More than 45% of LGBTQIA+ persons in Kerala have been subjected to conversion therapy (a practice that claims to 'cure' queerness), revealed a recent study that was part of a thesis submitted by Dr Sreya Mariyam Salim, who is doing her Post Graduation in Psychiatry at the Government Medical College, Thiruvananthapuram. The study, conducted with the help of Queerythm, a welfare organisation for queer persons, collected details such as the source that prompted them to undergo conversion therapy, the person who performed the procedure, and the method used. Questions also assessed symptoms of depression and anxiety, and ideation of self-harm and death by suicide.
Sreya, guided by Dr Lallchand Anilal and Dr Anil Prabhakaran, found that those who underwent Sexual Orientation Change Efforts (SOCE), commonly known as conversion therapy, suffered from severe distress and may need mental health support. She said that the study faced several limitations as it was done during the peak of the COVID-19 pandemic. Of the 130 participants interviewed for the study, 45.4% said that they had been subjected to conversion therapy. In other countries like the US and Canada, it is only between 3-7%. It was found that cisgender men (48.5%) are more likely to have a history of conversion therapy than cisgender women (28.5%). Most of the participants who had undergone conversion therapy were in the age group of 21-30. The study also recorded two participants who were subjected to it after the age of 60. In the case of those who had multiple experiences of conversion therapy, the first one would have happened before they were 20. The study also found a significant impact of religiosity on conversion therapies.
“The strictly conformist framework of Indian society and the social stigma associated with gender and sexual minorities,” the study said, could explain the high incidence of conversion therapy. Sreya said that her research on the practice was prompted by the absence of studies on the prevalence and effects of conversion therapy. "We could not find a study in the Indian context, though we had heard of cases of the LGBTQIA+ community being subjected to conversion therapy," she said. A survey by the market research company Ipsos (2021) had found that 17% of the Indian population identify as not being heterosexual. "The participants in our study had social media access and were helped by support groups. On the ground, the number of persons subjected to conversion therapy may be a lot more," Sreya said.
While conversion therapy is not banned in Kerala, an ongoing case at the High Court, in a petition filed by the welfare organisation Queerala, has demanded that the procedure be banned, and guidelines for therapy for queer persons be put in place. In December 2021, the High Court asked the Kerala government to form guidelines to prevent conversion therapy. Meanwhile, the Supreme Court had, in early February, stayed a High Court order in another case that asked a lesbian woman to undergo conversion therapy. In neighbouring Tamil Nadu, the government has issued a notification warning disciplinary action against attempts at conversion therapy.
The participants revealed that conversion therapies were mostly performed by doctors, psychologists, and/or religious leaders. "We found that there is a significant involvement of doctors. At least 30% of the procedures were done by professionals," Sreya said. Even mental health professionals are known to influence queer persons to take conversion therapy. The study said, "The most common method of conversion therapy meted out was psychotherapy. According to the global prevalence report on conversion therapy, methods used for SOCE are broadly categorised into psychotherapeutic, medical, faith-based, and punishment-based (Adamson et al., 2020). In our study, other methods of SOCE, such as forcing oneself to develop heterosexual interest, prayer, medicines, surgery, and hormone therapy, too were reported."
While it is known that conversion therapy is often forced on LGBTQIA+ persons by family members, the study revealed that 47.5% of it is self-prompted. "There is a lot of internalised stigma, formed from the pressures of the society and family," Sreya explained. High religiosity also seemed to lead to these procedures.
Analysing the mental health effects of the procedure on queer persons, the study found severe distress in more than 25% of the participants, and very severe distress in 39%. However, it could not find a conclusive relation between symptoms of depression or anxiety and a history of conversion therapy. But the study said that this could be due to the small sample size. "We found wishes of death and self-harm to be more prevalent among those who had undergone conversion therapy, but the difference was not statistically significant," it added.
The study stated that legislative action is vital. Apart from providing support to survivors of conversion therapy, the study suggested that Queer Affirmative Clinical Practice be included in the curriculum for medical professionals and that interventions should include persons from the community and professionals.