As many of the youthful generation are feeling comfortable with coming out and telling the world that they are not afraid to be who they are, some of the narrow-minded are still grappling with the concept of being a member of LGBTQ no longer being a mental illness.

Labeling the LGBTQ community as "mentally sick" has historically served as a doorway and explanation for atrocious prejudice, stigma, and inhumane treatment practices. Before some of these DSM revisions, therapists were "curing" homosexuality with lobotomies, electroconvulsive therapy, and chemical castration.

Not because they are LGBTQ, but frequently as a direct result of discrimination, violence against LGBTQ people, and societal stigma, LGBTQ people do experience mental illness at a higher rate. In this way, society has frequently reinforced its prejudice against the LGBTQ community, wrongly categorizing them as "mentally ill" for generations and thereby contributing to the LGBTQ mental health problem.

One of the most important events in LGBTQ history was when homosexuality was removed from the DSM, but it wasn't without controversy. Despite the fact that homosexuality was eliminated, it was quickly replaced by "sexual orientation disturbance," which indicated that homosexuality was only a disease if the person was "disturbed by, in conflict with, or sought to change their sexual orientation or gender identity." Surprisingly, the World Health Organization (WHO) didn't formally declassify transgender identity as a "mental illness" until 2019.

These choices hold a lot of weight and frequently send a message to society about how to treat LGBTQ people. The way that members of the LGBTQ community are viewed and discussed in the mental health community has the potential to make or break almost every aspect of their daily life. The evidence is clear: the mental health field has been slow to understand and protect the transgender and non-binary community on a national and global level, and at the same time, transgender and non-binary people continue to be the most targeted, discriminated against, and stigmatized members of our LGBTQ communities. It has only been roughly three years since the WHO declassified being transgender as a mental disorder.

Although there has been significant progress in the mental health sector in recognizing the special needs of the LGBTQ community, there are still significant barriers to therapy or online counselling for this group, including the inability to locate a clinician or best psychologist in India who can provide thorough, empathic care without bias. This also falls under the category of being culturally knowledgeable or affirming. Many LGBTQ people have a reasonable concern that the mental health professional or a clinical psychologist they finally find the bravery to see will misunderstand or mistreat them.

It may be quite subdued. If your front desk personnel or new hires are not trained on these cultural skills, even if you have a mental health clinic with therapists or queer affirmative online therapy that are culturally welcoming, it may really get folks off to a bad start. Other people who have signed up for our outpatient courses have told us that they were told not to talk about their sexual orientation in public so as to not offend others.  We also know a person who had therapy at an inpatient facility, and when they came to the front desk, the staff member there openly discussed the person's gender and pronouns in front of them.

From the perspective of treatment or online counseling, this could result in a reluctance to seek care, which for some could be a life-threatening choice. LGBTQ individuals are more likely to experience depression, anxiety disorders, and suicidal thoughts and attempts. In their lives, 40% of transgender adults have attempted suicide, and PTSD is substantially more common in LGBTQ people.

For example, a client who, out of concern that their anti-LGBTQ landlord may overhear the conversation, was unable to take therapy calls at home and was forced to do it on the street.

"In such cases, the guilt is often associated with their identities and is reinforced as a bad experience. They are told that the topic they want to talk about is "bad" or "filthy." He claimed that it was a replay of messages to which they may have been exposed throughout their lives. Clinically, it could lead patients to leave early or just opt not to seek care again. Will everything be fine when I arrive? People often ask questions.

There is already a scarcity of mental health professionals in the country, and for LGBTQ people, the burden of locating culturally competent care can make the process far more challenging. We advise TalktoAngel as a wonderful place to start when looking for a culturally competent care provider in terms of Queer Affirmative Therapy.

Contributed by: Dr (Prof) R K Suri, Clinical Psychologist, Counsellor, & Life Coach & Ms Varshini Nayyar, Psychologist