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Forcefully changing identities and orientations: Conversion therapy or coercion therapy? 

01 Mar 2021

As the famous saying goes, “all five fingers are not the same”, and being different is exactly what makes every person unique. Uniqueness is a quality that adds value to our lives. However, the way people view each other’s differences has a lot to do with what they believe is normal and acceptable, which depends on their thought patterns and knowledge. People of diverse sexual orientations and gender identities have always existed, and have added a certain beauty to society by showing that sexual orientation and gender identity is a human quality that cannot be labelled and regulated. The lesbian, gay, bisexual and transgender (LGBT) community has become more and more visible in the past few decades, and has emerged as a strong community fighting for their rights in a majority heterosexual and cisgender society. Sri Lanka’s LGBT community has also been fighting and struggling for decades, even though general Sri Lankan society seems to be rather slow and hesitant in accepting their right to be treated equally and humanely. On top of the lack of acceptance, they face more severe issues, such as human rights violations on the basis of their sexual orientation and/or gender identity, which have further stifled their voice for equality. Among a myriad of issues faced by the LGBT community in Sri Lanka, in the last decade, “conversion therapy” has popped up from time to time, and remains unaddressed, despite activists’ attempts to get authorities to put an end to it. According to the Stonewall campaign, an international movement for the equality of LGBT persons, conversion therapy (also known as “cure” therapy or reparative therapy) refers to any form of treatment or psychotherapy that aims to change a person’s sexual orientation, or to suppress a person’s gender identity, and is based on an assumption that being LGBT is a mental illness that can be “cured”.   Conversion therapy in Sri Lanka?   Even though media reports about conversion therapy in Sri Lanka have somewhat declined in recent years, LGBT activists claim that it has not stopped, and instead, continues in various forms behind closed doors. To look into how conversion therapy takes place in Sri Lanka, The Morning spoke to several LGBT activists who have extensively dealt with such incidents. LGBT and Sexual and Reproductive Health and Rights (SRHR) activist Thushara Manoj told The Morning that in Sri Lanka, children and teenagers are more likely to be subjected to conversion therapy than adults. He said: “When a parent or a close relative gets to know that a child is an LGBT person, their first understanding of the situation is that the child in question is not normal. People tend to think that this is an illness or an addiction that needs to be cured – this is their first reaction, which is based on their wrong understanding. “The first step is based on the society’s medicalisation of sexual orientation and/or gender identity, and the first response is usually seeking medical practitioners’ assistance. Parents usually seek medical practitioners’ support to address what they believe is wrong with their LGBT child; i.e. the child’s characteristics/habits pertaining to their sexual orientation and/or gender identity, such as same-sex relationships in homosexual or bisexual children, or cross-dressing in transgender or gender nonconforming children. “Some medical practitioners including mental health professionals see this situation as a good way of earning money, and subject the LGBT person to therapy, in order to change their sexual orientation and/or gender identity, which amounts to conversion therapy.” According to Manoj, some of these medical practitioners look into the LGBT person’s history of sexual relationships and/or habits, or desires pertaining to sexual orientation and/or gender identity, and use them to “treat” them. He added that at times, these medical practitioners try to convince the LGBT persons that their sexual orientation and/or gender identity is a result of their past actions pertaining to their sexual relationships and/or desires, and that they were not LGBT before such actions. He explained: “These treatments include certain elements of counselling. There were incidents where LGBT children were given medication that are usually prescribed for neurosis – which, according to Cambridge Dictionary, is ‘a mental illness resulting in high levels of anxiety, unreasonable fears and behaviour, and, often, a need to repeat actions for no reason’ – in order to cure their situation, and it results in these children experiencing unwanted side effects of this medication.  “Even though this medication itself may not necessarily result in any positive change or cause any harm, those who prescribe it give the LGBT children and their parents the idea that the medication is supposed to help resolve the situation. However, when the medication does not help, parents usually subject the LGBT children to further verbal harassment.  “After that, parents tend to seek other forms of treatment provided by both qualified and non-qualified medical practitioners based in various parts of the island. Some of them are very famous, and some are evgen attached to leading health service providing institutions.  “In addition, when none of the medical treatments deliver the results they seek, parents go on to take their LGBT children to astrologists as well as traditional healers, who come up with various traditional healing methods such as thovila, which further harass the child.” Manoj explained that in Sri Lanka, conversion takes place in three main forms; namely, “great tradition culture” under which medicalisation of sexual orientation and/or gender identity is used; “lower tradition culture” under which traditional medicinal methods are used; and “popular tradition culture” under which dangerous and unconventional methods that do not involve western or traditional medical treatment methods, are used. He added that under the third category, various practices concerning LGBT persons’ bodies including their genitalia, and training them to behave according to their biological sex to “improve their personality”, take place. When asked whether medical practitioners’ associations have taken any step in connection with conversion therapy in Sri Lanka, he added: “In 2018, the Human Rights Commission of Sri Lanka (HRCSL), informed a leading association dealing with mental health services to look into taking steps to prevent conversion therapy, as such incidents of were being reported; however, so far, no action has been taken.” Speaking of incidents of conversion therapy in Sri Lanka, he added: “A large number of incidents of medical practitioners attempting to convert LGBT persons to heterosexual and/or cisgender persons have been reported. Some of them are not even qualified, while some of them are quite famous. “According to the information we have received, one such doctor attached to a leading hospital employs a method involving humiliation as part of his conversion therapy. He humiliates LGBT persons that go, or are