Till about fifty years back, all over the world, many believed that homosexuality is a disease and can be treated. It was even listed in the official classification of diseases in various countries. In 1973 however, the Diagnostic & Statistical Manual (DSM) which is the official classification of diseases in the United States removed homosexuality from the list. The WHO followed suit after some years and removed it from its list of diseases called the International Classifification of Diseases (ICD). The message to the doctors world over including the psychiatrists was loud and clear; stop trying to treat homosexuality since it is not even a disease and that it is a normal variation of sexuality which is a spectrum rather than a single codified sexual behaviour.
However, many psychiatrists in India not only continued to believe that it is a disease but also continued to treat it with what they called ‘Conversion Therapy’ on hapless young men and women brought to them by desperate parents who would do anything to make their wards straight and ‘normal’.

Conversion Therapy (CT) was (and is!) a set of procedures crudely based on principles of Behaviour Therapy which posits that any behaviour which is rewarded gets repeated and any behaviour which is punished gets extinguished overtime. In a particularly dainty version of treatment, during the session, imagining sex with a person of opposite sex is followed by pleasant images or music and imagining a same sex person with sexual intent is accompanied with an aversive stimulus like a mild electric current. As late as 1983, Indian Journal of Psychiatry, the official Journal of Indian Psychiatric Society published a paper entitled, “Homosexuality: A Study of Treatment and Outcome”. Six ‘exclusively homosexuals,’ five males and one female between the ages of 19 and 30 were treated and “in five of them the therapy was successful”. The rewarding stimulus used was personal favourite music and the aversive stimulus was 50 volts current! The study was done at the AIIMS, New Delhi and was presented at the annual conference of Indian Psychiatric Society at Bombay. The paper can be read in full here-
https://ncbi.nlm.nih.gov/pmc/articles/PMC3012326/pdf/IJPsy-25-235.pdf.

The practice however decreased over the years as the world including the Indian psychiatrists accepted the fact of normalcy of a wide variety of sexual behaviours including homosexuality. However desperate parents continued to approach psychiatrists and many psychiatrists including some very senior ones continued to believe that homosexuality is a disease and needs treatment.

In January 2014, the then President of Indian Psychiatric Society Dr. Indira Sharma at the annual conference of the Society, during her speech from the podium of the society said that homosexuality was un-natural, homosexuals made rest of the people uncomfortable and should seek psychiatric help. The talk was widely reported in the press [TOI article here]  countrywide brouhaha [see editorial footnote].

I happened at that time to be the Chairperson of Task Force on Mental Health Legislation of the IPS and wrote to the then President and the VP requesting for some action even a symbolic one against the outgoing President. When nothing like that happened, I resigned from the membership of the society. I received several concerned calls asking why was I doing it, was I gay! I replied, no, I was doing it because I was a scientist and medical science said homosexuality is normal and should be left alone.

Things improved some years later, particularly because of the vociferous stand by the younger psychiatrists. For the first time in 2018, under the leadership of one of the best Presidents so far, Dr. Ajit Bhide, the IPS came out with a clear position statement on its website, saying that since homosexuality is not a disease no treatment is necessary. What helped further clear the air was the Supreme Court judgement of 2018 de-criminalising homosexuality.

At the same time the adage ‘More things change, more they remain the same’ continued to apply. According to Mariwala Health Initiative as reported in 2022 by the Scroll, 80% of the queer persons still go through either faith healing or the equally mumbo-jumbo Conversion Therapy from psychiatrists.

So much so that the Madras High Court in June 2021, on the plea of a queer rights NGO, ordered that all forms of Conversion Therapy were to be treated as professional misconduct and asked the National Medical Commission and the Indian Psychiatric Society to take disciplinary action in each case reported.

In 2022, a queer rights activist Dr. Prakash Dandekar (a radiation oncologist and co-founder of Mumbai Seenagers), reported to the Indian Psychiatric Society the case of a psychiatrist from Maharashtra, who has a million followers on Youtube and is a practising proponent of ‘homosexuality needs treatment’ school of thought. The IPS asked its LGBT task force to enquire into it but according to a frustrated member of the enquiry committee, was ‘persuaded’ later by the seniors in the IPS not to take any action based on the specious argument that the videos on the Youtube were posted before the Madras High Court Judgement, totally ignoring the fact that those continued to run long after the said judgement was delivered and many say still do. What such protectionism by the IPS does is to nullify even some of the progressive steps taken by the society itself like supporting gay people’s rights to adopt children.

