KUALA LUMPUR, May 27 — Several lesbian, gay, bisexual and transgender (LGBT) activists and healthcare professionals have warned against conflating the community with mental health patients, saying this could harmfully suggest that sexual orientation and gender identity can be "cured”.

Transgender rights advocacy group Justice for Sisters (JFS) also urged the Ministry of Health (MoH) to immediately debunk the misinformation presented by two MPs from Islamist party PAS, explaining that such notions seem to excuse harmful conversion therapies.

"The problem with such claims is that it results in attempts to correct LGBT people’s sexual orientation, gender identity and gender expression (Sogie) by various actors, from family members, teachers, religious bodies, the state, and others,” Justice for Sisters’ co-founder S. Thilaga told Malay Mail.

Thilaga added that efforts to change a person’s Sogie, so-called "rehabilitation”, or conversion practices are not backed by any scientific evidence, but still subject LGBT persons to humiliating and degrading treatments and violence.

"Research shows that Sogie change efforts result in severe long-term impact on mental health and well-being, self-worth, access to education, right to self-determination, freedom of expression, among others,” she said.

JFS also added that such misinformation is counter-productive to the MoH’s efforts to reduce health vulnerability and risks among marginalised groups, such as the LGBT community.

"The Malaysian MoH acknowledged in its 2020 Global AIDS Monitoring report that access to HIV prevention services for gay, bisexual and queer men and MSM ‘have been poor probably because they are the most hard-to-reach and difficult to identify due to stigma and discrimination’,” said the group.

MSM is the clinical abbreviation which refers to "men who have sex with men”.

Similarly, a joint statement to Malay Mail by a group of medical professionals also pointed out that conversion therapy has been banned in many countries such as the United States Canada, Taiwan, India, New Zealand and France due to evidence that such practices could cause harm to the community.

"Conversion therapy has been found in many studies to result in psychological harm (for example, increased depression, anxiety and suicidality) towards LGBT individuals as this form of therapy reinforces discrimination towards, as well as internalised homophobia in these individuals,” they said.

The statement was co-signed by Dr Keng Shian Ling, associate professor and clinical psychologist at Monash University Malaysia; Dr Rachel Ting, associate professor and clinical psychologist at Monash University Malaysia; Dr Phang Cheng Kar, psychiatrist at Sunway Medical Centre; and Dr Alvin Ng Lai Oon, professor and clinical psychologist at Sunway University.

Sexual orientation is not a choice

Earlier this week, Perikatan Nasional’s (PN) Pasir Salak MP Jamaluddin Yahya suggested in Parliament that LGBT persons should be considered as suffering from mental health illnesses, to which his Kapar MP colleague, Dr Halimah Ali, agreed.

However, the four medical professionals told Malay Mail that there are numerous studies indicating that sexual orientation is an innate trait that could not be changed.

The group said that criminalising or treating same-sex behaviour as a medical disorder is more a "political act” than one grounded in scientific evidence.

"Law and policymakers should consider the negative impact of an outdated law and let the international healthcare researchers decide what is ‘pathological’ and ‘ill’. Politicians should consider the well-being and equity of the citizens (taxpayers), regardless of their sexual orientation,” they said.

They emphasised that homosexuality, bisexuality and transgenderism are not subcultures and cannot be imposed onto others.

"LGBT individuals are sexual minorities and do not pose any unique threat to society. They do not try to ‘convert’ others into being LGBT. One also does not simply ‘become’ LGBT just by hanging out with individuals who are LGBT.

"It is imperative that LGBT individuals be seen, accepted, and respected as who they are, and not be seen as people with mental illnesses. Sexuality is not the enemy — hatred is,” they added.

History of homosexuality in the DSM

Dr Chua Sook Ning, clinical psychologist and founder of Relate Malaysia, said that LGBT is no longer classified as a mental disorder in the latest editions of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) and the International Statistical Classification of Diseases and Related Health Problems (ICD-11).

"Thus, it is important to not pathologise differences, but instead to focus on addressing the social conditions such as lack of access to physical and mental healthcare that has been shown to contribute to the higher prevalence of mental illness among the LGBT community,” she told Malay Mail.

The DSM is a publication by the American Psychiatric Association and serves as one of the principal guides for mental health professionals when diagnosing and treating mental health illnesses.

The ICD on the other hand is an internationally used diagnostic tool for diseases, disorders and other health conditions, maintained by the United Nations’ World Health Organisation (WHO).

Homosexuality was originally classified as a mental disorder under "sociopathic personality disturbance” in the first edition of the DSM which was published in 1952. In 1973, homosexuality was removed in the second edition of the DSM, although it was instead replaced with "sexual orientation disturbance”.

In the following three editions of the manual, homosexuality was deemphasised as a psychiatric disorder until its eventual complete declassification or removal in 2013 from the fifth edition (DSM-5).

It, however, listed "gender dysphoria”, indicating "significant distress or impairment” for persons whose gender identity does not reflect their sex as registered at birth.

A step backwards in global progress towards inclusivity

Andi Suraidah, founding director of local LGBT rights organisation Legal Dignity, applauded the recent passing of the mental health amendments in the Parliament, but said that the proposal by the PAS MPs to categorise LGBT persons as mental health patients was a "deliberate reversal of global progress towards inclusivity”.

"As it stands, many reports and research can vouch how LGBT persons suffer from a variety of mental health issues as a result of varying degrees of exclusion and discrimination due to their Sogie,” she told Malay Mail.

"Kapar MP, a medical practitioner herself, should be conversant with the ‘do no harm’ principles, and must instead speak out against her colleague’s suggestion.”

Hasbeemasputra Abu Bakar, a mental health and human rights advocate, agreed that the suggestion was unscientific and should be used as an opportunity to destigmatise LGBT, yet it perpetuated the stigma surrounding LGBT instead.

"As a medical practitioner, Dr Halimah should have known better. Instead, she chose to use Parliament to enable public discussion that is harmful to two vulnerable communities,” he told Malay Mail when asked to comment on the matter.

He said that the suggestion to classify being LGBT as a mental illness highlights the public misconception about mental ill-health and mental disorders, adding that this further underscores how much those with mental disorders are "devalued and dehumanised”.

Meanwhile, Gavin Chow, a co-founder of the local LGBT advocacy group People Like Us Hang Out (Pluho), said that elected MPs should uphold the values of diversity and inclusion in order to build a more progressive nation.

"Pathologising LGBTQ persons purely based on the differences of our gender identities and sexual orientation is clearly an act against the Malaysia Madani spirit.”

Earlier this week, local gay rights advocacy group Jejaka had said that the proposal by the two MPs not only went against the medical consensus widely accepted globally, but also perpetuated harmful stereotypes and discrimination against the safety and well-being of those in the minority community.

"This unfounded assertion in Dewan Rakyat is a disservice to the LGBT community and those genuinely struggling with mental health issues.

"Being LGBT is not an illness but a part of human diversity. It is high time our lawmakers recognise and respect this fact,” Jejaka deputy president Dhia Rezki Rohaizad said.