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Abstract
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Psychiatry has an ugly history concerning sexual orientation and gender, having previously pathologised those attracted to the same sex or who did not conform to feminine or masculine norms. After late-19th century psychiatrists attempted to explain what they saw as innate morbid conditions, early 20th-century psychoanalytic approaches viewed homosexuality as truncated psychosexual development linked to family dynamics and treatable with therapy. Behaviourism added aversion therapy to the toolkit in the 1960s, while cognitive therapists tried to change thought patterns. The position of psychiatry has long since changed--homosexuality was removed from DSM-III-R in 1987 and from ICD-10 in 1992, and minority gender identity was scaled back to gender incongruence or dysphoria. But conversion therapies are not consigned to history.
Efforts to change someone's sexual orientation or gender identity and expression (SOGIE) are not well documented, but they have been reported in at least 60 countries in all world regions. These efforts span talk therapies, prayer and religious rituals (eg, exorcism), physical deprivation, aversion therapy (eg, inducing nausea), electroconvulsive therapy, and medication. They are carried out by religious leaders, traditional healers, and private and public mental health professionals. Few of those receiving conversion therapies have sought them out themselves; many are brought by family members, driven by a combination of religion, family honour, and cultural pressure. Although various national governments are currently working towards banning conversion therapy, only five countries have a complete ban and 13 have partial bans.
The persistence of conversion therapy is intricately linked to enduring homophobia and transphobia--criminalisation remains in 71 countries. Anti-LGBTQ+ sentiment draws on different reasoning around the world, united by a sense of moral panic: a perceived threat to societal values and interests. Opposition is often based on religious ideas of a natural order or divine plan, as for US Evangelical Christian and European and South American Catholic groups. In some African countries, an LGBTQ+ agenda is seen as neo-colonialism pushed by Western countries, and anti-LGBTQ+ discourse is also framed in terms of public health and the HIV epidemic. Family values are often implicated, as in Russia, where being LGBTQ+ is portrayed as Western decadent liberalism gone too far.
Language: en |