Racism Was Always In the DSM-5—Under Sociopath
Let me be clear:
Racism is not a mental illness. And trying to make it one won’t heal the people it harms. If anything, it risks protecting the very people causing that harm—from legal responsibility, social accountability, and the need to confront their choices.
There’s a quiet movement—online, in media, and in some advocacy circles—proposing that racist behavior should be classified as a mental disorder. The argument goes: who but a sick person could harbor such hate?
But this logic misses the mark.
Racism isn’t a glitch in mental wiring. It’s a calculated system of dehumanization, passed down, rationalized, and protected by policies. It’s a choice. And the truth is: you don’t need to invent a new diagnosis for racism. It’s already been in the DSM-5—just under another name.
The DSM-5 Criteria for Antisocial Personality Disorder (ASPD):
Disregard for the rights of others
Deceitfulness
Impulsivity and aggression
Irresponsibility
Lack of remorse for harming others
Read that list again—and then picture the history of redlining, lynchings, Jim Crow, mass incarceration, or denying medical care because of skin color.
The parallels aren’t incidental. They’re chilling.
So why, instead of calling racism what it is—a form of institutionalized antisocial behavior—are we trying to soften it with diagnoses?
The answer is uncomfortable:
If racism becomes a diagnosis, it becomes an excuse.
It becomes something we treat rather than something we confront.
It shifts the burden of recovery from the abuser to the abused.
This Juneteenth, Let’s Be Honest
America has never needed a DSM code to recognize the effects of racism: trauma, PTSD, anxiety, substance use, depression. But we also don’t need a DSM code to recognize its cause. Because the cause was never a pathology—it was power. And power, when abused, often hides behind the language of sickness to avoid accountability.
As a psychiatrist, I’ve seen the harm racism causes. As a Black man, I’ve lived it.
Let’s stop pretending hate needs help.
It needs consequences.
It needs dismantling.
And if we’re going to diagnose anything this Juneteenth, let it be the system, not the symptoms.
Sources for Further Reading:
Metzl, J. M. (2009). The Protest Psychosis: How Schizophrenia Became a Black Disease.
Williams, D. R., & Cooper, L. A. (2019). “Reducing Racial Inequities in Health.” IJERPH.
Haque, O. S., & Waytz, A. (2012). “Dehumanization in Medicine.” Perspectives on Psychological Science.
American Psychiatric Association. (2013). DSM-5, Antisocial Personality Disorder criteria.
