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. In the Shadow of Diagnosis helps us understand the adhesive and ongoing connection between queerness and sickness.