Asian homosexuals experience higher level of suicidal ideation: Child/adolescent psychiatrist

• Cites alienation due to low communal/social tolerance, perceived burden of sexual identity

By Ruwan Laknath Jayakody

Homosexual individuals in Asian countries have a higher level and burden of psychological distress and suicidal ideation compared to heterosexuals in the same context, due to the alienation associated with the low tolerance of communal social differences, as well as the perceived burden with regard to the sexual identity of these groups, a local child and adolescent psychiatrist observed.

This was noted by M. Chandradasa (attached to the Kelaniya University’s Medical Faculty’s Psychiatry Department) who cited S. Kim and E. Yang’s “Suicidal ideation in gay men and lesbians in South Korea: A test of the interpersonal psychological-model”, in a letter to the Editor of the International Journal of Social Psychiatry titled “Suicidal ideation in gay adolescents in the context of cultural stigma and criminalised homosexuality in Sri Lanka” which was published in said Journal’s 65th Volume’s First Issue in 2018.

As D. Jayasundara mentions in “Clients’ motives and justifications for visiting sex workers in Sri Lanka”, lesbian, gay, bisexual, and transgender (LGBT) rights have remained stagnant since the colonial era. In addition, homosexuality is illegal in Sri Lanka. Section 365 of the Penal Code, which deals with what it terms an “unnatural offence”, makes it an offence to “voluntarily have carnal intercourse against the order of nature with any man, woman, or animal”, and notes that upon conviction, it is an offence that carries a maximum term of imprisonment of 10 years and a fine. If said offence is committed by an adult on a minor (below 16 years in this instance), he/she shall be punished with a maximum term of rigourous imprisonment of 20 years and a fine, and court-decided compensation to the victim, according to the same Section.

However, according to K. Silva, T. Sivayoganathan and J. Lewis’s “Love, sex and peer activity in a sample of youth in Sri Lanka”, male-to-male sexual contact has been found to be common, with nearly two-thirds of men reportedly having engaged in same-sex sexual behaviour. Chandradasa further observes that the majority of boys do not, however, continue this behaviour, and function as heterosexuals during adulthood. A.J. Nichols notes in the “Intersections of gender and sexuality in Police abuses against transgender sex workers in Sri Lanka” that persons with same-sex orientation face significant abuse during their lifetimes. Also, A. Wipulasena points out in “The battle against homophobia in Sri Lanka” that the media portrayal of homosexuality in Sri Lanka has been, for the most part, derogatory.

According to the World Health Organisation (WHO), in 2015, Sri Lanka had the highest age-standardised suicide rate (34.6 per 100,000). As Chandradasa explains, the majority of suicides and acts of self-harm take place due to conflicts with intimate parties and family members. J. Marecek’s “Young women’s suicide in Sri Lanka: Cultural, ecological and psychological factors” points out that such is, for the most part, driven by feelings of anger, humiliation, frustration, and desire to strike back against perceived wrongful treatment.

Owing to the social discrimination faced by homosexuals in the Sri Lankan context, Chandradasa is of the view that it is highly likely that they are faced with a higher burden of psychological distress and suicide ideation, with the media rarely reporting experiences of harassment and suicide attempts related to sexual orientation and being forced into heterosexual marriages. The Immigration and Refugee Board of Canada claims that homophobia is rampant and that families may disown and force out homosexuals, thus leading to their further alienation by society, which in turn leads to their opting to die by suicide due to unbearable distress. Even though J.C. Gonsiorek’s “The empirical basis for the demise of the illness model of homosexuality” has noted that the illness model of homosexuality has been discarded, it is however, not uncommon to see Sri Lankan parents demanding psychiatric treatment for children with a homosexual orientation.

Chandradasa mentions that as in India, the British made homosexuality a criminal offence in Sri Lanka in 1883 under Section 365 of the Penal Code. However, the majority of European countries that considered homosexuality an offence have now legalised same sex marriages. India, thanks to a ruling by the Supreme Court (SC) which overturned the colonial era law which made gay sex illegal, has legalised gay sexual relationships. In Obergefell vs. Hodges, the SC of the US allowed the fundamental right to marry for same sex couples under the same terms and conditions applicable to opposite sex couples, and with the same accompanying rights and responsibilities afforded and affiliated to them.

In conclusion, Chandradasa points out that there is an opportunity for Sri Lanka to follow the path of India to restore legal equality in terms of sexual expression, and therefore called for the psychiatrists and health professionals to make a collective recommendation to the Justice Ministry.

Recently, the country’s psychiatric community called on the relevant authorities to decriminalise homosexuality by abolishing/repealing Section 365 of the Penal Code, which states that homosexuality is a criminal act.

The Sri Lanka College of Psychiatrists (SLCP) said in a media statement that the lifestyle choices of the LGBT, intersex, and queer/questioning (IQ) community should be respected and not discriminated against. The SLCP had not, however, clarified their use of the term “lifestyle choices”. However, it has also been noted in medical literature that there is scientific evidence to the effect that being LGBTIQ is a naturally-occurring, partially biologically inherent phenomena, the same as is the case with heterosexuality, and therefore is neither entirely a choice nor a lifestyle.

The SLCP categorically stated that they do not endorse the view that homosexuality is due to a disease of the mind or the body, as modern-day psychiatrists do not identify or diagnose homosexuality as a mental health disease or treat it as such, since the myth that homosexuality is a mental illness is not in keeping with evidence-based science practised by its membership.

However, Justice Ministry Secretary P.K. Mayadunne told The Morning that as of now, there are no plans to repeal or amend this Section of the Penal Code. “This is a decision that requires the consideration of the relevant facts and requests made in this regard,” he noted.

If you feel that you or someone you know may be dealing with mental health issues and/or suicidal thoughts, the following institutions would assist you.

The National Institute of Mental Health: 1926

Sri Lanka Sumithrayo: 0112 682 535

Shanthi Maargam: 0717 639 898

Courage Compassion Commitment (CCC) Foundation: 1333