An inclination for conformity

Three Indian mental health associations issued separate statements last month pointing to the dangers of ‘conversion therapy’ for LGBTQIA+ people, two years after same-sex relations were decriminalised

The suicide of Anjana Hareesh, a 21-year-old bisexual woman in Goa, on May 12 has brought to light the discrimination that LGBTQIA+ people in India continue to face despite legal reform and decades of activism. News reports indicate that her parents had forced this student, originally from Kerala, to undergo “conversion therapy” to alter her sexual orientation.

Why does such violence persist in India, and what can be done to prevent it? At the start of Pride Month and two years after the Supreme Court read down Section 377 of the Indian Penal Code, Indian society is still struggling to accept same-sex relations. That is why “conversion therapy” is an increasingly popular instrument for conservative families.

There is a disturbing lack of data on this trend but the issue is clearly developing dimensions serious enough for three Indian mental health associations to issue statements, warning against the dangers of “conversion therapy” ( see table, Same difference)

As the Indian Association of Clinical Psychologists (IACP) pointed out, “conversion therapy” is widely practised by mental health professionals who use “operant conditioning methods, a variety of shaming, emotionally traumatic or physically painful stimuli to make their victims associate those with their queer identities, often at the insistence of misinformed parents or caretakers.”

These practices continue even after the Supreme Court of India’s landmark ruling empowered many LGBTQIA+ individuals to assert their identity. The legal victory, however, seems limited if our society leaves a bisexual woman no choice other than suicide.

The verdict delivered by then Chief Justice of India, Dipak Misra, noted, “To compel a person having a certain sexual orientation to proselytise to another is like asking a body part to perform a function it was never designed to perform in the first place… Whether one’s sexual orientation is determined by genetic, hormonal, developmental, social and/or cultural influences (or a combination thereof ), most people experience little or no sense of choice about their sexual orientation.”

After Hareesh came out to her family, she faced extensive physical and mental abuse, including being into conversion treatments without her consent. She has spoken publicly about the torture she was put through, including solitary confinement in a mental health facility. Though the parents must be held accountable, what also needs to be addressed here is the patriarchal expectation for women to seek fulfilment in a heterosexual marriage and procreation.

In a 2016 academic article titled “Medical Response to Male Same-sex Sexuality in Western India: An Exploration of Conversion Treatments for Homosexuality” Dr Ketki Ranade writes, “The use of conversion techniques presupposes that homosexuality is pathological or problematic and warrants treatment or repair...almost all medical organizations maintain that there is little or no empirical evidence supporting the efficacy of these treatments.” This article was published in the book Nothing to Fix: Medicalization of Sexual Orientation and Gender Identity edited by Arvind Narrain and Vinay Chandran.

Ranade wrote the article based on a study conducted in Mumbai and Pune between April 2007 and January 2008 using an exploratory, descriptive and qualitative research design. “The health care providers, originally selected for the study, comprised psychiatrists, sexologists, gynaecologists, dermatologists, urologists and counsellors who had been consulted by their homosexual clients,” she wrote. Eventually, 40 health care providers from both cities became participants. The findings indicate that many of them define “success” or “cure” in terms of their client “getting married or reporting a happy marriage or returning to show them his/her baby”, thus celebrating compliance to heteronormative standards.

Ranade, who chairs the Centre for Health and Mental Health at the School of Social Work, Tata Institute of Social Sciences, is also the vice-president of the Association of Psychiatric Social Work Professionals (APSWP). This newly formed association issued a public statement on May 18, highlighting the negative consequences of conversion treatments, which include lowered self-esteem, increased self-hate, guilt, shame, self-harm and suicidal ideation.

The IACP and APSWP statements advocate that mental health professionals must speak out against conversion therapy, and align their practice with India’s Mental Healthcare Act (2017) and the Yogyakarta Principles on Application of International Human Rights Law in Relation to Sexual Orientation, Gender Identity, Gender Expression and Sex Characteristics (2007, 2017).

In 2015, the Kolkata-based Varta Trust, a queer rights-focused group, published “Challenging queer cures”, a dialogue between psychiatrist Dr Ujjaini Srimani, advocate Kaushik Gupta and social activist Bappaditya Mukherjee. Gupta offers legal strategies to counter forced conversion therapy. Apart from lodging a police complaint against parents, formal complaints can be filed against the erring health care providers with the Medical Council of India (MCI).

Gupta adds, “If the MCI does not take any step, the complainant can move an appropriate court to get a direction for effective steps. One of the legal provisions under which health care providers making false claims through advertisements can be charged is the Drugs and Magic Remedies (Objectionable Advertisements) Act, 1954.”

It is time for mental health professionals to address the damage that psychology, psychiatry and psychoanalysis have caused to LGBTQIA+ individuals. This can be done by adopting approaches that affirm all orientations — not only heterosexual, bisexual and homosexual but also asexual and pansexual.