A dangerous inclination for conformity

(An edited version of this piece was published in Business Standard.)

The recent suicide of Anjana Hareesh, a 21 year old bisexual woman in Goa, has brought to light the discrimination that LGBTQIA+ persons in India continue to face despite legal reform and decades of activism to counter culturally entrenched prejudices. News reports indicate that this young student, originally from Kerala, had been forced by her parents to undergo ‘conversion therapy’ in the hope that it would alter her sexual orientation. Why does such violence persist in India, and what can be done to prevent it?

Anjana was found dead on May 12. Her post-mortem report certifies the cause of death as asphyxia due to hanging. Yet another life has been lost because Indian parents refuse to accept their children as sexual beings with desires, needs and dreams of their own. The intimacies they want to pursue, and the people they want to love, lie outside the heteronormative framework that comes with a stamp of social approval.

On May 21, 2020, the Indian Association of Clinical Psychologists (IACP) issued an official statement recognizing that conversion therapy is “dangerously harmful and discredited” but it 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 stimuli with their queer identities, often at the insistence of misinformed parents or caretakers.”

Anjana Hareesh (Source: thenewsminute.com)

It is disturbing to learn that these practices continue even after the Supreme Court of India’s landmark judgement in 2018, which led to the reading down of Section 377 of the Indian Penal Code. This ruling empowered many LGBTQIA+ individuals to assert their identity, believing that India is now ready to embrace those who have been rejected so far. However, the legal victory seems limited if our society leaves a young bisexual woman no choice other than suicide. There are numerous anecdotal reports of conversion therapy in India but there is a disturbing lack of research and quantitative data on numbers of people who have undergone such treatments.

The verdict delivered by Chief Justice of India, Dipak Misra, noted, “To compel a person having a certain sexual orientation to proselytize 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 Anjana came out to her family as bisexual, she faced a lot of physical and mental abuse. In their attempt to ‘cure’ her of bisexuality, they pushed her 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 certainly be held accountable, what also needs to be addressed here is the patriarchal expectation for all women to seek fulfilment in a heterosexual marriage, procreation, and the raising of children.

In an academic article titled ‘Medical Response to Male Same-sex Sexuality in Western India: An Exploration of Conversion Treatments for Homosexuality’ (2016), 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 Nothing to Fix: Medicalization of Sexual Orientation and Gender Identity, a noteworthy academic volume edited by Arvind Narrain and Vinay Chandran.

Dr. 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 conducted by homosexual clients,” writes Dr. Ranade. Eventually, 40 health care providers from both cities became the 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.

Dr. 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. It also establishes that homosexuality is no longer classified as an illness by the American Psychiatric Association as well as the World Health Organization.

We cannot afford to lose more LGBTQIA+ persons; therefore the role of professional associations in laying down guidelines for ethical practice and ensuring accountability is quite crucial. The statements released by IACP and APSWP advocate that mental health professionals must speak out against conversion therapy, not discriminate on the basis of sexual orientation, 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, which focuses on research, advocacy and training around queer rights issues 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.

Gupta adds, “If the health care provider has put out advertisements claiming a ‘cure’ for homosexuality or transgender inclinations, then copies of the advertisements should also be enclosed. If the Medical Council of India does not take any steps, the complainant can move an appropriate court to get a direction for effective steps. If there is sufficient material evidence, criminal complaints can also be lodged against the health care provider or clinic concerned. 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.”

There is an increasing demand for mental health services today, and not all service providers are trained to locate distress in the social systems that individuals are part of. As a result, the person is deemed sick rather than the society that traumatizes them. 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.

As mentioned in the Pune-based Centre for Mental Health Law and Policy’s position statement dated May 20, 2020, “Conversion therapies are inherently unconstitutional as they violate the fundamental rights to life, liberty, privacy, personal identity and freedom of expression…Any person or mental health establishment who indulges in such practices must be prosecuted under the law and subject to institutional disciplinary proceedings for revocation of licenses and professional affiliations.”

Writer, educator and researcher

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