And it is no surprise that, as reported by Wire  on 14th July 16, 2023. under the heading,
“Lesbian Couple’s Harrowing Journey Shines Light on Continuing Dangers of ‘Conversion Therapy’ (and that is what triggered this post), a lesbian girl was admitted and forcibly medicated at parents’ behest, at a psychiatric hospital in Kozhikode, Kerala to treat her sexual orientation! What medicine it could be is beyond me because there is no medicine to alter sexual orientation. Many times, when asked, the rationalization given is that, they were just trying to treat depression which many of queers have. Of course, many of them are depressed but that is just because of the societal and family pressures and listening to them sensitively and some medication occasionally, is all that is required. That does not need involuntary admission and forced injections. I tell them just do what you would do if a person with O-ve blood group comes to you with depression. You treat the Depression but you never try to change his blood group just to mainstream him, because a) It is normal even if uncommon and more importantly b) it cannot be done.

And Dr. Indira Sharma continues to hold responsible positions in Indian Psychiatry Society, year after year including, the Advisor to the Task force on Human Rights(of all the things) in 2022 !

It is high time for Indian Psychiatry to get its act together and ask its members to accept the scientific fact that all genders and sexualities are normal and that there is nothing here to treat!

Footnote from the editors:

• For more information, see query sent to IPS at https://new2.orinam.net/indira-sharma-homosexuality/ and response by Prof.T.V.Asokan, then President,  at https://new2.orinam.net/indian-psychiatric-society-homosexual-not-mental-illness
• Also see open letter to Dr Dinesh Bhugra, World Psychiatric Society, in connection with Dr. Indira Sharma’s statements.
• Orinam’s letter to Dr Raju, then General Secretary, on his statement “the IPS… is working on finding out the majority opinion among psychiatrists regarding the classification and management of homosexuality.” is here.

The Diagnostic and Statistical Manual of Mental Disorders (DSM)** published by the American Psychiatric Association and considered the standard classification manual by medical and mental health practitioners all over the world does not classify homosexuality as any form of mental or psychosexual deviation.

Nor does it question forms of orientation or states it as something that needs “curing”. But I’m sure Delhi doctors are far too talented to follow any norm or even a standard classification system that would question their redundant cultural and social belief system – which of course, as it seems, is way above their medical knowledge and scientific grounding.

In a recent sting operation report by Mail Today, when a number of certified medical doctors claiming to cure homosexuality through electroconvulsive therapy, hormone replacement therapy, psychological counseling and many more deceptively formulated modalities, were exposed, it brought to light the hideously substandard quality of medical practitioners in India. And their scary lack of understanding not just of medicine and psychiatry but also of the human race as a whole.

Being a certified medical doctor and a psychotherapist myself, I wonder how in spite of years of training (and mind you, not two or three years, but more than six years – the average amount of time to become a doctor in India), can one still harbour and formulate such unscientific and preposterous theories about homosexuality. This only shows, how unexposed most doctors are, and validates the unscrupulous attitude and extorting tendencies of medical practitioners all over the country.

One Dr Vinod Raina who claims to have cured over 1,000 homosexuals through hormone replacement therapy, demanding Rs. 1.1 lakh per package, perhaps has no idea of the set guidelines under which HRT can be prescribed. The list of indications include post-menopausal women, osteoporotic patients, patients suffering from ovarian failure, or people – be it a heterosexual/homosexual/transsexual – having a physiological deficiency of androgen, testosterone, estrogen or progesterone. Homosexuality is, of course, not one among them, as it is nowhere classified under any hormonal or endocrine disorder. Not to mention the side effects of HRT, which includes cardiovascular disturbances, thromboembolism, and even breast cancer. Yes, males can have breast cancer too.

Then, going one step ahead, when sexologist Dr PK Gupta talks about the existence of “recessive gay gene” in parents that later become active in homosexual children, he doesn’t realise the faux pas he has already made of his great knowledge of genetics. It is to be noted that medical graduates are taught about advanced genetics (including recessive and dominant gene functioning) right in the first year of MBBS. And nowhere in the course of medical history is there genetic or biological evidence to homosexuality, let alone recessive or dominant. Though twin studies on tracing the “gay gene” were conducted for a long period, no substantial proof were ever found. Everything about the gay gene and its propagation is only a hypothesis.

Also, people visiting such quacks and fraudulent practitioners should know that the concept of a sexologist in India is very ambiguous. There are no fixed medical degrees that certify a doctor as a sexologist or a sex therapist in India. Also, the Medical Council of India does not recognise sexologists who do not have a postgraduate degree in Psychosexual Medicine, which in turn is a part of MD Psychiatry coursework.

