Homosexuality is not a medical disorder

Yesterday, the Indian Psychiatric Association issued a statement saying that “In the opinion of the Indian Psychiatric Association, homosexuality is not a psychiatric disorder. This is in line with the position of the American Psychiatric Association and the International Classification of Diseases of the World Health Organization which removed homosexuality from the list of psychiatric disorders in 1973 and 1992 respectively. The IPS recognises same sexuality as a normal variant of human sexuality much like heterosexuality and bisexuality. There is no scientific evidence that sexual orientation can be altered by any treatment and that any such attempts may, in fact, lead to low self-esteem and stigmatisation of the person.”

We agree with this statement of the Indian psychiatric Association.

Section 377 ‘Unnatural offences’ of the Penal Code of India, instituted way back in 1860, criminalizes private consensual sex between adults of the same sex. It states, “Whoever voluntarily has carnal inter­course against the order of nature with any man, woman or animal, shall be punished with 1[imprisonment for life], or with impris­onment of either description for a term which may extend to ten years, and shall also be liable to fine. Explanation.—Penetration is sufficient to constitute the carnal intercourse necessary to the offence described in this section”.

Section 377 thus criminalized homosexuality, which has led to discrimination and stigma against persons engaging in homosexual acts.

Medicine and psychiatry employ terms like homosexuality, heterosexuality, bisexuality and trans-sexuality to encompass all related issues, while current social usage argues for lesbian, gay, bisexual and transgender (LGBT), which focuses on identities (Indian J Psychiatry. 2012 Jan-Mar; 54(1): 1–3)

We also attempted to find out prevalence of homosexuality in the society.  

Alfred C Kinsey et al first reported on homosexual experiences among men in the US in their report “Sexual behavior in the human male” published in 1948. Recent studies have shown that internationally the prevalence of homosexuality ranges between 5-10%. Although there are no official demographics for the LGBTQ population in India, there were about 2.5 million gay people, but only self-declared, in India, according to data submitted by the Govt. to the Supreme Court in 2012 (Wikipedia).

Is homosexuality a mental disorder?

Prior to 1973, homosexuality was included in the Diagnostic and Statistical Manual of Mental Disorders as a mental disorder. But in 1973, following a review of scientific evidence, the American Psychiatric Association (APA) determined that homosexuality was not a mental disorder or illness and passed a resolution to this effect “by itself, homosexuality does not meet the criteria for being a psychiatric disorder.” Homosexuality was removed from the DSM in 1973.

The Preamble of the APA position statement on therapies focused on attempts to change sexual orientation (reparative or conversion therapies) published in 2000 says, “In December of 1998, the Board of Trustees issued a position statement that the American Psychiatric Association opposes any psychiatric treatment, such as "reparative" or conversion therapy, which is based upon the assumption that homosexuality per se is a mental disorder or based upon the a priori assumption that a patient should change his/her sexual homosexual orientation. In doing so, the APA joined many other professional organizations that either oppose or are critical of "reparative" therapies, including the American Academy of Pediatrics, the American Medical Association, the American Psychological Association, The American Counseling Association, and the National Association of Social Workers.”

The World Health Organization (WHO) also removed homosexuality from its ICD classification in 1992 in ICD-10, which states that “sexual orientation by itself is not to be considered a disorder” (Bull World Health Organ. 2014;92:672–679). 

Both the APA and WHO have recognized homosexuality as a natural variant of human sexuality and not a disease or illness to be treated.

Homosexual behavior has since then been decriminalized in many countries.

In 2009, the Delhi High Court had decriminalized homosexuality in its judgement in Naz Foundation vs Govt. of NCT of Delhi, which was overturned by the Supreme Court in 2013. In 2016, the Supreme Court agreed to reconsider its judgement passed in 2013.

A five-judge constitution bench of the Supreme Court of India is presently reviewing Section 377 and hearing petitions seeking to decriminalize homosexuality.

This ruling of the Supreme Court of India will be crucial, especially in light of its judgement on right to privacy as a fundamental right and the future of many is at stake.

Dr KK Aggarwal

Padma Shri AwardeeVice President CMAAOGroup Editor-in-Chief IJCP Publications

President Heart Care Foundation of India

Immediate Past National President IMA