In India, the LGBTQIA+ (lesbian, gay, bisexual, transgender, queer/questioning, intersex, asexual, and others) community has had a pivotal decade. Following the Delhi High Court’s original judgement in 2009 and the Supreme Court’s ultimate verdict in 2018, the legal discourse has been accompanied by considerably more societal conversation regarding the LGBTQIA+ community. In his decision on Section 377, Justice Chandrachud underlined the responsibilities of mental health practitioners in providing responsible mental health care and advocacy. There are no comprehensive statistics on the number of LGBTQIA+ people in India.
Jagruti R. Wandrekar and Advaita S. Nigudkar looked at research articles from prominent LGBTQIA+ organisations and organisations (Humsafar Trust, CREA, LABIA, and others) that are listed on their websites and databases. Studies on the mental health of LGBTQIA+ people in India piqued our curiosity. They discovered 22 reviews and reports, four viewpoints and comments, seven editorials, one conference proceeding, and sixty original publications.
Read More: Mental Health in the LGBTQIA+: A Persistent Concern
According to interviews and focus group conversations with LGBTQIA+ people around the country, LGBTQIA+ people face actual, felt, and internalised stigma. They face family-enacted violence and a lack of familial acceptance, as well as pressure to marry, aggression from peers and partners, institutional violence and prejudice in schools and workplaces, and discrimination in jobs, housing, and health-care facilities. According to one study, three-quarters of respondents felt it was critical to keep their identity hidden.
Some studies looked into the idea of ego-dystonic homosexuality, which is a common diagnosis. External attributions for discomfort were discovered in both quantitative and qualitative investigations, casting doubt on this diagnosis and suggesting that homosexual people’s unhappiness with their sexuality is mostly due to societal factors such as stigma and discrimination.
Stigma and the resulting violence and discrimination, according to participants’ accounts, may contribute to low self-esteem, sadness, suicidal thoughts, limited self-efficacy to confront abuse, and increased HIV risk.
Read More: Gender Sensitivity in Mental Health Practice
Certain factors may help LGBTQIA+ people avoid stigma and mental health problems. Researchers have collected quantitative data supporting the minority stress theory, indicating that resilient coping and social support are adversely connected with depression and stigma, and that they are mediating elements in the stigma-depression association. Peer support, familial acceptance (which is linked to lower self-stigma and more confidence in dealing with public stigma), supportive partners, and offline and online support from LGBTQIA+ communities are all examples of social support. In qualitative studies, resilient coping has been associated with agency and self-acceptance.
One study looked at how different pressures shape GLB people’s identities over time. Individuals reported experiencing gender non-conformity as a child and having it corrected by self, parents, school, and medical professionals, as well as the emergence of their sexuality, which presented unique developmental challenges such as isolation, confusion, and questions about sexuality, invisibility due to a lack of language and images of sexual diversity, denial, fear, and internalised homophobia, working out causations, and working through popular misconceptions.
Read More: Sexuality vs. Gender: What’s the Difference?
Some research looked into how many LGBTQIA+ people were out and how they felt after doing so. MSM had an average age of 19.71 years when they came out of the closet. In one study, 47 per cent of participants had mixed feelings about coming out, while 38 per cent had favourable feelings. Bisexually identified males were less likely to be out than gay men, according to two studies, and many of them passed as straight.
Intimate partner relationships were found to be significant for LGB individuals’ identity consolidation, with same-sex partnerships providing mirroring and self-affirmation. Negotiating their relationships in a heterosexual society, the need for secrecy, the continuum of loneliness, isolation, breakups, depression, and self-harm, experiences with nonmonogamy, the complexity of gender equations, exploring relationships with their bodies and sexual pleasure, and some experiences of intimate partner violence are all reported to be challenges in these relationships.
According to one survey, 23% of lesbians, 47% of gays, and 11% of bisexuals have had some form of support from their surroundings, whereas roughly 20% of lesbians, 20% of gays, and 2% of bisexuals have not been welcomed by anyone. In discussions with many LGBTQIA+ people, family acceptance came up as a major element. Various levels of family acceptance and their impact on LGBTQIA+ people have been studied.
Read More: Family Acceptance and LGBTQ+ Youth
In terms of the acceptability of homosexuality, India is in the middle, and opinions have improved with time. Acceptance, on the other hand, is still a long way off, since recent studies of heterosexual attitudes toward homosexuality have indicated ambiguous sentiments and the persistence of a variety of detrimental biases. According to one study, undergraduate medical students had indifferent opinions regarding the LGBTQIA+ community and lacked understanding about it
Cis-gay males, transgender women, and hijras have been the subjects of the most studies, while cis-lesbian women, bisexual people, genderqueer people, transmen, and asexual people have been underrepresented. The adapted minority stress model, which explains how stigma faced by various minority groups correlates to higher stress and poor mental health outcomes, is supported by evidence.
Researchers and reviewers have discussed how mental health practitioners frequently pathologise these identities, and how stigma and prejudice by health care providers frequently impede treatment access.