But that isn’t where the quackery stops. It is without evaluation and inspection people are prescribed anti-psychotic drugs like Oleanz and given electro-convulsive therapies to cure them of their homosexuality. Oleanz (Olanzapine) in psychiatric practice is an anti-psychotic drug prescribed for severe forms of schizophrenia and bipolar affective disorders. Schizophrenia and bipolar, both are classified as organic mental health disorders according to ICD-10 (International Classification of Disease) – a standard system of coding diseases formulated by the World Health Organisation – and homosexuality doesn’t even fall under any organic criteria, which needs a proper, clearly defined physiological change in the brain or any other organ system.

Similarly, the practice of electroconvulsive therapy in India is highly controversial, as its mechanism of action is still not fully known and under set guidelines is used for severe depression, schizophrenia, mania, epilepsy or co-morbid psychiatric ailments only. It is deeply condemned among the medical community in various parts of the world as a violation of human rights.

It is a pity that people in Delhi, in spite of being generally aware than most other parts of the country, still lack basic scientific temperament. It is for this lack of knowledge that they still fall for the false claims made by such dubious doctors. Desperate parents, relatives and sometimes repressed gay men who who’d want to live a so called “normal” life still think that “conversion therapy” is real, whereas in truth there exists no such modality.

Have your say. You can comment here. It is high time people should realise that it is only and only pure quackery.

* This note was originally published as “Doctors who claim they can cure gays need shock therapy” [link] in the Daily O, and has been republished with consent of the editor.

** Nor does International Classification of Diseases (ICD) of the World Health Organization,

Dr N N Raju
Professor and Medical Superintendent
Government Hospital for Mental Care (GHMC)
Visakhapatnam, Andhra Pradesh

Dear Dr. Raju,

First, our hearty congratulations on your becoming the first psychiatrist from Andhra Pradesh to be  elected General Secretary of the Indian Psychiatric Society (IPS).

We read the recent interview “Looking into minds wired differently” in the Times of India [Sulogna Mehta, TNN Feb 3, 2014], in which you have stated:

“Homosexuality is a grey area, entailing confusion and complexity, and black and white comments can’t be made on it. Globally doctors are divided on whether to label it normal or a deviation from the norm as genetics, environment and peer pressure contribute to it. However, homosexuals are not criminals, even though legally or morally they are considered wrongdoers. As of now, the IPS, consisting of around 5,000 registered psychiatrists, is working on finding out the majority opinion among psychiatrists regarding the classification and management of homosexuality.”

Respected Sir, we draw your attention to the fact that the Indian Psychiatric Society, of which you are now the General Secretary, has published not one but two editorials [2012, 2014] in its official journal IJP, confirming that homosexuality is a normal variation of human sexuality, and citing primary research that demonstrates that “people with homosexual orientation [do] not have any objective psychological dysfunction or impairments in judgment, stability and vocational capabilities”. In writing this, IPS has echoed the position of the World Health Organisation, World Psychiatric Association and psychiatric associations in a number of countries.

Homosexuality is not a disease to be “classified and managed”, as you appear to have suggested. The ignorance of psychiatrists on this issue, on the other hand, may well be.

We hope that you, in your capacity as General Secretary of IPS, will push for a public position statement by the Society that homosexuality is not a mental disorder, such as the one recently issued by LPS. Such a statement would not be contingent on “majority opinion” of the members as though they were voting on a logo design, but on the Society’s acknowledgment and endorsement of scientific consensus, dating back to 1973.

We further ask that the IPS issue a general directive to its members to cease attempts to “manage” homosexuality through practices as ECT and aversion therapy.

We remain optimistic of your and IPS’ timely attention and response in this matter.

Sincerely yours,

Orinam team, Chennai
orinamwebber@gmail.com

p.s.  Please refer to the open letter signed by healthcare professionals in India, calling for greater sensitivity and non-judgmental approaches on the part of the medical establishment towards lesbian, gay, bisexual and transgender people.

The  authors, TS Sathyanarayana Rao, the Journal’s Honorary Editor from JSS Medical College, Mysore, and KS Jacob, Christian Medical College, Vellore, state that “the argument that homosexuality is a stable phenomenon is based on the consistency of same-sex attractions, the failure of attempts to change and the lack of success with treatments to alter orientation”.

Staying clear of the polarizing nature-nurture debate, they conclude that “as with all complex behaviors and personality characteristics, biological and environmental influences combine to produce particular sexual orientation and identity.”

They question unethical and unwarranted attempts at conversion therapy and call for physicians to provide medical service with “compassion and respect for human dignity for all people irrespective of their sexual orientation.”

Orinam takes this opportunity to thank Professor KS Jacob for his extraordinary commitment to welfare of LGBT people.

Click here to download the editorial.