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A look at the history of psychiatry's foundational impact on the lives of queer and gender-variant people. In the mid-twentieth century, American psychiatrists proclaimed homosexuality a mental disorder, one that was treatable and amenable to cure. Drawing on a collection of previously unexamined case files from St. Elizabeths Hospital, In the Shadow of Diagnosis explores the encounter between psychiatry and queer and gender-variant people in the mid- to late-twentieth-century United States. It examines psychiatrists' investments in understanding homosexuality as a dire psychiatric condition, a judgment that garnered them tremendous power and authority at a time that historians have characterized as psychiatry's "golden age." That stigmatizing diagnosis made a deep and lasting impact, too, on queer people, shaping gay life and politics in indelible ways.