While visiting Karachi University a few months back for a fieldwork assignment, I had a rather peculiar run-in with a group of clinical psychologists. All of them were involved in clinical and rehabilitative projects and had recently banded together to start a small forum to teach people aspiring to enter mental health and also to disseminate specialised information among professionals. They felt that such knowledge was largely disaggregated in Pakistan.
This meeting was atypical for me since it was one of my first encounters with a group of well educated and professionally active psychologists who wanted to inject some vigour into the largely lethargic domain of mental health in the country.
One of the psychologists I talked to was working on a project in which he was the chief counselor for a group of HIV positive men – mainly sex workers. I found the topic quite novel and decided to question him further. Obviously when discussing the sex trade, it is pertinent to ask which genders are involved. When I asked him, he told me that he was working with MSM (men who have sex with men). When I asked him if he meant gay men, he brushed me off with a severe ‘no’.
Call me a skeptic, but I assumed that at least some men out of the several ‘MSM sex workers’ in Karachi must be gay. Here I define gay as being attracted to and engaging in sexual activity with the same gender out of natural inclination or choice.
This clinical psychologist, a counselor to the MSM, explained that such men do not exist in the country. Unfortunately for him, I had done some research of my own and therefore I provided him a personal account of several self-identified gay men that I had encountered in the country during my own research work. His response to that was simple, sneering, and not well thought-out:
“Gay men may exist in the upper elite class, but no men from the middle and lower classes would want to have sex with men.”
This man probably belonged to the middle class himself and obviously saw me as ‘the elite’. But much to my surprise, not one person out of this group of professional clinical psychologists and counsellors refuted his statement.
Finally a researcher, who was also a guest at the gathering, spoke up saying that homosexuality exists across the spectrum amongst all people and that it was a mistake to think otherwise. After a minor quibble, the discussion ended with neither side relenting their position.
For most people, this would be a simple belief-based argument, that people are allowed to believe what they may about the etymology of homosexuality – choice or nature – so long as they do not impress this belief on others. But the reason it is not acceptable for a psychologist to think this way is because homosexuality was removed from the list of mental illnesses from the Diagnostic and Statistical Manual of Mental Disorders (DSM) in 1973 and for an entire group of psychologists to be either unaware of this or unwilling to accept it, is outrageous.
Why is this a problem when no one explicitly said that homosexuality is a mental disorder?
It’s a problem because it is a counselor’s job to be judgment free so that his clients can express themselves in a way they are unable to do outside the safety of the counseling room. It is a place created for people to let out their fears so that the trained professionals can help their clients learn how to tackle their fears and problems. However, when a counselor has a negative attitude towards homosexuality or any ‘deviant’ sexuality for that matter, clients will either be incapable or unwilling to present their problems fully.
If the counselor is particularly adamant on stamping out certain sexualities, he/she may recommend conversion therapies which are aimed at rectifying all forms of sexuality till they match conservative heterosexual standards. These can further debilitate the mental health of their clients.
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