In A Sociological Approach to Social Problems, Noel Timms underscores the importance of understanding how historical and social contexts shape the framing of social problems—insights that remain true as we approach the book’s semicentennial. This article applies Timms’ concepts to the social construction of mental illness for lesbian, gay, bisexual, and transgender (LGBT) persons over time in the United States, by comparing changes in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders. Variations between versions reflect how mental illness diagnoses associated with LGBT persons are highly intertwined with dominant social and cultural norms of sexuality and gender at a given time.