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According to a Supreme Court judgement, nobody can be forced to undergo ‘any form of medical or psychological treatment...based on sexual orientation and gender identity’. (Photo: Getty Images)
According to a Supreme Court judgement, nobody can be forced to undergo ‘any form of medical or psychological treatment...based on sexual orientation and gender identity’. (Photo: Getty Images)

The pain and cruelty of ‘conversion therapy’

Even today, the illegal method of ‘conversion therapy’ is used against LGBTQ+ people in India. A young queer woman’s suicide shines a harsh light on such practices

Hi, I am Anjana Harish. You might know only some of my story, I have come live today to tell you what has been going on."

On 13 March, 21-year-old student Anjana Harish posted a video on Facebook alleging over two months of physical and mental abuse at two de-addiction centres in Kerala. In painstaking detail, Harish—who had only recently told her family she was bisexual—narrated her ordeal, which started when she was bundled into a car at the Kannur railway station by her family and some others. She was taken to Coimbatore, where she was assaulted and sedated, and woke up to find herself in a de-addiction centre in Palakkad. After three weeks of isolation in a cell, which she left only during mealtimes, she was taken to another centre in Thiruvananthapuram. She claimed she had been given over 40 injections as well as heavy medication at this centre, leaving her physically and mentally traumatized. “My own family did this to me, that’s what saddens me the most," she says in the video. “The ones who were supposed to protect me tortured me so much."

Two months later, Harish was dead. She had been in Goa since mid-March—a short break with three friends that was extended indefinitely because of the lockdown. On 12 May, her friends realized they hadn’t seen her in over an hour and began a search. They found her body. “The cause of death has come as asphyxia due to ante-mortem hanging," North Goa superintendent of police Utkrisht Prasoon told independent news website The News Minute. “Suicide due to hanging."

Suicide is a complex phenomenon and it’s inadvisable to try and ascribe any single cause or trigger. But it’s hard to imagine that the months of alleged abuse—purportedly in an effort to “cure" her of bisexuality—did any good to Harish’s mental health. “When she came back, she was on 800mg of medication usually prescribed for epilepsy or bipolar disorder," says her friend Gargi Harithakam, adding that Harish had been seeking treatment for depression before she was taken to the de-addiction centres. “Emotionally, she was very broken. This depressed and suicidal girl was put in a cell where she cried herself to sleep every night." The director of Kanurasai—the second de-addiction centre Harish was taken to—says she was admitted for cannabis and alcohol de-addiction, and had responded well. “At the time of admission, she was craving for cannabis," says L.R. Madhujan, when asked about Harish’s claim that the treatment was aimed at changing her sexual orientation. “But after her withdrawal period, she was very happy to stay here."

Harish’s death has put the spotlight on the prevalent—but largely undocumented—practice of so-called “conversion therapy", an umbrella term for a diverse set of dangerous and discredited pseudo-scientific “treatments" aimed at changing a person’s sexual orientation or their gender identity. These can range from counselling, medication, institutionalization and hormone injections to rare but extreme methods like electro-convulsive therapy and hormonal castration. Outside the clinical context, there are any number of spiritual godmen and gurus who claim to “cure" homosexuality, usually through prayer, physical violence and mental conditioning.

“These (practices) are all rooted in the belief that you can change your sexuality," says Raj Mariwala, director of the Mariwala Health Institute, which aims to make mental health services accessible to marginalized communities. “They normally coexist with abuse and pressure faced by the individuals within their families. This sort of coercion and violence can have huge mental health consequences, including internalized homophobia, self-hate, depression and suicidal ideation."

*****

The history of “conversion therapy" is almost as old as that of psychiatry itself. Sigmund Freud’s contemporaries were already pathologizing homosexuality as a mental illness in the early years of the 20th century, with a number of inhumane—often excessively cruel—methods deployed as “gay cures". Notably, mathematician and computer scientist Alan Turing was forced to undergo chemical castration in the UK in 1952 for “gross indecency", i.e. a homosexual relationship. The man who played a crucial role in cracking Nazi Germany’s codes during World War II died two years later, apparently committing suicide.

