The Mental Impact of Being Queer: Is therapy queer-inclusive?
The fact that being a part of the queer community is tough is no longer debatable. Living in a narrow-minded society built to benefit certain groups of people, not fitting in can be extremely challenging. Inevitably, this leads to a significantly difficult experience when it comes to their health, especially mental health.
According to the National Survey on Drug Use and Health (NSDUH), members of the queer community are much more likely to develop mental health issues that might manifest into substance use, intoxication as well as serious mental disorders.
This survey focused on two major aspects of sexual orientation:
1. Sexual Identity
2. Sexual Attraction
This made it the first comprehensive representative source of federally collected information on inebriation and mental health in the LGBTQIA+ community. The aim was to correlate sexual orientation with substance use, substance use treatment, mental health issues and the use of mental health services.
Results (for adults i.e., people aged 18 or older):
Total participants identifying as a sexual minority: 4.3 per cent
Homosexual (lesbians or gays): 1.8 per cent
Bisexual: 2.5 per cent
Adults belonging to sexual minorities were particularly more likely to use illicit drugs and to be current cigarette smokers or alcohol drinkers when compared to their sexual majority counterparts. They were also more likely to have substance use disorders, including disorders related to marijuana, or misuse of pain relievers which might lead to the requirement of serious substance use treatment.
AMIs (Any Mental Illness), SMIs (Serious Mental Illness) and MDEs (Major Depressive Episodes) were also found to be more frequent, causing severe impairments with the urgent need of receiving mental health care.
This first set of results from NSDUH on this matter is incredibly important to the Substance Abuse and Mental Health Services Administration in order to understand the health issues faced by the queer community in the United States. Additional data from future research will allow changes in these patterns to be tracked and observed, hence enabling researchers to examine issues in greater depth for these subgroups.
Graphical representation of the statistics linking sexual orientation (sexual identity + sexual attraction) to mental health issues:
Stigma & Public Opinion
According to the World Values Survey (WVS), a global survey project, the share of Indian respondents who believed “homosexuality is never justifiable" fell from 89% to 24% between 1990 and 2014, —from an overwhelming majority to a clear minority. However, homophobia (negative and usually unfair beliefs about the community), and discrimination (unfair treatment of a person or community) is still extremely prevalent.
A 2017-18 survey of people in eight states by the Centre for the Study of Developing Societies (CSDS) and Azim Premji University showed that while 28% agreed or somewhat agreed that homosexual or same-sex relationships should be accepted by society, 46% disagreed. The rest had no opinion on this matter or refused to state it.
A 2016 survey of young people (between the age of 15 and 34) in 19 states conducted by CSDS and the Konrad Adenauer Stiftung found that a mere 24% of the American youth either approved, or somewhat approved of queer relationships.
Younger people such as millennials and Gen Z across the world tend to be more accepting of homosexuality than older people, and acceptance of gay marriage has sharply accelerated in the western world. In India, too, there is a broad move towards more liberal values, specifically in urban areas or metropolitan cities. The recent scrapping of Article 377 of the constitution that criminalized homosexuality was a major milestone. However, same-sex marriage is still opposed and according to the most recent development on this matter, it is still a long shot. The Centre considers it to be contradicting with “age-old customs, rituals, practices, cultural ethos and societal values” and the “Indian family unit concept”.
The practice of conversion therapy and the harm caused by it
According to the editions of the Diagnostic and Statistical Manual (DSM), homosexuality was considered to be a mental disorder. This continued till clinical research demonstrated that attraction to someone of the same gender, whether sexual or romantic, is normal.
The uncountable negative connotations have led to a multitude of methods used to prevent homosexuality or seeking to change the gender identity of a person. This includes black magic, ayurvedic medicine, spiritual lessons, etc. One of the most common ways is conversion or reparative therapy. An extreme version of this method is corrective rape, faced mainly by lesbians and bisexual women. This has been known to lead to severe depression, anxiety, intoxication issues, drug use, sexual abuse, molestation, assault, homelessness, and suicide.
These practices have been repeatedly rejected by multiple mainstream organisations, both medical and psychological. However, due to the unceasing discrimination against the LGBTQIA+ community, some practitioners continue to conduct conversion therapy. A major threat is posed to minors because of their extreme vulnerability.
