Conversations about Queer Perspectives on Mental Health are an important reckoning moment in the history of the psy-disciplines alongside Mad Pride, deinstitutionalization, and other survivor-based movements. It is an opportunity to undo the damage of the past and set out on a journey to see how social inequality affects mental health – that we are not individuals living in bubbles, untouched by social structures.
The mental health establishment has been complicit in pathologizing various ways of being and offering cures for what is not disease. As societal norms treat cis-heterosexual relationships as “normal,” mental health disciplines have also joined in labeling anything outside of that as “abnormal.” There is a long tradition of labeling LGBTQ+ identities as a pathology or disease and offering “treatments” to transform them into socially acceptable heterosexual cis people. The history of so-called “conversion treatments” (attempts to change gender and sexual orientation) is violent and shameful.
The historical pathologization of mental health has also meant that at some point in their life a person from the LGBT+ community will be “taken” to the clinic by family or end up there themselves to understand the need of making a living fraught with stigma and discrimination.
The mental health facility in India had previously operated in the shadow of Section 377 of India’s Penal Code, which was interpreted to criminalize same-sex relationships. Legal and societal sanctions have created a whole range of difficulties for the queer community in India. Following the removal of Section 377, more and more mental health practitioners are reaching out to the queer community and wanting to know how they can support them.
It is encouraging that practitioners today are happy to grapple with this troubled story in hopes of doing better. This article will try to provide some pointers on how to start this journey.
First, it is important to recognize that existing mental health curricula and training are insufficient to support the LGBTQ+ community. Ironically, it’s easier to find a practitioner who offers “healing” to a queer person than it is to find someone who doesn’t.
Second, this recognition then requires a commitment to address the social conditioning of gender and sexuality. This process of unlearning is ongoing as we are all drilled with notions of acceptable sexuality, gender, and relationship formats. This type of social training is quite effective, and we realize how deeply we hold these beliefs when we start questioning ourselves. The work required deep reflection on our response to non-normative genders and sexualities.
Once the practitioner recognizes the need to unlearn social notions of “normal”, it is important to begin the knowledge gathering process, as the mainstream does not know much about LGBTQ+ life and communities. It is crucial that the source of knowledge is not mainstream, which only stigmatizes and stereotypes. The source of knowledge should ideally be the lived reality of individuals who have struggled because the world has not accepted them for who they are. The Queer Affirmative Counseling Practice Resource Book can be a good starting point for practitioners. It was written by psychologists who are themselves queer and have been involved in teaching, teaching and educating in the fields of mental health, gender and sexuality for many years. The resource book is the result of a course called Queer Affirmative Counseling Practice (QACP), a pioneering capacity-building initiative for practitioners.
Finally, being Queer Affirmative means that the practitioner understands how social structures and inequality affect mental health. One can hardly expect an ideal state of well-being from an individual who is constantly viewed as unworthy. The mental health costs of such a life are immense. It is not only queer identities that are pathologized in mental health, but also the effects of living in discrimination. Everyday discrimination does not make for rosy mental health.
The other reason to be queer positive is that those on the fringes need multiple forms of support systems to survive in this hostile world. Mental health or counseling support goes a long way in helping queer people cope with everyday stressors that come with being queer. These are often people who were thrown out of their birth families because of their identity. They lose friendships, livelihoods and even homes because of their queerness. We’re not saying that mental health support can make up for these losses, but at least it provides a safe space to cope with them.
The views expressed above are the author’s own.
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