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| Picture Coutesy- Q Graphy |
Mental Health is essential for everyone- however, the present social structures and institutions make certain sections of the society, like the queer community, more vulnerable to mental health problems. The kind of marginalization and stigmatization that the society subjects the LGBTQ+ community exposes them to conditions that inflict mental stress and trauma.
The discussions surrounding the queer community have been fraught with misunderstandings, particularly regarding their mental health. Nathaniel M. Lewis in his article- “Mental health in sexual minorities: Recent indicators, trends, and their relationships to place in North America and Europe” mentions,
This gap may be attributable to the fraught past relationship between the psychiatry community and sexual minorities, characterized by the pathologizing and subsequent depathologizing of homosexuality, studies in mostly medicalized settings, and the (mis)application of various ‘‘reparative’’ therapies.
Being Gay, Bisexual, Pansexual or Asexual is not an issue or a problem that can be cured with therapy or medicines. Being Queer is a part of one’s identity, it is who a person is, there is no cause or cure or precaution, it is as natural as being heterosexual, the only difference being that heterosexuality has been normalized through years of conditioning to the point that anything other than that appears to be “abnormal and unnatural”.
Mental Health for the LGBTQ+ community remains important because of the way society perceives and treats them. In a country like India, where inter-caste marriage is seen as a crime, it is unsurprising that almost no statistics related to the LGBTQ+ community are available. The subject has been studied more intensively in the west and according to the NAMI (National Alliance on Mental Illness), an American Mental Health organization,
- LGB adults are more than twice as likely as heterosexual adults to experience a mental health condition
- LGBTQ people are at a higher risk than the general population for suicidal thoughts and suicide attempts
- High school students who identify as lesbian, gay, or bisexual are almost five times as likely to attempt suicide compared to their heterosexual peers
- 48% of all transgender adults report that they have considered suicide in the past 12 months, compared to 4% of the overall US population.
Even though our country is culturally very different from America and the familial structures, traditions and values that are instilled in the children here are poles apart from that of the Americans, if statistics related to the mental health of the queer community are ever collected, it would be similar, if not worse from the given data.
Hence people who are not heterosexual and do not conform to the binary gender division, are at a higher risk of falling prey to mental challenges because of the world in which all of us live, which systematically excludes them, demeans them, subjecting them to oppression, forcing them to question their identity, to fit into a world which is so unaccepting of diversity that they are forced to pretend their entire lives, be someone else, suppress their self- hood. The social environment attempts to influence the mental health of the LGBTQ+ people on three levels-
1) Self
For some people the awareness that they are different from what the society mandates comes early in life. The difference between their internal reality and what is expected of them puts them in denial and eventually end up doubting their own self. Often the LGBTQ+ people begin to believe that it is they who are in the wrong, hence from childhood they enter into a conflict which is re-enforced by the way people treat them.
Coming to terms with one’s identity is a very personal process, hence, it would be unfair to generalize one’s relation with the self- for some, it is early, for others it is later in life, some are confident about their queerness, others, unsure or even reluctant. The external world, never the less, adds some complexity to this process.
2) Family
Family plays a very important part in the running of the society, the former in fact, serves as a mirror of the latter at the micro level. So, it is only evident what kind of reactions the LGBTQ+ people receive from their families when they come out to them. Parents who, find that their children are different from what they expect them to be, often try to “correct” the child by either taking the child to a psychiatrist or camps that are specially meant for these types of “corrections”. For the children who come out to their parents later in life, they often face exclusion, unacceptance, refusal. However, universalizing this experience would not be fair to the families, that are accepting and supportive of the identities of their children. Come early September last year, the Indian legal system took the first step toward a more accepting society, the sanction of the legal system definitely pushed a lot of parents to stand by their queer kids.
3) Society
From a very early age, people belonging to the LGBTQ+ become subject to ridicule. The lack of sensitization in the children leads them to create an uncomfortable or even a dangerous environment- mentally and physically for their peers who are different from them- that is, the children who identify as heterosexual and are comfortable with the gender attached to their sex, (even though the point of the queer movement is to break down definitions, allow people to be whoever they want to be, it is important to generalize and define the section of the society that doesn’t see a problem in sidelining the people who are different from them). This leads to seclusion, isolation and victimization at a very young age when the individual is trying to come to terms with his/ her identity. This situation puts the child at great risk of anxiety or even depression, the child might be forced to resort to coping mechanisms that often do more harm than good.
It is not just school, the marginalization continues in the public sphere, regardless of whether the parents are supportive or not. Even though a lot of workplaces claim to be free of any kind of discrimination, the LGBTQ+ people continue to suffer. Even outside the workplace, queer people are forced to live lives, without any freedom, always forced to be careful.