taken, to him, about their sexual orientation and/or gender identity, in order to compel these LGBT persons to feel ashamed about themselves. “This method also involves talking about religion/religious beliefs, and making the LGBT persons feel that they are sinners and a burden to the society, country, and themselves, in order to convince the LGBT persons to change their sexual orientation and/or gender identity. “In some cases, making the LGBT persons feel that they are a disgrace to their families and are therefore not eligible to inherit any property from their families, were also reported. This method and a lot of other methods are not based on scientific processes; instead, they involve psychologically manipulating LGBT persons to change.” Also speaking to The Morning, Venasa Transgender Network (VTN) Executive Director Thenu Ranketh said that when it comes to conversion therapy in Sri Lanka, there is an issue of lack of awareness, adding that sometimes neither the LGBT persons being subjected to this practice, nor the medical practitioners who are performing it, are aware of its gravity or consequences. He noted that from the moment an LGBT person’s family or friends learn about his/her sexual orientation and/or gender identity until they take that LGBT person to someone who performs conversion therapy, various incidents take place within the family in order to convert that LGBT person to become cisgender or heterosexual. Ranketh added: “Sometimes, practitioners including traditional healers employ various methods, which sometimes involve physically harassing or encouraging the LGBT person to opt for various sexual acts. Sometimes, those close to the LGBT person attempt to convert him/her by molesting them.” Adding that such practices lead to various consequences, the most common one being the LGBT person being subjected to such practices experiencing mental breakdown/depression, Ranketh emphasised: “It does not always involve medical or psychological approaches. Family members of an LGBT person keep telling him/her various things with the aim of changing their sexual orientation and/or gender identity – sometimes involving shaming him/her – which is also a form of conversion attempt.  “Depression is the very first consequence, and sometimes, LGBT persons run away from their homes, which puts them in a risky situation. There are reasons to believe that conversion therapy or similar attempts are likely to cause suicides and self-harm also, even though reports in that regard are lacking.”   Is conversion therapy not a pressing issue? To inquire about steps taken or planned to be taken by medical professionals to curb conversion therapy in Sri Lanka, The Morning spoke to two leading bodies representing medical professionals, and both organisations said that they have not paid attention in this connection. Sri Lanka Medical Association (SLMA) Ethics Committee Secretary Dr. Surantha Perera told The Morning that the SLMA has not addressed the issue of conversion therapy yet, nor has it issued any sort of guidelines for medical practitioners. He also stated that for the time being, the SLMA is focused more on the Covid-19 situation in Sri Lanka, which it identifies as a more pressing issue. Government Medical Officers’ Association (GMOA) Assistant Secretary Dr. Naveen De Soysa also stated that the GMOA has not taken any decisions regarding taking steps in this connection.   A worldwide issue Even though other countries in the world can be seen progressive steps in countering this practice, conversion therapy is still a pressing issue faced by many countries, including those identified as developed countries.  A report on conversion therapy prepared by Victor Madrigal-Borloz, an independent expert on protection against violence and discrimination based on sexual orientation and gender identity, which was presented at the United Nations Human Rights Council (UNHRC) in 2020, said that in the world, a number of conversion therapy techniques are believed to be in practice, namely, psychotherapeutic, medical, and faith-based. According to the report, among the practices used in Sri Lanka are medication, people being encouraged to masturbate while fantasising about persons of a different gender, Ayurvedic, homeopathic and other traditional medical approaches, and electric shocks as an aversion methodology (subjecting a person to a negative, painful, or otherwise distressing sensations while being exposed to a certain stimulus, under the premise that the stimulus will become associated with the negative sensation). Other countries where conversation therapy is prevalent are China, Ecuador, India, Iran, Panama, Turkey, the US, Cambodia, Viet Nam, and Uganda. The report, analysing the situation of a number of countries including Sri Lanka, stated that while some of the conversion practices are directly aimed at changing sexual orientation and gender identity, others are aimed at supporting individuals to not act on their same-sex desires. It also pointed out that conversion therapy, most of the time, involves both physical and psychological methods, and that there were instances where practices of sexual violence were linked to alleged intentions of conversion.  The report also added that while the practice of LGBT persons being encouraged to masturbate while fantasising about persons of a different gender exists in countries such as Iran, Peru, Spain, and the US, certain practices involving hypnosis also exist in countries such as China, Indonesia, Iran, Kazakhstan, Panama, the Russian Federation, Sri Lanka, and the US. The report added: “The deep impact on individuals includes significant loss of self-esteem, anxiety, depressive syndrome, social isolation, intimacy difficulties, self-hatred, shame and guilt, sexual dysfunction, suicidal ideation and suicide attempts, and symptoms of post-traumatic stress disorder, as well as significant physical pain and suffering.” When it comes to conversion therapy, Iran takes a special place as a country that medically and financially assists its gender nonconforming citizens to change their sex. The country also legally recognises transgender persons, and holds the record as one of the countries that carry out the largest number of sex change surgeries.  However, LGBT activities worldwide allege that even though assisting those in need of sex change surgery is a positive move, at the same time, the Iranian Government is trying to indirectly force people to adapt to binary gender roles, i.e. male or female, and that as a result, the country’s homosexual community is at risk of being coerced to changing their gender according to social norms. Sri Lanka is a country that takes pride in its culture and tradition, and Sri Lankan tradition has always advocated loving one another, and not harassing fellow citizens on any ground. Forcing, deceiving, or threatening another person because we cannot agree with their lives was never acceptable in Sri Lanka’s culture. A non-LGBT person may not be able to perfectly understand how an LGBT person feels – but that does not matter. What matters is letting others live their lives and make their own choices.


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