Explained | The ban on conversion therapy for the LGBTQIA+ community

What is the National Medical Commission directive to State Medical Councils? Why is the therapy considered to be dangerous?

The story so far: The National Medical Commission (NMC), the apex regulatory body of medical professionals in India, has written to all State Medical Councils, banning conversion therapy and calling it a “professional misconduct”. In a letter dated August 25, it also empowered the State bodies to take disciplinary action against medical professionals who breach the guideline. The letter said the NMC was following a Madras High Court directive to issue an official notification listing conversion therapy as a wrong, under the Indian Medical Council (Professional Conduct, Etiquettes and Ethics) Regulations, 2002.

Conversion or reparative therapy is an intervention aimed at changing the sexual orientation or gender identity of an individual with the use of either psychiatric treatment, drugs, exorcism and even violence, with the aim being to make the individual a heterosexual. The conversion therapy umbrella also includes efforts to change the core identity of youth whose gender identity is incongruent with their sex anatomy. Often, the therapy is offered by quacks with little expertise in dealing with the issue. According to the American Academy of Child and Adolescent Psychiatry (AACAP), the interventions under conversion therapy are provided under the false premise that homosexuality and diverse gender identities are pathological. “They are not; the absence of pathology means there is no need for conversion or any other like intervention.” Further, according to AACAP and other health experts, conversion therapy poses the risk of causing or exacerbating mental health conditions, like anxiety, stress and drug use which sometimes even lead to suicide.

On June 7, 2021, Justice N. Anand Venkatesh of the Madras High Court gave a landmark ruling on a case he was hearing about the ordeal of a same-sex couple who sought police protection from their parents. Pending adequate legislation more protective of the community, Justice Venkatesh issued a slew of interim guidelines for the police, activists, Union and State Social Welfare Ministries, and the National Medical Commission to “ensure their safety and security to lead a life chosen by them.” The ruling prohibited any attempt to medically “cure” or change the sexual orientation of LGBTQIA+ (lesbian, gay, bisexual, transgender, queer, intersex, asexual or of any other orientation) people. It urged the authorities to take action against “professional[s] involving themselves in any form or method of conversion therapy,” which could include the withdrawal of licence to practice medicine. On July 8, 2022, the court gave an order to the National Medical Commission directing it to “issue necessary official notification by enlisting ‘Conversion Therapy’ as a professional misconduct.” The NMC issued the directive to State Medical Councils on August 25.

In its 2021 verdict, the Madras High Court directed the police, for example, to close complaints of missing persons’ cases, “without subjecting them to harassment”, if it found on investigation that the parties were consenting adults belonging to the LGBTQIA+ community. The court asked the Ministry of Social Justice & Empowerment to draw up a list of NGOs and other groups which could handle the issues faced by the community, and gave it a time of eight weeks from the date of the order. This March, the court pulled up the Ministry for failing to compile a comprehensive list. The court said the community should be provided with legal assistance by the District Legal Services Authority in coordination with law enforcement agencies. Asking agencies to follow the Transgender Persons (Protection of Rights) Rules, 2020, and the Transgender Persons (Protection of Rights) Act, 2019, in letter and spirit, the court said it was imperative to hold sensitisation programmes for an all-out effort to understand the community and its needs.

Experts say schools and colleges must effect changes in curricula for a better understanding of the community. As late as 2018, medical books listed homosexuality and lesbianism as a “perversion”. People of a different sexual orientation or gender identity often narrate harrowing tales of bullying, discrimination, stigma and ostracisation. Gender-neutral restrooms should be compulsory in educational institutes and other places. Parents too need to be sensitised, because the first point of misunderstanding and abuse often begins at home, with teenagers being forced to opt for “conversion” therapies. Health professionals point out that even adults opting for sex reassignment surgeries need to get proper guidance like therapy pre and post operation; for an ordinary citizen, the cost too can be prohibitive.