Imagine meeting a doctor for a tummy ache, and instead finding yourself at the receiving end of “conversion therapy”! If you are a member of the LGBTQIA+ community, this could be a reality, and seeking professional help for your health can be an uphill task.
“The challenge begins with opening up to a doctor or counsellor — you aren’t sure if the person is homophobic, neutral or accepting”, says Dr. Prasad Raj Dandekar, a radiation oncologist and founder of Health Professionals for Queer Indians (HPQI). While judgemental professionals, who are dismissive of the patient or who hurl accusations of “sinning” are obvious red flags, Dr. Dandekar emphasises that, “You need someone who is not just compassionate, but working with you, for you”. Professionals have to understand the nuanced needs of the community, and HPQI aims to educate them on this.
Challenges aplenty
An upcoming conference by HPQI, in February, focusses on mental health issues faced by the community, and with good reason. “The queer community is one of the more marginalised within the field of mental health itself,” says Rajvi Mariwala, Director at the Mariwala Health Initiative (MHI), which funds mental health initiatives, especially those that grant access to help for marginalised persons and communities. She points to how, for a long time, homosexuality was declared a perversion and gender beyond the binary (i.e., of masculine and feminine) was pathologised. Members of the community still experience feelings of isolation and invisibility, and a fearfulness to trust those we would consider “traditional” caregivers (parents, teachers, and so on.).
Living with an identity that’s stigmatised across the board — in learning curriculum, law and in society itself — is bound to take a toll on one’s mental health. The challenge is to find a practitioner who understands this context.
Recognising this, MHI collaborated with the Tata Institute of Social Sciences (TISS) to offer a course on Queer Affirmative Counselling Practice (QACP). This aims to equip mental health practitioners, or MHPs, with a better perspective on the community, the unique life stressors that its members face, and modified approaches to traditional mental health practices.
“Unless the therapist questions his/her own idea of what constitutes “normal” and “abnormal”, the “root” of a mental health problem will be traced to the individual’s inability to cope, without looking at the monumental challenges that the individual has to cope with,” says Pooja Nair, independent MHP and a faculty member in the QACP course. She emphasises the importance of listening to and learning from queer voices. In fact, the QACP course has been designed by people who are queer and MHPs themselves.
Reaching out
Over the decades, a lot of the heavy lifting for mental health has been done — largely unfunded — by queer collectives: members of the community, reaching out to provide emotional support to their peers through difficult times, even meeting with family members. Mariwala recommends that those seeking therapy also ask their counsellor for referrals to peer support groups, so that they have other queer people to reach out to.
There is still a long way to go to enhance the quality of care to the community. “What needs to be done is changing people’s mindset,” says Dr. Dandekar. He advocates doing this early. For instance, by training medical college students, “You develop inclusive doctors who are open to learning.” Similarly, Nair views educating students — both aspiring MHPs and others — as essential. “We need to push for the institutionalising of material that comes from the margins. The textbooks do not reflect the reality.”
Says Dr. Dandekar, “I change the mindset of doctors, but in each walk of life we need to do that. Don’t wait for the activists and others to do something about it.”
The writer is a psychologist and management consultant. krithvis@gmail.com
