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Up until 1973, homosexuality was listed in The Diagnostic and Statistical Manual of Mental Disorders (DSM), psychiatry's standard reference on the classification of mental illness. People aware of this former categorization feel that the term homosexual still carries a negative connotation. And many feel that this word places undue emphasis on sexual activity, or that it sounds overly clinical. In fact, homosexual as an adjective and noun has been mostly replaced by gay except in medical or other formal contexts. People who still use homosexual are usually unaware that the term is a sensitive one, although some do use it with intent to cause offense. However, not all members of the gay community object to it. See also gay.