days to get a permit to visit the Otis Historical Archives at the museum, and, when they did, they had to view the images using a “magic lantern” device.
“The box weighs a ton,” Felts quips about the device, which illuminates slides.
The archives have “etiological studies” or diagrams that purport to map out pathologies common among LGBTQ people. To the lay eye, many of these slides appear quizzical, even absurd. One depicts concentric circles bisected by the words “homosexuality” and “incest,” both of which are surrounded by two curved instances of the word “masturbation.”
Another, labelled “Acute Homosexual Panic No. 1,” features a flow chart of a “family setting” that resembles a game of “Chutes and Ladders” with dramatic outcomes: “paternal ambivalence,” “guilt,” “inferiority,” “latent homosexuality,” “family slavery,” “frustration,” “marital difficulties,” “psychic impotence,” “oedipus complex,” “paraphiliac tendencies erupting to the surface.”
Diagrams on “female homosexuality” show the following: “alcohol,” “masturbation,” “masculine protest,” “neurosis.” Another chart, on “subclinical acute homosexual panic,” is color-coded by time of diagnosis and centered around the word “guilt,” which appears three times in concentric circles.
One image from the Otis Historical Archives is plain eerie. Called “Homosexuality; Many crimes of sexual motivation,” it depicts, in black-and-white, a man whose eyes have been redacted. He is white, has short hair and a collared shirt, and seems to be between his late 20s and early 40s.
Kunzel, the Princeton professor, and Chris Babits, a PhD candidate at the University of Texas at Austin writing his dissertation on conversion therapy and LGBTQ “cures,” helped the Mattachine Society interpret these slides. “They were the key validators,” Francis says.
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In their quest to obtain memos, correspondence, meeting minutes, and documents on other aspects of LGBTQ history, Felts and Francis have encountered what they call “rampant stonewalling.” But the Mattachine Society has a capable partner in international law firm McDermott Will & Emery.
Over the last several years, the firm has helped Mattachine to file public-records requests and, in a 2016 case that has not yet been resolved, to sue the Justice Department and the FBI for failing to satisfy a FOIA request for documents pertaining to an executive order by President Dwight Eisenhower. The order included “sexual perversion” as a basis for examining whether federal employees were national security risks, and was used to purge queer people.
McDermott now has 20 attorneys working with the Mattachine Society pro bono, up from half a dozen when the partnership débuted. On behalf of the group, the firm wrote an amicus brief in the landmark Supreme Court decision Obergefell v. Hodges in 2015 that legalized same-sex marriage nationally.
Lisa Linsky, a McDermott partner who launched an LGBTQ diversity committee at the firm more than a decade ago, met Francis via one of the committee’s events in 2012. She says the information the team has discovered in official records has given its members an appreciation “for just how pervasive the discrimination and animus by the government” against queer people was in the 1900s.
“The documents are mind-blowing,” she notes. “You see the way government officials spoke with such venom and disregard for their fellow citizens who happened to be gay. It’s shocking, absolutely shocking.”
No less shocking to the team are the treatments that LGBTQ patients underwent at St. Elizabeths, which they argue were directly tied to discriminatory U.S. policy. “It was something out of a horror movie,” Linsky says. “Coma-inducing shock treatments, lobotomies, solitary confinement. This wasn’t done in a vacuum. This was done in a culture of animus—created by the federal government—that made it OK to treat gay people in this way.”
McDermott is working on a white paper about the Mattachine Society’s latest research, due out before September. Francis and Felts have determined that St. Elizabeths played an essential role in the 20th-century assault on LGBTQ citizens and deleted queer history in the process. “This is coercive federal psychiatry,” says Francis. “That’s what turned us on, the Leviathan doing it.”
In the Mattachine Society’s account, which a few academics have independently reviewed, the hospital was a “headwater” of pseudoscientific theories about LGBTQ people that combined the psychoanalytic teachings of Sigmund Freud with American homophobia. Francis and Felts say the ideas that St. Elizabeths’ leaders generated were codified in pedagogical materials that cast queer identities as pathologies, bolstering the dominant narrative at the time.
The team is quick to underscore the contemporary relevance of their research. They point out that one can draw a line from the oppression that the LGBTQ community suffered under the pretext of psychiatric “cures” to modern-day discrimination against transgender people and conversion therapies promoted by members of the religious right.
“Conversion therapy brings it home for us,” says Francis. “The gay community today, they can’t understand lobotomies and shock insulin treatments, but they can understand that.”
To the researchers, the historical treatment of queer Americans at St. Elizabeths falls on the same spectrum as the U.S. Public Health Service’s notorious “Tuskegee Study of Untreated Syphilis in the Negro Male”—which tracked the illness’ progression among black Americans, but did not provide them with curative treatment—and the contemporary torture of alleged terrorists.
It is also a harbinger of specifically anti-LGBTQ policies that persist: the ban on transgender servicemembers floated by President Donald Trump; denied bathroom access for people whose gender identities do not match the genders assigned to them at birth; international persecution of gay men and women; and, in some corners of the U.S., conversion therapy performed on LGBTQ youth under the guise of “praying the gay away.”
“This whole idea of LGBT Americans being broken and in need of a cure—religious or psychiatric—is still a pernicious, damaging lie,” says Francis.
He points to the story of Garrard Conley, an Arkansas native on the Mattachine Society’s board of advisers who in 2004 entered a conversion therapy camp called Love In Action after being outed to his Baptist parents while in college. Conley wrote a memoir about his experiences, Boy Erased, that was made into an upcoming movie starring Lucas Hedges, Joel Edgerton, Nicole Kidman, and Russell Crowe. (David Johnson, the author of The Lavender Scare, and Jim Obergefell, the plaintiff in the landmark Supreme Court case on same-sex unions, are also on the group’s advisory board.)
The federal government no longer clinicizes anti-queer ideology to the extent that St. Elizabeths did last century, but the Mattachine Society worries that discriminatory ideas still have a grip on political leaders and the Trump White House. The Republican Party’s 2016 platform defended “the right of parents to determine the proper medical treatment and therapy for their minor children,” and Vice President Mike Pence once supported federal funding for institutions that assist people “seeking to change their sexual behavior.”
Linksy, the attorney who works with the Mattachine Society, says the nonprofit’s research demonstrates that the queer community’s struggle is far from over. “We cannot rest on our laurels,” she says. “LGBTQ youth in schools, suicides and attempted suicides, bullying: There is so much work yet to be done.”
“Have we made strides?” she continues. “Yes. But now’s not the time to stop.”