Since its inception in 1952 the Diagnostic & Statistical Manual of Mental Disorders (DSM) has reflected sociopolitical positions while simultaneously shaping them. No topic has gone through more revisions, or been more controversial, than sexuality. The diagnosis of sexual orientations, behaviors and genders continue to have significant impacts on marginalized communities and the rights they are afforded and denied. This seminar will trace the evolution of these diagnoses, examine what the DSM current does and does not address and muse on future directions the manual may take.