Sexual Orientation Change Efforts Still Occurring in Lebanon

Abstract

Back to table of contents Previous article Next article International NewsFull AccessSexual Orientation Change Efforts Still Occurring in LebanonHossam Mahmoud,M.D., M.P.H., Omar Fattal,M.D., M.P.H., Suha Ballout,Ph.D., R.N., Bianca Sallum,B.S.N., M.P.H.Hossam Mahmoud,Search for more papers by this authorM.D., M.P.H., Omar Fattal,Search for more papers by this authorM.D., M.P.H., Suha Ballout,Search for more papers by this authorPh.D., R.N., Bianca Sallum,Search for more papers by this authorB.S.N., M.P.H.Published Online:29 Oct 2018https://doi.org/10.1176/appi.pn.2018.11a9AbstractProfessional associations in Lebanon have affirmed that homosexuality is not an illness, but efforts to change people’s sexual orientation still persist.In the past decade, Lebanon, a relatively liberal country in the Arab world, has witnessed significant advancement in mental health advocacy for lesbian, gay, bisexual, and transgender (LGBT) persons. Since 2013, professional associations, including the Lebanese Psychiatric Society, Lebanese Psychological Association, and the Lebanese Medical Association for Sexual Health (LebMASH), have affirmed that homosexuality is not an illness and, therefore, does not require treatment. Yet, the practice of sexual orientation change efforts (SOCE) persists. SOCE have gained significant attention in the past few years, especially due to their lack of efficacy and documented harm, which include interpersonal, social, psychological, and spiritual harm.Community Pilot ProjectIn 2018, LebMASH, in collaboration with a local non-governmental organization (NGO), Helem, conducted a community pilot project to explore the practice of SOCE in Lebanon. The team communicated with 10 individuals who had been subjected to SOCE. The team also talked to five mental health professionals who had heard about SOCE practices through their patients and three providers who practiced SOCE. In addition, the team reviewed television interviews involving health care professionals who discussed SOCE between 2010 and 2016. The team also reviewed a recording of a 2017 lecture presented at a university by a Lebanese urologist who practiced SOCE.FindingsThe project provided insight into SOCE practices in Lebanon, including practitioners’ profiles, methods, and approaches; the driving forces behind SOCE; and the sequelae of such efforts.SOCE practitioners’ profiles: The SOCE practitioners who were encountered during the project were mental health professionals (nonpsychiatrists), physicians, and clerics. It is important to point out that in Lebanon, not all mental health professionals are licensed, and physicians and mental health professionals are not necessarily affiliated with major professional organizations.SOCE methods and approaches: SOCE appear to be guided by a combination of religious beliefs, traditions, culture, and misinformation with regard to modern health care practices and up-to-date professional clinical guidelines. SOCE practitioners perpetuate inaccurate and largely refuted theories about sexual orientation, such as the belief that same-sex attraction is caused by trauma or the absence of a father figure, that having sexual relations with the opposite sex can change sexual orientation, that homosexuality is a temporary phase, and that homosexuality is related to pedophilia. In addition, there were reports of the use of hormonal interventions and other medications, such as medications for erectile dysfunction.During the recording of the lecture presented by the Lebanese urologist, he described performing electroshock “therapy” and giving emetic medication to “patients” while they were watching gay pornography.The SOCE phenomenon in Lebanon is driven by different key figures, including (1) parents of gay and lesbian people; (2) school counselors and other school personnel, such as principals or nurses; (3) gay and lesbian individuals struggling with acceptance of their sexual orientation; and (4) providers practicing under religious or cultural influences.Lesbian and gay individuals who have been subjected to SOCE reported negative comments from the practitioners, as well as violation of provider-patient confidentiality and privacy. They experienced anxiety, depression, feelings of guilt and shame, and even suicidal thoughts following SOCE sessions.This community project serves as a window into SOCE practices in Lebanon and highlights the need for a multifaceted approach to combat SOCE in Lebanon. ■Hossam Mahmoud, M.D., M.P.H., is medical director of Regroup and a clinical assistant professor in the Department of Psychiatry at Tufts University School of Medicine. Omar Fattal, M.D., M.P.H., is assistant chief for quality in the Department of Psychiatry at Bellevue Hospital and co-founder and board member of the Lebanese Medical Association for Sexual Health (LebMASH). Suha Ballout, Ph.D., R.N., is an assistant professor at the College of Nursing and Health Sciences at the University of Massachusetts and a LebMASH board member. Bianca Sallum, B.S.N., M.P.H., has significant experience working with NGOs on LGBT health. ISSUES NewArchived