Up until 1986, 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 may feel that the term homosexual stills carries a negative connotation. And some feel that this word places undue emphasis on sexual activity, or that it sounds overly clinical. In fact, homosexual as an adjective and noun is somewhat dated, except in medical and other formal contexts; the term gay has mostly replaced it. People who still use homosexual are usually unaware that the term may be 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.