Lesbian, gay, bisexual, and transgender sexual and gender identities should be classified as mental illnesses, according to a new classification made by the leading psychiatric organization in Indonesia.
“We really do care about them,” Suzy Yusna Dewi of the Indonesian Psychiatrists Association told the Jakarta Post. “What we are worried about is, if left untreated, such sexual tendencies could become a commonly accepted condition in society.”
Dewi denied the overwhelming scientific evidence that sexual orientation and gender identity are rooted in an individual’s biology, and said that they could be modified through social interactions. Giving credence to the widely discredited practice of sexual conversion therapy, she said that individuals’ sexualities and genders could be shifted in the way that drug addicts can be treated, but said that the process requires a high degree of vigilance.
“Without constant intervention, a person can easily return to their previous sexual tendency once he or she experiences withdrawal,” Dewi said.
This belief that sexual orientation and gender identity can be shifted through therapy is one that a group of American psychiatrists is actively trying to combat on a global scale.
Although the World Health Organization (WHO) removed homosexuality from its list of psychiatric disorders in 1990, it still relates several psychological disorders to an individual’s LGBT identity.
The WHO’s International Classification of Diseases (ICD) is the most widely used diagnostic reference in the world, and yet it still includes mental illnesses that are tied directly to sexual orientation and gender identity.
Among them is “sexual maturation disorder.” Based on an outmoded Freudian theory that considers homosexuality a symptom of a lack of proper sexual development, the disorder relates a patient’s “uncertainty about his gender identity or sexual orientation” as the cause of anxiety and depression.
“It is not justifiable from a clinical, public health or research perspective for a diagnostic classification to be based on sexual orientation,” a group of mental health professionals wrote in a recent report calling on the WHO to remove homosexuality and gender identity-related classifications from the ICD.
The group, which is headed by Susan Cochran, a Los Angeles-based epidemiologist, says its appeal for the WHO to edit the ICD stems from human rights principles as well as the views of most major psychological organizations, including the American Psychological Association, which no longer see homosexuality itself as a mental disorder.
The group also noted that “a variety of factors, including social environmental stressors and cultural norms,” especially in regions of the world where homosexual and transgender people might face a great deal of stigma, can “lead to psychological experiences and behaviors that do not necessarily reflect an underlying disorder.”
Treating anxiety or depression as a symptom of a patient’s sexual orientation or gender identity, the group argues, implicitly pathologizes them for being LGBT instead of addressing their anxiety and depression on their own.
By doing so, WHO has left the door open to sexual conversion therapy as a way to address the mental illnesses that it’s associated with LGBT identities.
Following the recommendation by Cochran and her colleagues, the WHO has agreed to perform field tests in several countries to decide if the new criteria will empower clinicians to make more accurate diagnoses. The task won’t be easy, since LGBT people face such immense stigma around the world. Homosexuality is still a criminal offense in 80 countries.
Although Indonesia isn’t one of them, one state, Aceh, criminalized homosexual relations in 2014. That deeply conservative part of the country passed a law that makes same-sex intimacy punishable by 100 strokes of a cane.
“The law is to safeguard human dignity,” Syahrizal Abbas, a provincial authority on Islamic law told AFP. “It is to protect Aceh’s Muslims from committing immoral acts.”
That sounds an awful lot like the justification Suzy Yusna Dewi of the Indonesian Psychiatrists Association gave for the decision to diagnose homosexual and transgender people with mental illnesses.
“We must respect Indonesian traditions, which culturally do not accept same-sex marriage, and we should not bow to the influence of foreign values that may not fit in with our values,” she said.