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Addressing mental health concerns of the LGBTQ community 

08 Dec 2021

The LGBTQ community in Sri Lanka are a group of marginalised persons who are unfortunately forced to endure consistent discrimination at the hands of varying service providers and authorities.  However, while the community continues to suffer greatly at the hands of medical professionals, and other state officials whom are sworn to protect the general public, there have been small glimmers of hope shining through on occasion, and one such situation is the “Sex and Couple Therapy Clinic with a Special Focus on LGBTQ Community” at the National Institute of Mental Health (NIMH).  A discussion was held by the NIMH on the topic of “Addressing the Mental Health Concern of LGBTQ Community” yesterday (7) at the Deeghayu Day Centre, NIMH, where they shed some light on the current concerns and challenges experienced by the medical professionals in providing the necessary services for the LGBTQ community.  The discussion featured NIMH Senior Consultant Psychiatrist Dr. Kapila Ranasinghe, who was instrumental in the current circular that allows transgender persons to change their identification via the Gender Recognition Certificate, i.e. the GRC.  Addressing the role of the mental health professional in gender dysphoria was NIMH Senior Registrar Dr. Piyumi Ranwella and talking about the mental health facilities available for the LGBTQ community was NIMH Senior Registrar Dr. Indu Maheshika. Moreover, a brief discussion on service provision at the Navodaya Treatment Centre was conducted by Navodaya Medical Officer in Charge (MOIC) Dr. Nadeera Attanayake. Additionally, there was a brief presentation on the importance of safe sexual practices by the national STD/AIDS control programme.  The discussion opened the floor for clarification of a number of concerns that the community has been experiencing, with one primary concern being that often when the LGBTQ community, more specifically the trans community are addressed, they are often spoken of in the sphere of sexual health. One of the community members expressed that while at the very beginning of the struggle this was a method in which trans issues were able to get addressed, however, the continued inclusion of transgenderism amidst sexual health and the various sexually transmitted infections and their many consequences is outdated.  They shared that it is time that trans issues were discussed in a more holistic manner, adding that trans persons experience a spectrum of social, political, and medical concerns, just like any other individual, and it is time that they are discussed in this way.  Yet another concern which was raised was the matter of acquiring consultation from the state institute. It was shared that as of right now, all the clinic dates have been booked and because of their limited resources and very few trained doctors, they are unable to accommodate the sheer demand of LGBTQ persons, especially trans persons looking for mental health consultations, particularly in order to begin their process of transitioning and also to acquire their legal documentation so they may live as they were meant to.  It is important to note that there was a general concern of “gatekeeping” by the NIMH doctors with regard to trans persons’ documentation and even the gender reassignment surgeries. Considering that no private medical professional is allowed to carry out these diagnoses, however, it was assured by Dr. Kapila Ranasinghe that the matter remains a sensitive issue and they must tread carefully and so, because they do not wish to ruffle any feathers at the Ministry, they have not been aggressive in their demands. However, he assured that post-Covid-19, they hope to further expand their efforts to diversify these services so that more and more people can have access to them.


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