By the mid-20th century, "gay" was well established in reference to hedonistic and uninhibited lifestyles and its antonym "straight", which had long had connotations of seriousness, respectability, and conventionality, had now acquired specific connotations of heterosexuality. In the case of "gay", other connotations of frivolousness and showiness in dress ("gay apparel") led to association with camp and effeminacy. This association no doubt helped the gradual narrowing in scope of the term towards its current dominant meaning, which was at first confined to subcultures. "Gay" was the preferred term since other terms, such as "queer", were felt to be derogatory. "Homosexual" is perceived as excessively clinical, since the sexual orientation now commonly referred to as "homosexuality" was at that time a mental illness diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM).