South Africa arguably has the most progressive constitution in the world, one that includes the recognition of gay rights. However, just over four decades ago, when gay rights movements were gaining momentum worldwide, the South African government, in its homophobia, became increasingly vigilant at cracking down on any ‘homosexual’ activities within its borders. Heteropatriarchal views of sexuality in South Africa supported white male power structures, promoted binary ideas of masculinity and femininity, normalised heterosexuality, and determined social roles by biological sex. The state's control over the sexual activities of its population was more than just about controlling sexuality: it sought to prohibit interracial sex and to ensure that whites continued to propagate and retain political dominance. Ideas about homosexuality, in particular, threatened the Christian-nationalist procreative ideals of the apartheid government and increased fears about the perceived moral degeneration of society. Scholarship about homosexuality in South Africa, has shown how, in the 1970s and 1980s, psychiatrists in the South African Defence Force Military Hospital partook in human rights abuses by utilising aversion therapy, hormone therapy, sex change operations and barbiturates on young white homosexual men as a means to ‘cure’ them from their homosexual ‘disease’. Implicit in these studies of abuse is the notion that psychiatric practitioners were simply corrective agents of the apartheid state. However, most ignore the complex views of all those involved in debates about homosexuality that took place before the 1970s and outside the military. This article argues that psychiatric practitioners' attempts to quell the state's intensification of legislation on ‘homosexuality’ should be recognised. While many practitioners did support heteropatriarchal ideals of sexuality and normality, practitioners held disparate ideas about the aetiology and treatment of homosexuality that sometimes, but not always, supported the Nationalist government's objectives.