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| Source- Causal pathways between minority stress and mental health outcomes in gay men. Notes: Model: N. Lewis. Sources: Bagley and Tremblay (2000), Balsam et al. (2005), Botnick et al. (2002), Cochran (2001, 2003, 2007), Diaz et al. (2001), DuRant et al. (1998), Harper and Schneider (2003), Herdt and Kertzner (2006), Mays and Cochran (2001), Paul et al. (2002), Rosario et al. (2006). |
Even when people try to bring about a change, the people who feel that everyone should have the right to define themselves, sometimes end up stereotyping. This stereotyping is largely a product of the portrayal of the community in the media. Counselors, often, ignorantly end up offending or misguiding their patients who belong to the LGBT+ community. ‘Gay-Affirmative Counselling Practice- Resource and Training Manual’, published in 2013 by Saksham and the Tata Institute of Social Sciences lists certain pointers in order to avoid misunderstandings and be more aware to the needs and concerns of the LGBT+ community, for mental health practitioners in particular and society in general. These suggestions will come in handy for anyone wants to help a queer person facing mental health challenges. Two tables included in the conclusion of the same paper summarize the points:
Table 1: The Unique Life Stressors that counselor practicing GACP should be familiar with
Difficulties with Self-Acceptance
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Sexual minorities grow up and live in a hetero-normative society, which stigmatizes and rejects non-heterosexual sexualities. Therefore, having a healthy acceptance of one’s sexual identity is often a tumultuous journey that they have to make.
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Coming Out
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Because of living in a hetero-normative society, heterosexual people never have to come out and tell others about their sexuality. It is already a given. So, the process of coming out becomes unique to sexual minorities when they are forced to acknowledge their own difference in the face of a more mainstream, acceptable sexuality.
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Invisibility
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Sexual minorities may live a double life in order to hide their sexuality from significant others. Invisibility also means that they may have no knowledge of any spaces, resources or people to mirror their realities. Not having any resources that affirm one’s existence results in a feeling of isolation and a deep sense of loss.
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Discrimination and Harassment
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Various systems like education institutes, workspaces, police and legal systems, hospitals and the medical system and even families can become sites of harassment if the non-heterosexual sexuality of a person becomes known
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Relationship Issues
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Heterosexual marriages give sanction and legitimacy to a relationship between two people. Rarely do any other relationships ever get the same affirmation and validity as marriage.
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Mental Health Manifestations
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In sessions, clients are unlikely to present their problems in the form of unique life stressors. What is visible will be feelings and problems that the gay client is going through. Making the possible link of client problems and manifestations to the unique life stressors of their sexuality, is the responsibility of the GACP practitioner.
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Source- “Gay-Affirmative Counselling Practice- Resource and Training Manual” Ranade, Ketki. Chakravarti, Shruti
Table 2: The 9 crucial tenets to becoming gay-informed are summarized here
Knowledge of and Using Gay Affirmative Language
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Using respectful language to affirm all sexualities, using sexuality-neutral language, building vocabulary and coining new words that reflect realities of sexual minorities
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Gay-inclusive Counselling Setup
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Creating spaces that are welcoming to sexual minorities by using more explicit homosexual messaging and ensuring that the staff employed are educated on these issues
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Avoiding Assumptions
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Creating a safe space for voluntary disclosure or respectfully asking clients about their genders, sexual orientations, sexual behaviors, and lifestyles is preferred rather than making assumptions about them.
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Challenging Misinformation in Clients
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Misinformation in clients may be about sexual behavior and health risks, about their sexual orientation and gender identities. It is important that GACP practitioners do not confirm or validate this misinformation.
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Facilitating Self-Acceptance
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GACP counselors must recognize that growing up and living in a society that is rejecting of same-sex desires contributes to internalized homophobia that impedes self-acceptance of clients
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Knowing of And Respecting Diversity
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Heterosexual individuals are seen as ‘whole people’, who have multiple identities, roles and affiliations in the society and we do not think of them merely in terms of who they have sex with. The same is true about sexual minorities whose realities are varied and diverse and not restricted to sex.
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Knowledge About and Engaging with Resources
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By knowing about these different resources and engaging with these, counselors will be better educated about their clients’ problems as well as about other services available for gay individuals. This will help the counselors to make better referrals and provide more effective services to their clients as well as assist in reducing their isolation
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Confidentiality
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This is an additional concern for sexual minorities given the societal stigma towards them. GACP counselors must also be aware that sexual minorities may belong to close-knit groups where information is quickly circulated
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Self-Awareness
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In the context of sexual minorities, GACP counselors need to recognize and address prejudice they may experience towards non- heterosexual sexualities. Being able to recognize and address same-sex attractions is another important aspect.
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Source- “Gay-Affirmative Counselling Practice- Resource and Training Manual” Ranade, Ketki. Chakravarti, Shruti
Mental Health Challenges consume the patients, facing the challenge and fighting the world for one’s basic rights is unfair, to say the least. It is an urgent need to spread awareness and bring about the most needed change and help our queer friends, relatives, and peers to find their share of happiness and peace in this world.
References:
Lewis, Nathaniel M. Mental Health in sexual minorities: Recent indicators, trends, and their relationships to place in North America and Europe. Health & Place Journal 15 (2009) 1029–1045 retrieved from https://www.academia.edu/2612113/Mental_Health_in_Sexual_Minorities_Recent_Indicators_Trends_and_Their_Relationships_to_Place_in_North_America_and_Europe
National Alliance on Mental Illness. (2016). LGBTQ. Retrieved from,
Ranade, Ketki. Chakravati, Shruti. Gay Affirmative Counselling Practise- Resource and Training Manual. Saksham- TISS Mumbai (2013). Retrieved from https://www.academia.edu/22507988/Gay-Affirmative_Counselling_Practice_Resource_and_Training_Manual
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