Sexual Orientation Change Efforts by Medical Professionals in India
by Deep & Dr. Raman
Even though for the past several years homosexuality is not considered a
disorder by itself in medical circles around the world, some Indian
medical professionals continue to be in the grips of homophobia,
religious intolerance and outdated knowledge. In India a very small
percentage of medical malpractice cases come to light chiefly because of
mass ignorance, poverty and lengthy court procedures. The irreparable
harm caused to the lives of numerous homosexuals across India by
unscrupulous psychiatrists and other mental health professionals,
"holy men", quacks and medical professionals is alarming.
Some homosexual people are ego dystonic, meaning that the person's
thoughts and behaviours are in conflict with the needs and goals of the
person's ideal self-image ("I am not happy being gay"). These
ego dystonic homosexuals need to be carefully assessed by an unbiased
mental health professional to see whether they would be happier living
their lives as heterosexual, bisexual or homosexual. Forcing the person
to "go straight" is certainly not the objective of any remedial
therapy. The mental health professional needs to see that an ego
dystonic homosexual is provided the right therapy such that s/he is
comfortable with whatever sexual orientation is innate in that person,
i.e., the person lives the ego syntonic life of a
homosexual/bisexual/heterosexual ("I am ok with being
gay/straight/bisexual and in a loving relationship, based on trust, with
my partner").
For the past few years the LGBT population in India has been at war with
psychiatrists and other medical professionals who actively prescribe
Sexual Orientation Change Efforts (SOCE) to homosexual men and women. In
India a surgeon may go scot free even after killing the patient, it is
no wonder then that homophobic psychiatrists/counsellors in India rarely
face the heat and almost always manage to wriggle out of trouble. A
medical professional may not say upfront to the homosexual patient that
the objective of the "treatment" is SOCE. It is often cleverly
disguised as treatment for "anxiety", "hypersexuality",
and "depression". Here are two cases (with names changed to
protect identities).
Case 1:
Bobby, 28, is taken by his distressed parents to a Mumbai based
psychiatrist when Bobby comes out as a gay man to his parents. The
psychiatrist talks to the family and convinces them to send Bobby to a
clinical psychologist for a battery of tests, Bobby is also sent to a
pathological laboratory for blood and hormone levels tests. Bobby is
very clear that he is completely homosexual and does not want an SOCE
treatment. Bobby is successful in his career and is socially active. He
says that he does not feel depressed or anxious. However there is a lot
of strain between Bobby and his parents. His weeping mother insists that
Bobby can "change". His father admonishes Bobby to "cease
all contacts with those friends". Bobby's test reports are
normal. Bobby is put on a daily dose of anti-depressant (escitalopram)
which may have side-effects like decreased libido and erectile
dysfunction. The psychiatrist instructs Bobby to come to him for
consultations (which may last anywhere between 20 minutes to 45 minutes)
every ten days and charges him Rs. 500/- per visit. The tests cost Bobby
Rs. 4500/-. Bobby is forced by his mother to take the tablet every day.
Bobby manages to spit it out on most days. Any psychological test is
open to interpretations. In Bobby's case the psychiatrist may argue
that the daily dosage of anti-depressant given to Bobby will ease the
strain within Bobby's family by making Bobby more
"adjusting". Bobby asks the psychiatrist point blank if he feels
that homosexuality is a curable disease. The psychiatrist does not give
a clear cut answer to Bobby or his parents.
Case 2:
Vivek, 26, has recently come out to his parents as a gay man. His
hysterical mother and infuriated father take Vivek to a "baba"
who insists that it is "easily curable" by any doctor who will
prescribe hormone therapy for a week. Vivek's parents take him to a
child specialist whom they respect. The child specialist tries to reason
with his parents saying that there is nothing wrong with being
homosexual and that they should be happy that Vivek is honest about his
sexual orientation. Vivek's parents are not convinced. The child
specialist refers Vivek and his parents to a prominent sexologist and
therapist who has previously published articles in news papers where he
has argued that all homosexuals indulge in unsafe anal sex and hence
should be termed as criminals. Back home, Vivek breaks down in front of
his parents. He insists that he will never get married to any female and
would rather castrate himself to beg on the streets as a eunuch. Vivek
tells his mom that if she hates him so much he can leave his home. His
mother is mollified somewhat and tells Vivek that they want him to
change by daily prayers and rituals. But if in the end he cannot change
they will let him be.
Authors:
Deep is a Mumbai based IT professional (gaymanpartner at gmail dot
com)
Dr. Raman is a gay friendly psychiatrist
References:
The American Psychological Association's report on SOCE:
http://www.apa.org/pi/lgbt/resources/sexual-orientation.aspx
<http://www.apa.org/pi/lgbt/resources/sexual-orientation.aspx>
The description of when and how homosexuality was removed from the
Diagnostic and Statistical Manual of Mental Disorders is given here:
http://en.wikipedia.org/wiki/Diagnostic_and_Statistical_Manual_of_Mental\
_Disorders#DSM-III_.281980.29
<http://en.wikipedia.org/wiki/Diagnostic_and_Statistical_Manual_of_Menta\
l_Disorders#DSM-III_.281980.29>
The International Classification of Diseases (ICD-10) manual published
by the WHO:
http://www.who.int/classifications/icd/en/bluebook.pdf
<http://www.who.int/classifications/icd/en/bluebook.pdf>
`Ego syntonic and ego dystonic', an explanation in Wikipedia:
http://en.wikipedia.org/wiki/Egosyntonic_and_egodystonic
<http://en.wikipedia.org/wiki/Egosyntonic_and_egodystonic>
