Queer perspectives in mental health- How can mental health practitioners be queer affirmative

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The conversations around Queer Perspectives on Mental Health are an important moment of recognition in the history of Psy disciplines alongside Mad Pride, deinstitutionalization, and other survivor-based movements. It is an opportunity to undo the damage of the past and get on the path of seeing how social inequality impacts mental health. That we are not individuals living in bubbles, oblivious to social structures.

The mental health establishment has been complicit in pathologizing different ways of being and offering cures to what is not a disease. Since societal rules treat cis-heterosexual relationships as ‘normal’, mental health disciplines have also banded together to describe anything outside of them as ‘abnormal’. It has a long history of labeling LGBTQ+ identities as a pathology or disease and offering “treatments” to turn them into socially acceptable cis-straight people. The history of so-called ‘conversion treatments’ (attempts to change gender and sexual orientation) is violent and shameful.

Historical pathologization within the mental health space has also meant that there is a good chance that an individual from the LGBT+ community will at some point in their life be ‘brought’ to the clinic by family or end up there for care. make sense of the anguish of living a life of stigma and discrimination.

The mental health establishment in India had previously been working under the shadow of section 377 of the Indian Penal Code, which in its interpretation criminalized same-sex relationships. The legal and social sanction led to a great deal of hardship for the queer community in India. In the wake of the repeal of section 377, more and more mental health professionals are coming forward for the queer community and wanting to know how to support them.

It is encouraging that practitioners today are willing to engage in this troublesome history in hopes of making it better. This article will try to offer some tips on how to start that journey.

First, it is important to recognize how the existing mental health curriculum and training are inadequate to support the LGBTQ+ community. Ironically, it’s easier to find a doctor who offers a queer person a “cure” than it is to find someone who doesn’t.

Second, this recognition will require a commitment to engage with social conditioning on gender and sexuality. This unlearning process is ongoing because we are all pierced with ideas of sexuality, gender, and acceptable relationship formats. This type of social training is quite effective and we realize how deeply we hold these beliefs once we start questioning ourselves. The work required deep reflection on our response to non-normative genders and sexualities.

Once the professional recognizes that there is a need to unlearn societal ideas of ‘normalcy’, it is important to begin the knowledge gathering process because the mainstream does not know much about LGBTQ+ lives and communities. It is crucial that the source of knowledge is not the mainstream that only stigmatizes and stereotypes. The source of knowledge should ideally be the lived realities of people who have struggled because the world does not accept them for who they are. The Resource Book on Queer Affirmative Counseling Practice can be a good starting point for practitioners. It is written by mental health professionals who are gay and have been involved, taught, and trained in the areas of mental health, gender, and sexuality for many years. The resource book is the result of a course called Queer Affirmative Counseling Practice (QACP), a pioneering capacity-building initiative for professionals.

Finally, being queer affirmative means that the professional understands how social structures and inequality affect mental health. An ideal state of well-being can hardly be expected from an individual who is constantly viewed as deserving of neither respect nor consideration. The mental health costs of living a life like this are immense. Not only queer identities are pathologized in mental health, but also the effects of living a life of discrimination. Everyday discrimination does not make mental health rosy.

The other reason to be affirmative queer is that those on the margins need multiple forms of support system to survive in this hostile world. Mental health support or counseling goes a long way in helping queer people deal with the everyday stressors of being queer. These are often people who have been expelled from their birth families because of their identity. They lose friendships, livelihoods, and even shelter due to their rarity. We’re not saying that mental health support can make up for these losses, but it does at least provide a safe space to cope.

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