The American Psychological Association reviewed thoroughly an already existing research on the efficacy of conversion therapy. It showed there was very little methodologically sound research on sexual orientation change efforts (SOCEs) and that the "results of scientifically valid research indicate that it is unlikely that individuals will be able to reduce same-sex attractions or increase other-sex sexual attractions through SOCE. There are no methodologically sound studies of recent SOCE that would enable the task force to make a definitive statement about whether or not recent SOCE is safe or harmful and for whom." This was done in 2007.
In 2020, Anjana Hareesh committed suicide. She was a 21-year-old bisexual student who was allegedly forced into conversion therapy which caused her death by suicide. According to a Facebook video, she was being put under heavy medication by a Christian community health center.
The legality and laws regarding conversion therapy
The Mental Health Care Act is often used to offer protection to the community against such atrocities, albeit limited. Further, brainwashing and indoctrination is fairly common in our society. The concept of ‘informed consent’ seems to be perfect but the reality is that it is unable to prevent this problem.
To attribute criminal liability for conversion therapy in India, there are two possible paths.
Section 319 of the Indian Penal Code (IPC) provides that causing infirmity will constitute the offence of “Hurt.” Hence, an inference can be made that the conversion therapy may fall under the ambit of “Hurt,” due to sufficient evidence of mental infirmities like depression, anxiety, trauma, etc. caused by it.
Section 304-A of the IPC offers protection against medical negligence. However, the threshold of establishing the same is extremely high. Consequently, due to the ambiguity, it gives the medical practitioners a way to get away without any consequences.
This gives rise to a need for specific criminal provision/statute addressing the same.
Therapy and professional help
Mental health is already a taboo topic in India, so much so that even privileged individuals forming the sexual majority struggle to find a safe space to deal with their issues. This problem is exponentially more intense for the queer community. Finding a qualified mental health professional who has experience and familiarity with the specific challenges faced by the members of the LGBTQIA community often face can be critical. Intersectionality is a must.
In India’s conservative families, providing a safe space to talk about beliefs, emotions, fears and feelings can be extremely beneficial. More open conversations without the risk of things getting heated resulting in conversations turning into arguments are the basis of change and revolution.
Recently, Madras High Court judge Anand Venkatesh made the headlines for banning gay conversion therapy and speaking about tackling his “ignorance and prejudice”. He ruled in the favor of a lesbian couple who had accused the police of harassing them.
“I have no hesitation in accepting that I too belong to the majority of commoners who are yet to comprehend homosexuality completely... I am the society, with all the misconceptions present,” he said in the ruling.
“Ignorance is no justification for normalizing any form of discrimination,” he said, adding that he wanted to educate himself in order to “guide the LGBTQIA+ community towards social justice”.
Coming out, couple’s therapy and sex therapy
One of the most affected aspects of a queer person is their love life and sexuality. Although straight couples also seek professional help to sort out their feelings, it becomes significantly more difficult when combined with the distressing experience of coming out, transitioning, etc. Disagreements regarding intimacy, clash of religious beliefs, individual experiences with respective families and social rejection are extremely common.
We live in a heteronormative patriarchal society. It is imperative that factors that do not enable these values are highly discouraged and not talked about, which is why a lot of queer people take a lot of time to figure out who they are. This leads to anxiety, stress and confusion over sexual identities and attraction. Better sex education and mental health institutions are the need of the hour to combat these issues such as manifestations of male power, lesbian erasure, etc.
Various organisations have been working to make this world more inclusive for the community. More and more queer inclusive mental health practitioners are coming up, even though they are largely limited to big urban metropolitan cities.
[Photo source: https://www.instagram.com/p/BwL-JrTnAWz/]
Nazariya is a queer feminist resource group based out of Delhi. Built-in 2014, they address the problems faced by lesbians, bisexual women as well as trans people assigned female at birth (AFABs)
Helpline number: 9818151707
Timings: Monday to Friday (10 am to 6 pm)
iCALL is an LGBTQIA+ friendly, judgment-free counselling service. It emphasized confidentiality and anonymity as well as appropriate inclusive language.
Contact information: firstname.lastname@example.org
Timings: 8 am to 10 pm