LGBTQ+ activism in the wake of the Stonewall riots of 1969—demonstrations against police brutality that catalysed the gay liberation movement—forced the American Psychiatric Association (APA) to remove homosexuality from the 1973 edition of the Diagnostics And Statistical Manual Of Mental Disorders (DSM), though it took a few more decades of activism for the APA and other influential mental health institutions to categorically disavow “conversion therapy". Indian psychiatry, however, didn’t get the memo.

The 1983 issue of the Indian Journal Of Psychiatry, the official publication of the Indian Psychiatric Society (IPS), includes a study of the “treatment" of six LGBTQ+ individuals conducted at the All India Institute of Medical Sciences (Aiims), Delhi. The study involved showing the subjects sexually stimulating photographs of the same sex and the opposite sex, in a form of “aversion therapy" startlingly similar to the Ludovico technique from A Clockwork Orange. For the same sex pictures, the subjects were given electrical shocks in order to induce aversion, while pictures of the opposite sex were positively reinforced through music and/or perfume. This “successful" experiment, which involved Aiims and the IPS, was as mainstream as they come.

It was only in 2014 that the IPS came out with its first “position statement on Homosexuality", declaring that same-sex sexuality was not a psychiatric disorder and there was no evidence sexual orientation could be altered by treatment. Even this statement was in response to former IPS president Indira Sharma’s controversial remarks about homosexuality, terming it “unnatural", to a newspaper. The IPS reiterated its stance in 2018, after the Supreme Court read down section 377 of the Indian Penal Code and decriminalized homosexuality.

However, as the Anjana Harish case makes clear, doctors and mental health professionals continue to offer such so-called treatment. In 2015, Mail Today ran an expose of doctors and psychiatrists who claimed to “cure" homosexuality through medication, hormone replacement therapy, even electric shocks. For years, LGBTQ+ organizations have campaigned against psychiatrists and psychologists who continue to claim they can change sexual orientation. In the last week of May, immediately after several mental health organizations released statements condemning the practice, a prominent Tamil Nadu psychiatrist, Dr Shalini, posted a video on YouTube linking homosexuality to child sexual abuse and promoting “conversion therapy". The video has now been taken down. Dr Shalini denies these allegations, saying she isn’t curing “homosexuality" but the fetishes and activities “learned" by children who have been sexually abused. “The video was about a young man who wanted to overcome his child sexual abuse," she says. “I was explaining to him about his choices and how neuroplasticity favours him." However, there is no conclusive evidence of a causal link between abuse and sexuality; such theories can provide a seemingly legitimate cover for “conversion therapy" practitioners.

“Even in the conversation about conversion therapy that we started after the death of Anjana Harish, we saw that plenty of mainstream mental health practitioners claimed that this actually doesn’t happen," says Mariwala. “But the reality is that this happens to a lot of people and we have heard testimonies from a whole lot of people. It’s an open secret."

*****

“For two years I tried to convince my mother that I have a female soul," says Shreya Reddy, a trans-woman activist who works as a training officer for LGBTQ+ rights NGO Humsafar Trust. Reddy was only 12 when her mother—convinced she was possessed by an evil spirit—started taking her to the dargah at Reay Road in Mumbai where she would be beaten in an effort to exorcise the spirit. The baba also prescribed water mixed with the ash of an incense stick, to be drunk three times a day. “I would pray for a miracle to turn me into a woman," says Reddy. “The beatings went on for three-four weeks but obviously nothing changed."

Reddy’s mother then took her to a government hospital, where a psychiatrist started giving her testosterone injections. “I was bleeding from my nose and my ears, it burned when I peed," she remembers. “I sunk into loneliness, depression, anger. I ran away from home and joined a hijra community. I was 13 years old at the time."

Reddy now works to ensure that LGBTQ+ individuals don’t have to undergo the struggles and traumatic experiences she did. The Humsafar Trust often receives complaints from LGBTQ+ individuals on its helplines.

“Just six months ago, we had a similar case in which a person in Delhi came out to their family about their sexual orientation and then they insisted he go to conversion therapy," adds her colleague Tinesh Chopde, an advocacy manager at the Humsafar Trust. “Thankfully, we managed to intervene with the parents and connected him to a queer affirmative counsellor in Delhi. But it’s a very common reaction when an individual comes out to family, their first instinct is to ‘cure’ this."

