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.

Recently,  the British Association for Counselling and Psychotherapy (BACP) struck member Lesley Pilkington off its rolls for offering to ‘convert’ an undercover journalist. BACP has notified its 30,000 members that it “opposes any psychological treatment such as ‘reparative’ or ‘conversion’ therapy which is based upon the assumption that homosexuality is a mental disorder, or based on the premise that the client/patient should change his/her sexuality.

In May 2012, the Pan American Health Organization (PAHO, regional office of WHO) released a statement that denounced conversion therapies as “lack[ing] medical justification and [being] ethically unacceptable.”

Attempts at reparative therapy in multiple forms are, unfortunately, alive and well in India. Parents often take their children who appear to be homosexual, bisexual or gender-non-conforming to mental health professionals, who subject them to a variety of unscientific and inhuman treatments ranging from medication to electro-shock therapy. Earlier in 2012, the Indian Journal of Psychiatry, official publication of the Indian Psychiatric Society, had an editorial on homosexuality in which they opposed attempts on the part of the psychiatry profession to change sexual orientation.

We appeal to bodies such as the Ministry of Health and Family Welfare, Indian Council of Medical Research and professional medical associations to take cognizance of these developments. If you are concerned about reparative therapy in India, consider signing on the the Campaign for Open Minds as an LGBT community member , friend/ family member/ ally or  a healthcare provider – there’s a letter for each of these.

NATIONAL CENTER FOR LESBIAN RIGHTS / EQUALITY CALIFORNIA
FOR IMMEDIATE RELEASE
September 29, 2012

Media Contacts: Erik Olvera | Communications Director | NCLR Office:
415.392.6257×324 | Mobile: 415.994.3242 | EOlvera@NCLRights.org || Stephan
Roth | Media Contact | EQCA Office: 323.951.0059 |
Steve@OutThinkPartners.com

CA Governor Brown Signs Bill To Protect LGBT Youth From Psychological Abuse Signature on Bill Authored by Senator Ted Lieu Will Stop Discredited
Practices

(San Francisco, CA, September 29, 2012) — California Governor Jerry Brown made history today by signing a landmark bill that will protect lesbian, gay, bisexual, and transgender youth from psychological abuse by deceitful mental health professionals who falsely claim to be able to change their sexual orientation or gender expression. With Governor Brown’s signature, California becomes the first state in the nation to protect LGBT young people from these dangerous practices, including the use of shame, verbal abuse, and aversion therapy, that place youth at high risk of depression and suicide. The law, which goes into effect January 1, 2013, prohibits state-licensed therapists from engaging in these practices with minors.

Authored by Senator Ted Lieu, Senate Bill 1172 was co-sponsored by the National Center for Lesbian Rights, Equality California, Gaylesta, Courage Campaign, Lambda Legal, and Mental Health America of Northern California, and supported by dozens of organizations.

“Governor Brown today reaffirmed what medical and mental health organizations have made clear: Efforts to change minors’ sexual orientation are not therapy, they are the relics of prejudice and abuse that have inflicted untold harm on young lesbian, gay, bisexual and transgender Californians,” said Clarissa Filgioun, Equality California board president. “We thank Senator Ted Lieu and Governor Brown for their efforts in making California a leader in banning this deceptive and harmful practice.”

Added NCLR Executive Director Kate Kendell: “Governor Brown has sent a powerful message of affirmation and support to LGBT youth and their families. This law will ensure that state-licensed therapists can no longer abuse their power to harm LGBT youth and propagate the dangerous and deadly lie that sexual orientation is an illness or disorder that can be ‘cured.'”

Ryan Kendall, a survivor of the practice who testified in the Perry v. Brown legal challenge to Proposition 8, described his experience earlier this summer to the Assembly Business, Professions and Consumer Protection Committee: “As a young teen, the anti-gay practice of so-called conversion therapy destroyed my life and tore apart my family. In order to stop the therapy that misled my parents into believing that I could somehow be made straight, I was forced to run away from home, surrender myself to the local department of human services, and legally separate myself from my family. At the age of 16, I had lost everything. My family and my faith had rejected me, and the damaging messages of conversion therapy, coupled with this rejection, drove me to the brink of suicide.”

This victory would not have been possible without the dedication and collaboration of dozens of organizations and individuals, many of whom–such as survivors Kendall and Peter Drake–opened their lives and sacrificed their privacy to share the damage they suffered as a result of these abusive practices. In addition to the SB 1172’s sponsors, the bill was supported by dozens of organizations, including a number of mental health organizations, including: The California Psychological Association, the American Psychoanalytic Association, the California Board of Behavioral Sciences, the American Association for Marriage and Family Therapy (California Division), the National Association of Social Workers (CA Chapter), the California Latino Psychological Association, and the California Council of Community Mental Health Agencies.

###

The National Center for Lesbian Rights is a national legal organization committed to advancing the human and civil rights of the lesbian, gay, bisexual, and transgender community through litigation, public policy advocacy, and public education. http://www.NCLRights.org

Equality California (EQCA) is the largest statewide lesbian, gay, bisexual, and transgender advocacy organization in California. Over the past decade, Equality California has strategically moved California from a state with extremely limited legal protections for lesbian, gay, bisexual and transgender people to a state with some of the most comprehensive human rights protections in the nation. Equality California has partnered with legislators to successfully sponsor more than 85 pieces of pro-equality legislation. EQCA continues to advance equality through legislative advocacy, electoral work, public education and community empowerment. http://www.EQCA.org

Image source: allexperts.com

In the same (I quarter, 2012) issue of Indian Journal of Psychiatry as the editorial by Drs. Rao and Jacob titled ‘Homosexuality and India’ – the closest the Indian Psychiatric Society has come to an official progressive stand on homosexuality –  is an article by Dr Gurvinder Kalra from the Department of Psychiatry, Lokmanya Tilak Medical College and Sion General Hospital, Mumbai. Dr. Kalra provides guidance to psychiatrists who are encountering clients from the LGBT community in the wake of Delhi High Court’s 377 decision decriminalizing consensual same-sex behavior among adults.

Dr. Kalra echoes the Rao-Jacob editorial in calling on psychiatrists not to continue with the unethical practice of aversion therapy, and provides a simple flow chart illustrating how a psychiatrist should support a client who is lesbian, gay, bi or trans*.  He asks the doctor to assess whether the client has any accompanying (“co-morbid”) conditions needing psychiatric intervention, and provide those if needed. If there are no such conditions, he asks the doctor to facilitate the client’s journey towards self-acceptance, help him/her address internalized homophobia, provide referrals to local support groups, and assist her/him in coming out to immediate and extended family.

While similar points have been made previously in public forums by other psychiatrists such as Dr. Shekhar Seshadri from Bangalore, Dr. Suresh Kumar from Chennai, and Dr. Raman from Mumbai, having such an article published in the official journal of the Indian Psychiatric Society is laudable.

Read Dr. Kalra’s article here.

We, as members of the LGBT communities, can do our bit through

• providing structured voluntary assistance such as support groups
• letting psychiatrists in our towns know about LGBT resources available
• reaching out with peer support to individuals trying to deal with coming out issues.

There are LGBT groups and mailing lists in many Indian cities. Additionally, online resources may be found at  websites such as Orinam and GayBombay. If you would like to contribute to our coming out resources, please let us know.

Thanks to Sandeep for letting us know of this journal article.

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.