For long, a major section of our population considered people belonging to sexual ‘minorities’ as being mentally ill. They believed that their sexual orientation could be ‘cured’ by therapy, psychiatric consultation, medicines and counselling. Many, even today, hold similar opinions, and it cannot be denied that we still have a long way to go. But advances have definitely been made and today, we have evidence from many studies that being homosexual, bisexual or transgender is not a mental illness in itself. Certain sexualities, however, might be associated with other mental illnesses. New research shows that Lesbian, Gay, Bisexual Transgender Queer Intersex (LGBTQI) people may have higher rates of depression, higher rates of substance abuse, and higher rates of suicide than the general population. Trying to link sexual orientation and mental health is like opening up a Pandora’s box, simply because the connections are just too many!

It would be an understatement to say that one’s mental health is closely affected by the society to which a person belongs. It is also not news that India, like many other nations, has not been very friendly towards its LGBTQI community. Earlier this year, in another ‘unfriendly’ act towards the LGBTQI community, India’s censor board ordered that the word ‘lesbian’ be muted in the film ‘Dum Laga Ke Haisha’ and included in a list of cuss words to be banned. It should not be a surprise, coming from a country where homosexuality continues to be a crime. At a time when many in the country are working for the repeal of Section 377, this is a huge step backward! By labelling the word ‘lesbian’ a cuss word, the government sends a clear signal to its people – homosexuality is not just a crime by law, it is not even recognized by society, so much so that it had to be censored out from movies! This act can compound the animosity which already exists in a large chunk of our society, towards sexual ‘minorities’, and can have disastrous consequences. Talking about LGBTQI people is still taboo in India even though they are no different from those comfortable with a more ‘conventional’ sexual orientation or gender identity. But within a heteronormative community, they are marginalised and they continue to struggle for acceptance – acceptance for being who they are, acceptance for loving whom they love and acceptance to be a part of the society in which they physically live. And this lack of acceptance can cause severe distress and even lead to mental illness.

It goes without saying that it is confusing and difficult to be different from your friends, cousins and others around you while growing up. To top that, some influential leaders constantly preach that certain sexualities are more sinful than others. As adolescents, members of the LGBTQI community have little clue of whom to talk to and how to better deal with feelings that are clearly different from the heavily heteronormalised picture that the media paints. Sex education, in general, is an area where very few Indian parents tread. Talking about different sexualities, then, is completely out of the question. Not being able to talk to parents and teachers leads to bottled up emotions, anxiety and depression. These young people reach adulthood and face the responsibilities of an adult life, clueless of ways to handle it.

As a result of these societal pressures, people with an orientation that is not heterosexual may choose to never come out of the closet. Scared of the isolation and shame that family and society will throw at them, they may choose to play along conventionally – even getting married and having children – all the while carrying the burden of a hidden identity, not to mention the mental trauma that years and years of such ‘consensual’ heterosexual relationships can inflict. ‘Consensual’ here, then, becomes a mockery in itself. There have been media reports of many such ‘marriages’ ending up in divorce, scarring the minds of not one but two people in the process.

Relief is not ascertained by the act of coming out alone. Coming out before people who view human sexuality as a black and white phenomenon and hold a dichotomous view of what is ‘normal’ or ‘abnormal’ is a herculean task in itself. But, what follows may turn out to be worse. The popular myth that ‘marriages can cure mental illnesses’ combined by the notion that ‘unconventional sexuality is a mental illness’ may, in fact, prompt families to further pressurize their homosexual/transgender family members into adopting the ‘cure’ that is heterosexual marriage. Even if a forced heterosexual relationship is avoided, the discrimination that knocks on their door relentlessly is enough to corner them into a land of depression, with no return. Mockery, ridicule, isolation, sexual exploitation and a constant nagging to get ‘treated’ is what most members of the LGBTQI community face on ‘coming out’. Internalisation of this stigma sometimes pushes people down a dark tunnel from where the only route of escape seems to be ending one’s life. Some others seek solace in alcohol and drugs, which in some cases further complicates their health.

Poor mental health among LGBTQI people is, then, not something inherent to their sexuality but is an outcome of non-acceptance by the dominantly heterosexual society in which they live; it is an ‘illness’ they have been forced into. There is a strong need to make people aware of the spectrum of sexuality that exists if we want to make things any better for the LGBTQI or asexual people living among us. A multipronged effort in the form of education and health programmes covering the entire range of sexualities is needed. People need to be supported in acknowledging their sexual orientation, talking about it and coming out to their friends and family without fear of being judged or discriminated against.

However, no justice against discrimination and sexual exploitation can ever take place in a country that criminalises homosexuality. Mental health support for LGBTQI people entails decriminalisation of homosexuality. A society that prides its cultural diversity, yet cannot accept sexual diversity among its people is in serious denial and cannot help the cause of improving its mental health status. And even as we talk about the increasing burden of mental illnesses in the community, the Government of India has released another National Budget which shows that we have not been investing in mental health! With little government support, the onus is now on society at large to contribute to improving the mental health status of the LGBTQI community and of society as a whole.