The Humsafar Trust and other NGOs are aided in their efforts by the significant progress in LGBTQ+ awareness and legal protections over the last few years. The first milestone is the Mental Healthcare Act of 2017, which makes it illegal to treat an adult without their express consent, or that of a nominated representative in case they can’t give informed consent. It also prohibits mental health professions from prescribing medicines or performing treatments “not authorised by the field of his profession".

The Supreme Court’s judgement in the case of Navtej Singh Johar v. Union of India also discouraged “conversion therapy", while in the National Legal Services Authority v. Union of India (Nalsa) case, the court declared that nobody could be forced to undergo “any form of medical or psychological treatment…based on sexual orientation and gender identity". In the absence of a specific law banning “conversion therapy", these Acts and judgements can be interpreted to argue that such practices are illegal and discriminatory. In the wake of Harish’s death, a number of organizations are working to put that interpretation to the test.

In Kerala, LGBTQ+ community organization Queerala has started putting together a list of doctors and healthcare centres that practise “conversion therapy", based on information from members of the community. The initiative hopes to use the list to lobby with state medical authorities to crack down on these practitioners.

“We are in touch with the Kerala chapter of IPS," says Rajashree Raju, a board member at Queerala. “We are also going to share the list with IACP (Indian Association of Clinical Psychologists). We are hoping that they send emails to the doctors/centres on the list with their position on conversion therapy and repercussions on breaking the rules."

The Queerala initiative has met with some early success. On 28 May, the Kerala chapter of the IPS released a statement saying that “offering conversion therapy… amount(s) to human rights violation [sic] and may invite legal action". Queerala has also inspired others, such as the Law Schools’ Queer Alliance (LSQA), which has 84 members from 32 law schools across the country. The LSQA plans to take the initiative nationwide and push medical councils and state mental health boards to take action against their members. It is also exploring the possibility of a judicial intervention.

*****

Alongside legal efforts, activists and organizations are working to sensitize mental health professionals to the needs of LGBTQ+ patients. The Mariwala Health Initiative, for example, offers a certificate course in queer affirmative counselling practice for mental health professionals. Another such initiative is the Health Professionals for Queer Indians (HPQI), co-founded by Prasad Dandekar, head of radiation oncology at the Sir H N Reliance hospital in Mumbai. The HPQI organizes seminars and conferences to train students and professionals in queer-affirmative practice.

But until comprehensive changes are made to medical education curricula that still stigmatize LGBTQ+ identities, the struggle remains an uphill one.

“When I started HPQI, I tried to put together a vetted list of queer-friendly mental health practitioners," says Dr Dandekar. “The last person I called was a senior psychiatrist from Coimbatore. He told me that he works a lot with the LGBT community and that he has gotten so many of them married. Now this is a man who genuinely thinks he’s helping people by getting gay men married to women. That’s the level we are at."

The biggest challenge, however, lies in changing social and cultural attitudes to LGBTQ+ persons. The demand for such “therapies" is driven by ignorance and fear—of social censure, of the idea that their children may not get married or enjoy a decent quality of life. The prevailing notion that being queer is an abnormality drives families to take drastic measures to “normalize" their children. These fears are often reinforced by media and political discourses that continue to demonize queer sexuality.

Many of these factors were at play in the Anjana Harish case. According to Harithakam, Harish’s abduction was aided by a fringe radical group called the Hindu Democratic Front, a claim that is confirmed by the group’s Facebook page. When Harithakam—along with members of Sahayathrika, an LBT community organization that Harish was in touch with—tried to file a missing person complaint, the police responded with threats and derision. And in the days following her death, local news channels in Kerala gave a platform to individuals who claimed that Harish’s attempted “conversion" was legitimate, and put the blame on her friends in the queer community instead. As long as that sort of rhetoric remains mainstream and acceptable, the fight against “conversion therapy" will be an herculean task.

“We have won some legal rights now, which is very important," says Sahayathrika founder Deepa Vasudevan. “But we still have a lot of work to do in terms of having people understand that people’s sexuality and their personal choices need to be respected. We have been doing this kind of intervention for 10-15 years and just having it be a public discussion, having everyone understand what’s happening, has taken such a long time."

Bhanuj Kappal is a Mumbai-based writer.

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