Socarides was a practicing psychiatrist and psychoanalyst in New York City from 1954 until his death. He treated patients for homosexuality throughout his career. He reported that "about a third" of his patients became heterosexual after treatment. He taught Psychiatry at Columbia University and the State University of New York Downstate Medical Center, and was Clinical Professor of Psychiatry at the Albert Einstein College of Medicine, New York City, from 1978 to 1996. He lectured on his research findings in London at the Anna Freud Centre, the Portman Clinic, the Tavistock Clinic, and before the British Psychoanalytical Society. His awards include that of Distinguished Psychoanalyst from the Association of Psychoanalytic Psychologists, the first Sigmund Freud Lectureship Award from the New York Center for Psychoanalytic Training, the Physicians Recognition Award of the American Medical Association from 1970 to 1973, and the 1987 Sigmund Freud Award given by the American Society of Psychoanalytic Physicians in recognition of distinguished service to psychiatry and psychoanalysis. Socarides was honoured by the Association of Psychoanalytic Psychotherapists, an organization formed of members of the English NHS and NHS Wales, in April 1995. The award from the APP created controversy. Following a meeting of Psychotherapists and Counsellors for Social Responsibility, a Letter of Concern by Andrew Samuels, Joanna Ryan, and Mary Lynne Ellis expressing dismay at the invitation to Socarides to give the annual APP lecture was circulated.
Much of Socarides' career was devoted to studying homosexuality. He postulated that homosexuality was a neurotic adaptation, and that it could be treated. Socarides wrote that male homosexuality typically develops in the first two years of life, during the pre-Oedipal stage of the boy's personality formation. In Socarides's view, it is caused by a controlling mother who prevents her son from separating from her, and a weak or rejecting father who does not serve as a role model for his son or support his efforts to escape from the mother.
Charles Socarides was the father of four children: a son, Richard Socarides, and a daughter, from his first marriage, two children from his second marriage, and one from his fourth marriage, with Claire Alford Socarides. Richard Socarides is openly gay and was Bill Clinton's Senior Advisor for Public Liaison for gay and lesbian issues.
In 1992, Socarides met neuroscientist Simon LeVay, who interviewed him for Born That Way?, a British documentary produced by Jeremy Taylor for Windfall Films. According to LeVay, he asked Socarides what had caused his son Richard to become homosexual. Socarides then, "...became incensed and said, among other things, "How would you like it if I asked you about your HIV status?"" This part of the interview was excised at Socarides' request.
The Human Rights Campaign, a gay rights group, issued a press release in 1999 saying that NARTH President, Charles Socarides, had "... run into trouble with the American Psychoanalytic Association (APsaA), of which he is a member. According to a letter from Dr. Ralph Roughton of the APsaA, Socarides misrepresented the position of the APsaA in a published paper and a court affidavit. Socarides attempted to make it appear that the APsaA agrees with his positions on homosexuality. He did this by quoting an APsaA document written in 1968, which supported his views and which he called the "official position" of the APsaA, while ignoring a 1990 revised statement that drastically contradicted his views. The Executive Committee of the APsaA instructed the organization's attorney to write a letter to Socarides asking him to cease this misrepresentation and threatening legal action if he continued. Additionally, the APsaA newsletter decided to stop printing advertisements for NARTH meetings because the organization does not adhere to APsaA's policy of non-discrimination and because their activities are demeaning to our members who are gay and lesbian, according to Roughton."
In 1995, Socarides published Homosexuality: A Freedom Too Far. It contained an introduction, and eleven chapters, titled: Definitions, History, Ideology, Origins, Treatment, Psychiatry, Military, AIDS, Education, Parents, and Society. Socarides wrote in the introduction that, "...I have written a book that brings everything together in a familiar, question-and-answer format. In this I had a model, Galileo's Dialogue on the World's Great Systems." Socarides warned his readers that, "...some of my statements may come across as shocking, or crude, or too graphic - even pornographic. I can only say that these words derive from the subject matter itself; they are not meant to titillate, or amuse, or promote prejudice or bias."
In the fourth chapter, Origins, Socarides discussed the development of homosexuality. He criticized Simon LeVay's scientific research on the hypothalamus on several grounds, including the lack of proof of whether the size of INAH3 was the cause of homosexuality or the reverse, the fact that LeVay could not rule out the possibility that AIDS had affected the size of INAH3, the fact that the study had not been duplicated, and the possibility that INAH3 did not exist. Socarides denounced attempts to change homosexuality through lobotomy and aversion therapy as "quackeries", adding that "Doctors who tried them were only treating symptoms. They didn't get to the root cause." Socarides also suggested that serial killer and cannibal Jeffrey Dahmer was an extreme example of a common homosexual type, writing "Every homosexual who wants to incorporate the body of his male lover is utilizing the same mental mechanism: incorporation. Most homosexuals are content to do this symbolically. Dahmer was psychotic; he took his homosexual disorder beyond the limits."
In the sixth chapter, Psychiatry, Socarides wrote that the removal of homosexuality from the American Psychiatric Association's DSM-II was a mistake, and blamed it for the AIDS epidemic. Socarides compared the American gay community to confused children and the APA to their parents. Socarides criticized Dr. Robert Spitzer, writing that Ronald Bayer's book Homosexuality and American Psychiatry revealed him as, "...someone who crosses far over the line, from science to open advocacy of a political position. Bayer tells us that Spitzer had never even published a paper on homosexuality." Socarides claimed that the vote for the removal of homosexuality in the APA's Diagnostic and Statistical Manual of Mental Disorders, which was won by a 65% majority rule, was heavily influenced by a letter sent by the National Gay Task Force to the 18,000 APA members asking them to support its removal.