In Memory of Ralph E. Roughton, M.D.

By Dr. Susan Vaughan

Ralph E. Roughton, MD (1931 – 2026) is a man who spent the first half of his life keeping a dark personal secret and the second half teaching our entire field the painful costs of such secrecy and how honesty and authenticity could heal. He was one of the kindest and most thoughtful people I have ever known, and by any measure one of the most quietly consequential psychoanalysts of his generation.

Ralph was a Southerner through and through, born and raised in Georgia. He earned his bachelor’s degree from Duke University in 1953 and his medical degree from Duke School of Medicine in 1957. He interned and completed a year of general practice residency at Grady Memorial Hospital in Atlanta, then served in the United States Air Force as chief of the Air Base Outpatient Clinic in Yokota, Japan, from 1959 to 1962. He returned stateside for his psychiatric residency at Emory School of Medicine from 1962 to 1965, where he would remain Clinical Professor in the Department of Psychiatry and Behavioral Sciences for the rest of his career.

He completed his psychoanalytic training in 1972 at the Emory University Division of the Columbia University Center for Psychoanalytic Training and Research, was certified in adult analysis by the Board of Professional Standards in 1975 and was appointed Training and Supervising Analyst by Columbia in 1979. He was instrumental in establishing a new, independent psychoanalytic institute at Emory, serving as its Education Director from 1983 to 1986 and then as its Director through the crucial developmental years of 1986 to 1991.

Ralph was an active and vibrant presence within the American Psychoanalytic Association from 1976 onward — eleven years on the Executive Council, five years as a Fellow of the Board of Professional Standards, and service on innumerable task forces, committees, panels, and discussion groups, including a term from 1996 to 1999 as a Representative to the House of Delegates of the International Psychoanalytic Association. His scholarship was prodigious: he authored articles, book chapters, and reviews, served on the editorial boards of Psychoanalytic Terms and Concepts and of Psychoanalysis: The Major Concepts, and reviewed for The International Journal of Psychoanalysis and Yale University Press. Two of his papers — “Useful Aspects of Acting Out: Repetition, Enactment, and Actualization” (1993) and “Repetition and Interaction in the Analytic Process: Enactment, Acting Out, and Collusion” (1994) — became standard texts still assigned in institute curricula today.

His curiosity ran beyond the consulting room. He pursued graduate studies in English literature at Georgia State University, studied Shakespeare’s tragedies at Oxford, and brought his two disciplines together in papers on Hawthorne, reading The Scarlet Letter as a kind of psychoanalysis in its own right. It was characteristic of him — a mind that moved easily between rigor and imagination, between the clinical and the human.

But it is the second half of Ralph’s story — what he himself called “becoming gay” — for which he will be most remembered. When he entered psychoanalytic training in the 1960s, the field was, in his words, hostilely homophobic; it was simply not possible to be openly gay and train as a psychoanalyst. So Ralph first became an analyst, and only much later became gay — not in the sense of his feelings, which had been there all along, but in the sense of an openly avowed identity. He married, fathered two children, built a respected career, and carried his deepest truth in silence, even, he later believed, into his own training analysis.

Everything changed for him when the American Psychoanalytic Association adopted a nondiscrimination statement regarding homosexuality in 1991. In 1992, President Bernie Pacella and Marvin Margolis, chairman of the Board of Professional Standards, asked Ralph — still himself in the closet — to chair the new Joint Board and Council Committee on Issues of Homosexuality, with the charge of ending discrimination against lesbian and gay candidates and analysts at every level of the organization. For six years he led that committee with what one colleague described as “ferocious grace”: an interpersonal Southern gentility paired with an unswerving refusal to let discrimination, inside the organization or out, go unchallenged.

Ralph understood early that changing hearts at the national level was not enough — the work had to reach the institutes themselves. Between 1997 and 1998, as the Association’s official consultant, he traveled to affiliated institutes across the country — San Francisco, Cleveland, Boston, Washington, Topeka, Michigan, Denver, Pittsburgh, Seattle, St. Louis, Wisconsin, and many more — helping each one recruit and integrate gay and lesbian candidates and revise curricula that had not changed in decades. The committee’s most visible achievement was the Public Forum on Homophobia in December 1998.

