28 Aug Psychiatric perspective on LGBTQIA+ How can a believer help ?

LGBTQIA+ (lesbian, gay, bi, trans, queer, intersex, asexual) have surprising statistics. 8 to 10% of people have reported some or transient same-sex attraction, though purely same-sex attracted are only 1.5 to 1.7%, and the same number with bisexuals. There are reported to be 2.5 million LGB individuals in India, and the USA has recorded 650,000 same-sex couples, 114,000 married. Transgenders are known in India as Hijras. Seen at many traffic signals, they number 3 million. Intersex (I) people are 1 in 1500-2000 live births. While these statistics are open to debate, they give some idea of the extent of this people-group.

LGBTQIA+ issues have taken centre-stage over the last few decades for a variety of reasons. Possibly various events for freedom and rights – national anti-colonial freedom movements of the 20th century, the anti-slavery movement, inter-national human rights declarations, movements against caste or racial discrimination, the women’s empowerment movement – all these emboldened the

LGBT community to come out and demand acceptance, too.
The Christian community globally has struggled with its response to the LGBT issue, though many of the freedom movements mentioned above drew initial stimulus from the Christian perspective on human rights and equality of all humans before God. Christian faith also commits the church to help those in trouble, but scriptural passages hold the church back from acceptance of, in particular, homosexual lifestyles.

Psychiatric perspective on LGBTQIA+
What is the cause of LGBTQIA? Is there a mental disorder causing this, as many in India believe?
Scientific studies are underway to understand the causes. Intersex can often be caused by genetic variations or biological conditions, especially of reproductive hormones such as androgen. Studies show possible genetic markers for same-sex attraction on chromosomes 13 and 14, though they fall short of a definitive “gay gene”. Studies also show the influence of intra-uterine hormonal influences, on both subsequent gender identity as well as sexual orientation. Twin studies show that those with identical genetic structure (identical twins) have a higher rate of concordance for same-sex attraction than non-identical siblings – up to 65%. Noticeably, the concordance is not 100%, as it would be were the cause purely genetic. Studies also show increased incidence of same-sex attraction among those with a history of abuse – 8% in men, 5% in women, in some studies; but do not indicate which came first. Homosexual boys and men are often abused.

Coping with these issues has not been easy for this community. They are often rejected by their families, ridiculed (including in movies), bullied, or sexually harassed. The earlier laws marked them out as criminals, with sentence for even consenting same-sex couples being life imprisonment – while heterosexual rape, at that point, carried a sentence of only seven years. LGBTQ people can therefore end up with persistent anxiety, depression and other mental disorders.

Two examples from India demonstrate how complicated these issues are. Santhi Soundarajan, from a simple family in Tamil Nadu won a silver medal in the 2006 Asian games. She was required to take a sex test soon after, which showed the chromosomal structure of a man (23rd pair XY). However, due to androgen insensitivity from early conception, her body developed ambiguously, and her gender identity was female. She frequently wore saris, flowers in her hair. Repeatedly stripped of her medals and not allowed to participate in athletics, she fell into depression and twice attempted suicide. She was finally given a job as a coach, and now dresses as a man, she says, in the hopes that that will make people accept her.

Duttee Chand’s case is a little different. She, too, is a track and field athlete. She has hyperandrogenism, a condition where a chromosomally XX woman produces abundant testosterone in the range that is common among men. She too, was dropped from the Indian team because of this, but along with others like Olympic champion Castor Semenya, has caused the International Athletics federations to re-examine the sports regulations on this. Duttee has also come out as same-sex attracted.

Each LGBTQIA person is different, but the conditions sometimes overlap.

How should a Christian help a friend who claims they are LGBTQIA?

First, with compassion. Listen to their story. Do not show rejection, disgust or discomfort. Remember, all our righteousness are as filthy rags in God’s sight (Is 64:6), whether us or them. Let them talk, and assure them of your love and concern, and of God’s.

Second, with humility. There is much we do not understand about these conditions, and their biological causations. The details above show that many of these conditions are linked and often biologically based. Many got these conditions in the womb. It is possible some became that way following abuse, but it is still not something they chose. Most of them resist for years and it is often after much tears, bewilderment and sorrow that they may talk about it. So, listen with humility. Do not immediately jump to tell them they are sinning by being different in their body hormones, or genes, if they are not sure of their gender, or if they feel attracted to the same sex. We often don’t know everything about these issues. Santhi Soundarajan for instance could not be blamed for anything that happened to her.

Third, be clear about the finer distinctions between the various LGBTQIA issues. This is important because while these have been clubbed together, the Bible has condemnatory passages only on same-sex activity. It accepts matter-of-factly and does not condemn those born intersex, through genetic or hormonal changes (Jesus’ own words on “some born eunuchs”, Mt 19:12). It does not condemn those who do not have a stable gender identity. It doesn’t condemn same-sex orientation, if not acted on: that is, those who remain chaste and single.

It does however, condemn homosexual activity; so if a friend tells you they are gay and want to live an active homosexual lifestyle, pray and ask God to give you the wisdom to gently talk with them about it. Rather than simply denouncing them as sinful, suggest you study the biblical passages about sexuality together. Take the help of elders or other resources. They will probably come out with counter-arguments, or be angry with God, or the church. Listen respectfully, and patiently, and respond as the Lord leads you to. Ultimately, this is a decision they have to take, and it is one that will affect their whole life and discipleship. You can help best by being a loving friend ready to talk, listen and pray with them. Get them expert help if they are depressed or suicidal.

LGBTQIA issues are complex, distressing many people. Studies so far show several possible social, biological and genetic causes. People within this group are often prone to social rejection, injustice and violence of different kinds and often have periods of anxiety, depression and other mental disorders. To help them, we need to listen humbly, assuring them of God’s love, and ours, and not be quick to condemn or reject them. We, and they, need to understand through discussion, prayer and Bible study what cannot be controlled (biology, genes, hormones or orientation) and what can (acting on the attraction). May God help us to reflect Christ to all in this group.

Dr. Jamila Koshy was an EU student in the late 70s and early 80s; doctor and psychiatrist for almost 40 years; currently, a graduate in Bengaluru; contact : jamilakoshy@yahoo.com