A young man from a small town in the state of Gujarat approached a psychiatrist seeking treatment for his ‘condition.’ He was further referred to a psychologist. The client and his family approached the psychologist and put forward their simple request – cure our boy of the dangerous mental illness that he seems to have acquired off late: a homosexual orientation.
What followed was a series of sessions that involved a focused attempt on educating his family members about the reality with which they were faced. Despite several such sessions, the client chose to put himself through a phase of “conversion therapy” that he had studied about online. It is also known as “reparative therapy”, thus implying the scope of repair for a given individual. It involves an approach that has been discredited time and again by the medical field at large and mental health practitioners, in particular. It claims to change a person’s sexual orientation by “repairing” them or “converting” them. Let alone benefits, conversion therapy practices can in fact lead to complains of depression, drug use, anxiety, and even suicide.
This is the story of one man, and one family that struggled in their understanding of what was happening. Human kind has come a long way in its understanding and acceptance of differences that exist amongst people. Earlier, a different sexual orientation was a sin and even a pathology. The DSM-II (Diagnostic and Statistical Manual), which was first published in 1968, classified homosexuality as a mental disorder. This later shifted to a changed description of “sexual orientation disturbance”. In 1987 however, the DSM got rid of this classification entirely and homosexuality stopped being an illness.
Cut to January 2014, when a former IPS (Indian Psychiatric Society) president claimed homosexuality to be unnatural. This led to an enraged response from the LGBT community. While the then newly elected general secretary of IPS chose to remain noncommittal, a formal statement followed soon from the IPS. They stated, “Based on existing scientific evidence and good practice guidelines from the field of psychiatry, Indian Psychiatric Society would like to state that there is no evidence to substantiate the belief that homosexuality is a mental illness or a disease. IPS will issue a more detailed statement in due course of time.”
Despite the shift in the diagnostic stands, we continue to face the cultural stigma of abnormality when talking about homosexuality. Take for instance Baba Ramdev’s claim on curing the unnatural habit of homosexuality. As per his claims, Yoga saves the day in helping cure this ‘bad addiction’. Recently, there were efforts taken at understanding what all cures are provided for those seeking relief from a homosexual orientation. The doctors at the Patanjali Chikitsalayas in Delhi reportedly suggested that a homosexual orientation is a mental illness and Yoga and Meditation are thus the only possible cures for it.
A larger part of the society, while able to express an intellectual consent towards accepting a different sexual orientation, nonetheless easily continues to struggle with a real and genuine acceptance of the same. An earlier Mint-on-Sunday piece highlighted the on-going stigma experiences shared by people with different sexual orientations. The struggle to openly express oneself as a gay, lesbian, or transgender continues to a real one in households and family interactions. The LGBT foundation also lists discrimination, rejection by friends and family, bullying, prejudiced approaches, as well as abandonment as regular difficulties experienced by homosexuals individuals.
There is a gradual (almost invisible) shift in the approach towards a different expression of sexuality in recent times. Whether it is in the form an increased social media propaganda and awareness, more open family support, individuals choosing to come out, or the Pride parades, there is a definitive positive shift. Despite this however, individuals continue to face psychological challenges even as we read this.
A research study led by Dr. Apu Chakraborty (University College London, UK) concluded that there is a higher rate of mental health concerns experienced by the homosexual population as compared to their heterosexual counterparts. His research team focused on rates of mental disorders among 7,403 adults living in the UK. Rates of depression, self-harm, suicidal thoughts, alcohol and other drug dependence, anxiety, obsessive compulsive disorder, and phobia were noted to be significantly higher in the homosexual sample. In 2008, a meta-analysis of 28 papers (published between 1966 and 2005) pointed towards a higher prevalence of mental health problems amongst the homosexual population across years.
What do we do then? Working towards a slow and steady paradigm shift is of prime importance when moving toward a mentally healthy society.
An essential step for a healthier approach would be adequate information and awareness. Understanding homosexuality for the choice and subjective reality it is, and not misjudging it for an abnormality is a start. It is human tendency to classify people into ready-made categories simply because it is more convenient. The theory of cognitive miserliness resonates as being relevant here. However, it does not serve any functional purpose when it comes to the cause at hand. Information and understanding thus serve as effective weapons. The American Psychological Association (APA) released a brochure in 2008 to further this aim of generating awareness through relevant facts and information.
Saving the homosexual community from the ‘minority stress’ will help in building a clearer path towards better mental health. This is an experience of stress arising from a stigmatized approach towards minority groups of people. Seeking help, however, comes with its own set of disparities. As explained earlier, the scientific community has moved forward in its understanding and acceptance of homosexuality. At the same time, however, a disparity in providing health care exists. This arises from inadequate training and/or exposure for the health care practitioner himself / herself.
While there are rallies and protests about equality of the genders as well as about safeguarding heterosexual love on the roadside, there is an equally pressing need to safeguard those who choose to have a sexual orientation that is different.
The young man from Gujarat who began seeking help initially to ‘cure’ his sexual orientation, gradually changed his goals in therapy. He shifted towards more realistic and healthy goals of working on his self-esteem, vocational choices that can help him stabilize financially, and thus become independent, even emotionally independent, in the event his family chose to never accept him. At the time when he dropped out of therapy prematurely, his elder brother and sister-in-law had moved out into their own home, while he lived with his parents. His father chose to ignore his son’s reality while his mother put in her best efforts to look out for the best female match for him, hoping that at one point he will feel attracted to one of them and thus be ‘cured’ of his illness.
We do have to continue to looking for a cure at this point. A cure for the illness of stigma; a cure for the lack of understanding and the resultant fear people live with; and above all a cure for psychological difficulties experienced for making a different choice. But a cure for homosexuality? Looking for it might be as pointless as trying to hold water in one’s palms. What isn’t an illness calls for no cure.
Shama Shah is a consulting psychologist (clinical) based in Rajkot, Gujarat. She is currently associated with a school and two psychiatric clinics, and functions through the initiative of Manasthya.