And in the midst of changing his profession, he changed himself. In 1996, ahead of his own interview for reappointment as a training analyst at Emory, Ralph wrote to the chair of the Training Analysts Committee to say that he intended to discuss, openly, the question of his own sexual orientation. “I am ready,” he wrote, “for the walls of secrecy and isolation to come down, for my own benefit.” He went on to tell friends and colleagues across the analytic community, in letters of his own writing, that he was a gay man. The response overwhelmed him with its warmth. One colleague, Marvin Margolis, wrote back words Ralph would carry with him and quote often afterward: that the disclosure would not change how people felt about him — it would change how they thought about homosexuality itself.

Introducing him at his 2001 plenary address to the American Psychoanalytic Association, his friend and committee colleague Sidney Phillips reached for Wendell Berry’s poem “To Know the Dark” — because Ralph, unlike most analysts, had no unbiased fellow traveler to help him discover himself. He had to go into the dark alone, and find his own way out of it, before he could help guide an entire profession toward the light.

Those who worked beside him remember the person as much as the historic role he played. As a young resident navigating a hurtful and intrusive interview during my own analytic application — one that left me so shaken I walked three miles home in the rain without remembering the journey — Ralph offered not a lecture but a quiet, steady presence: soft eyes, a caring demeanor, and a hug when a hug was what was needed, understood as more powerful than any words. Together with Paul Lynch, myself, and the other first generation of openly gay and lesbian candidates and analysts, he built something rarer than policy change: real fellowship — dinners after long, difficult meetings, solidarity in rooms that did not always welcome them, and the particular joy of being part of a committee that was, visibly and durably, changing the world around it.

Colleagues who traveled with him to more than thirty analytic institutes over the years remember the camaraderie as much as the cause — long weekends on the road, shared meals and museums, and Ralph speaking with quiet pride of his children and, later, his grandchildren. I believe that we, as fellow Southerners, found in this work the particular satisfaction of being part of a civil rights movement that needed to happen, and that Roughton was glad, finally, to help lead us all into the open. He believed deeply that only authenticity and being one’s genuine self could lead us out of a shadowy period of prejudice and into an era that holds, far more fully than the one he entered, mutual respect and regard for all its members. He did this not by demanding the field change before he would, but by changing himself in full view of it — and trusting that others would follow. Many did.

He leaves an enormous gap in our community. He also leaves, in everyone he mentored, defended, and loved, something that does not go away. On the one hand, I will forever miss him. On the other, he is already in me, and with me, forever.

From the Holmes Commission on Racial Equality in American Psychoanalysis

As a Co-Chair of the Holmes Commission on Racial Equality in American Psychoanalysis, I am writing on behalf of the Commission to add our voice to those honoring Ralph Roughton-a clinician, educator, leader, and moral presence, a giant, who altered the trajectory of our field.

Roughton’s legacy lies not only in his institutional accomplishments but also in the courage with which he lived the psychic and social contradictions of his time. He understood, from the inside, the cost of enforced silence and the distortions required to survive within it. What distinguished him was not simply that he endured this, but that he transformed it-using his own experience to press psychoanalysis toward greater honesty, accountability, and humanity.  He was unswerving in his support of psychoanalytic equity for the LGBTQI+ community while always being kind and loving.  He was quintessentially and radically welcoming of all and demonstrated how psychoanalysis could and should be the same.

His leadership was marked instead by unwavering steadiness, relational conviction, and what has been called a kind of “ferocious grace”-a refusal to collude with exclusion, paired with a capacity to remain deeply engaged with those who struggled to change. In this way, he did more than challenge policy; he helped shift the emotional life of institutions and we dare say our society.

