Citation

Kabir A, Nazareth I. Lancet Psychiatry 2022; 9(4): e19.

Copyright

(Copyright © 2022, Elsevier Publishing)

DOI

10.1016/S2215-0366(22)00070-0

PMID

35305753

Abstract

Although the stigma of homosexuality has reduced over the past 20 years, it still persists in some countries worldwide. Now accepted in many countries, homosexuality was removed from the DSM-III in 1973 and from the ICD-10 in 2017; however, it carries the death penalty in Iran in accordance with the Islamic penal code (clauses 108 to 126). Religious institutions are opposed to homosexuality, leading to the rejection of gay men by families and society, the promotion of internalised stigma, and the development of pseudoscientific therapies by health professionals. Under the control of religious institutions, the Ministry of Health and Medical Education, the Ministry of Science, Research, and Technology, and the Psychology and Counseling Organization of Iran have condemned homosexuality. The attitude of Iranian health professionals poses a threat to the health of sexual minorities. Based on AK's clinical experiences, the coordinated activities of therapists, physicians, religious institutions, and parents have commonly promoted conversion therapy to change the sexual orientation of gay men. This situation is more common in adolescents, who cannot make legal decisions independently.

Conversion therapy is based on an unscientific assumption that people with a non-traditional sexual orientation are psychologically damaged and that changing their sexual orientation will benefit not only the individual themselves but also society. In Iran, conversion therapy can include counselling, prayers, aversion therapies, drugs or hormone injections, electroconvulsive therapy, and, at extremes, sex reassignment surgery. Most of these so-called treatments for homosexuality, including conversion therapy, are now banned in many parts of the world because they are considered to be inhumane and unscientific, while damaging the health and wellbeing of sexual minorities. Nevertheless, in Iran, therapists and religious institutions continue to believe that attraction towards the same sex is harmful and should be changed. The prevalence of the practice of conversion therapy in Iran is unknown. AK's clinical observations suggest that this type of therapy has reinforced the belief that sexual orientation is changeable; therefore, gay men refusing treatment pose a threat to their own lives by resisting cure. Additionally, AK has observed that this belief is one of the main reasons why family members kill their own gay relatives. Sexual orientation is inherent and irreversible, and conversion therapy violates ethical practice. Thus, any attempt to change someone's sexual orientation, contrary to their desire, violates their basic human rights and urgently needs to be banned.

Language: en