Gay rights activism and health care issues - Dr. M.M.Salahudeen

Public debate over repealing of section 377 unfortunately is marred by affirmative bias in the main stream media. Fairness of debate in a democratic civil society demands that the common man should be well informed of issues which have ramifications on his daily life. In his famous book Gay and Lesbian youth Gilbert Herdt wrote: “Homosexuality in contemporary America has arisen as a new form of homosexual practice that comprises sexual orientation, a social identity and political movement.” By repeatedly confronting the American Association of Psychiatrists, the Gay rights activists convinced them to drop any reference to homosexuality in DSM III (Diagnostic Criteria for Sexual Dysfunction due to General Medical Condition) formulated in 1973, which marked a significant cultural shift according to Kaplan and Sadock’s Comprehensive Text Book of Psychiatry. The influence of post-modernism and biomedical studies significantly contributed to this position of a majority of American psychiatrists although all psychiatrists do not subscribe to this idea.
Medical literature does not contain any hard biomedical evidence, either genetic or hormonal, in support of homosexuality. Dr. Baron in 1993 wrote in the British Medical Journal (BMJ) about the conflict of theory of evolution and homosexuality. He noted: “From evolutionary perspective, genetically determined homosexuality would have become extinct long ago because of reduced reproduction.”
Gilbert Herdt proposed the idea of ‘discontinuity’ in sexual development to explain variation in the psychological experience and symbolic meaning of sexuality, in contrast to the continuity in sexual development across life span that is assumed in most traditional approaches to understanding sexual development . There is no convincing medical evidence to prove that homosexuality is an inherent trait. It is an acquired alternate sexual orientation as a result of various psycho-social factors.
Risks aplenty
The risks faced by the gay community range from social discrimination and societal and domestic violence to health care risks both psychological and physical. Rigid ideological positions and homophobia, which is defined as fear or hatred of homosexual gays and lesbians, are the major causes of social discrimination. Increased suicidal rates in homosexuals as compared to heterosexuals have been adequately documented in medical literature in addition to alcohol addiction and drug abuse. However psychiatric literature attributes this to internalised homophobia, a personalised fear of homosexuality.
As regards health care issues in homosexuals, HIV infection plays a dominant role. To quote Kaplan and Sadock: “In general gay men have increased rates of sexually transmitted diseases, HIV infection and use of certain substances such as inhaled nitrites (poppers). Since 1980s the influence of HIV Infection and AIDS on the individual lives and communities of gay men has been enormous and has affected almost every aspect of the personal and public experience of being a gay. As a result, HIV infection must be considered as a potential problem in the life of every gay man who enters health care.”
Protecting civil society
According to community medicine experts, the pattern of spread of HIV infection in the U.S. could be closely traced to the increasing rate of practice of homosexuality. Proctitis (anal canal inflammation and infection) and anal cancer rates are alarmingly high among gay men. An Indian American family physician practising in Chicago recently remarked that they encounter proctitis and vaginitis now as commonly as any general practitioner in India encounters fever and diarrhoea in his or her practice. Civil society has a duty to protect the sexual minorities from discrimination, abuse and from physical and psychological risks by providing sympathetic psycho-social support. But propagating homosexuality would lead to this behaviour, resulting in individual and collective health care risks straining an already overburdened healthcare system, apart from the manpower loss and negative demographic pattern it would produce.
While judging the constitutional validity of section 377, the learned judges of the Supreme Court should also ensure that the State adequately fulfils its obligation of providing a healthy, risk-free and productive life of civil society at large. (The writer is consultant neurosurgeon, Billroth Hospitals, Chennai)

The Hindu:Open Page, August 16, 2009