For those of us engaged in work around racial equity, his life resonates profoundly. He understood that prejudice is sustained through distance and undone through encounter, and that institutional change requires both structural intervention and personal risk. His activism resonates deeply with the ongoing work of racial equity in psychoanalysis, reminding us that the struggle for recognition, dignity, and belonging is indivisible.

Ralph Roughton made it possible for psychoanalysis to become closer to what it aspires to be. He was a human rights warrior of our psychoanalytic generation. Ralph helped our field recognize that gay rights are human rights by every measure. May we honor him and uplift his memory by carrying that work forward.

In loving memory,

Beverly J. Stoute, MD 

On behalf of The Holmes Commission on Racial Equality in American Psychoanalysis:

Dorothy Evans Holmes, Chair
Anton Hart, PhD, Co-Chair
Dionne R. Powell, MD, Co-Chair
Beverly J. Stoute, MD, Co-Chair
Nancy Chodorow, PhD
Rafael Art. Javier, PhD
Michael Moskowitz, PhD
Fakhry Davids, MSc
Maureen Katz, MD
Donald Moss, MD
Ebony Dennis, PsyD
Kimberlyn Leary, PhD
Usha Tummala-Narra, PhD
William Glover, PhD
Rachel D. Maree, MD
Michael Russell, PhD
Francisco J. González, MD
Susan McNamara, MD
Jasmine Ueng-McHale, PhD
Forrest Hamer, PhD
Teresa Méndez, MSW
Kirkland Vaughans, PhD

From The Committee on Gender and Sexuality 

We grieve the loss of a monumental figure in psychoanalysis, and we honor the life of a man who, through deeply personal and intrepid work, changed our field forever. With courage, dedication, and diplomacy, Ralph E. Roughton broke down barriers and opened space in psychoanalytic scholarship and institutional life that had previously been inaccessible to LGBTQIA+ people. In short, he created a home for many of us. Dr. Roughton was the first chair of the Committee on Gender and Sexuality (CoGS), originally called the Committee on Issues of Homosexuality. As a community, CoGS members are well aware that we are a part of his legacy. Not only was Dr. Roughton a giant; those who knew him have consistently used the same words to describe him: kind, generous, and caring. It is unique to encounter a human being of such stature who also possesses these qualities, and it is a testament to the unyielding fortitude of his character that Dr. Roughton retained such gentle strength in the face of virulent heterosexism and homophobia. He is a model for us all, no matter our sexuality, gender, or social location.

CoGS members today are fortunate to stand on the shoulders of giants, those LGBTQIA+ psychoanalysts who paved a path where there had been none. Our intergenerational relationships make us strong. Keep reading to find information about the Ralph Roughton Paper Award, a testament to the scholarship, thinking and engagement he inspired.

Our hearts go out to Ralph Roughton’s family and his colleagues at Emory University Psychoanalytic Institute.

Thank you Ralph Roughton. May your memory be a blessing.

Andi P. Eliza-Christie and J Unterberg, Co-Chairs on behalf of The Committee on Gender and Sexuality

About the Ralph Roughton Paper Award sponsored by the Committee on Gender and Sexuality

The Ralph Roughton Paper Award was established in 1998 to honor Ralph Roughton, M.D., the founding Chairperson of APsA’s Committee on Gay and Lesbian Issues, as the present day Committee on Gender and Sexuality was then called.  In its first decade, the award honored outstanding published papers that deepened our psychoanalytic understanding of gay men and lesbians, and Dr. Roughton won the first award in 1998 for his paper “Four Men in Treatment:  An Evolving Perspective on Homosexuality and Bisexuality, 1965 to 2000.”  In 2007 the mission of the Award was changed to catalyze and inspire new writers/thinking/writing, and it now honors an unpublished manuscript that makes an original and outstanding contribution to the psychoanalytic understanding and/or treatment of lesbian, gay, bisexual, queer, trans, or gender-variant people.  Winners of the award are making important contributions to our field as thinkers/writers/leaders and will present their paper at APsA’s National Meeting.

We look forward to reading your submissions.

Carol Levin, Chair, Ralph Roughton Paper Award