Category: Position Statements

Summary:

In 2012, an initial partial ban on anal testing was issued. However, there were multiple reports that showed that anal testing continued to take place despite the ban. LebMASH played a significant role in cementing the ban on anal testing in 2014 through raising public awareness on the issue and lobbying with the Lebanese Order of Physicians and putting pressure on the Lebanese government.

Timeline

2012
Human Rights Watch brings attention to the issue:

The head of the Lebanese Doctor’s Syndicate, Dr. Sharaf Abu Sharaf, issued a directive on August 8, 2012 calling for an end to anal examinations, stating that they are medically and scientifically useless in determining whether consensual anal sex has taken place and that they constitute a form of torture. He added that they also violate article 30 of the Lebanese law on medical ethics, which prohibits doctors from engaging in harmful practices.

The tests also violate international standards against torture, including the Convention Against Torture and the International Covenant on Civil and Political Rights, which Lebanon has ratified. The U.N. Committee Against Torture, in its 2002 review of Egypt, investigated the issue of forensic anal examinations and called on the government “to prevent all degrading treatment on the occasion of body searches.”

In a statement given to the Lebanese daily Al-Akhbar on August 2, Justice Minister Shakib Qortbawi said that he had two months earlier written Attorney General Said Mirza urging him “to halt random rectal examination procedures, after the issue was raised by human rights organizations.” However, the attorney general’s subsequent directive, the text of which Legal Agenda, a Lebanese rights organization, published on August 7, contradicts the Minister’s statement to Al-Akhbar.

Far from ordering an end to the procedures, the attorney general’s directive in fact institutionalized them further, instructing public prosecutors to order the anal examination be carried out only “with the consent of the accused, according to standard medical procedures, and in a manner that does not cause significant harm.” The directive added that if the accused refused to undergo the examination, he should be informed that his refusal “constitutes proof of the crime.”

July 2014
Legal Agenda reports that anal tests are still happening

July 2014
LebMASH releases position statement on anal tests.

Aug 2014
LebMASH meets with LOP president Dr. Boustani to voice concerns over anal tests and urge LOP to reaffirm its position on banning anal tests and ensure that forensic doctors are not allowed to perform these test.

LebMASH offered to conduct sensitivity training workshops to Forensic doctors to explain the harms of anal testing.
For more info, click here.

October 2014
LebMASH sends a letter to Prime Minister Tamam Salam to urge him to put an end to anal tests. For more info, click here.

No further anal testing reported after that in Lebanon. 

Over 2,400 people living with HIV infection are estimated to live in Lebanon (1). Stigma and discrimination towards this population, as a consequence of their HIV status, result in significant negative consequences on their health and wellbeing (2) (3) (4). These issues affect a lot of people living with HIV in Lebanon and play an important obstacle for HIV treatment and prevention in Lebanon today.

Stigma towards people with HIV in Lebanon exists for a number of reasons. Inaccurate information regarding HIV transmission fosters irrational beliefs and behaviours, resulting in a poor perception of personal risk (4). HIV continues to be associated with societal taboos such as sex work, illicit intravenous drug use, and in particular, homosexuality. Negative attitudes towards homosexuality are common in much of the Lebanese society. Furthermore, men who have sex with men (MSMs) account for over half of cases of recent HIV infection in Lebanon (5). Legal discrimination as well as harassment and violence against gay men and transwomen is known to deem these groups more vulnerable worldwide. Article 534 of the Lebanese Penal code, which criminalizes sexual acts “contrary to nature” along with recent arrests and harassment of gay men in the country also deters potentially play a similar role in Lebanon and prevent also deters many MSMs from seeking HIV testing and treatment as they fear legal repercussions as a result of disclosing their sexual behaviours to health workers (6). Additionally, the World Health Organisation, for example, states that fear of discrimination and stigma is the principal reason deterring individuals from getting tested, disclosing their HIV status and taking antiretroviral therapy (7). Information on the infection of transwomen with HIV is not included in data that is presented by the National AIDS program in Lebanon.

Access to healthcare for people living with HIV in Lebanon poses a considerable challenge. Whereas anti-retroviral medications and HIV testing may be obtained free of charge, significant barriers exist to obtaining long-term HIV treatment (6). Patients who test positive for HIV fear that their diagnosis will not remain confidential and thus that this diagnosis will have profound negative implications for other areas of their life (2). Case reports exist of individuals who lost their medical insurance and job as a result of their HIV diagnosis (8). The stigma associated with the virus increases further the fear of individuals who test positive for HIV of seeking treatment or even having it in their households.

Sexual education is missing in all health related curricula in Lebanon and health care workers rarely discuss sexual concerns with clients. As a result, stigma against people with HIV is also common amongst health workers. Such stigma includes avoiding patients with HIV, refusing to treat them, breaking their confidentiality or indeed treating them with any less care or concern than any other patients. In many cases, these behaviours are complicated by discriminatory attitudes and actions towards HIV+ patients who are LGBT+, drug-users or of foreign origin. Such beliefs act as a further deterrent to health care access, worsening these patients’ health and wellbeing.

On World AIDS Day 2016, the Lebanese Medical Association for Sexual Health calls for:

• Better documentation of people living with HIV in order to make sure interventions are affecting people who need it the most. Particularly LebMASH calls on including transgender populations in national HIV data presented.
• Better education about HIV targeting health providers, the broad public and government workers.

While LebMASH salutes the efforts that sister organizations are doing in the field, wWe renew our commitment commend better efforts to:

• Increase education among health workers and the general public on the virus and how it affects specific vulnerable groups
• Further research and understand the epidemic in Lebanon and how to face it from a social and medical stand-point.
• Advocate for implementation of accurate treatment and prevention guidelines, particularly when it relates to treatment as prevention with treatment ensured to anyone living with HIV to both increase their longevity as well as prevent the transmission of the virus.

Bibliography

1. UN AIDS Report Lebanon. United Nations. 2016, p. http://www.unaids.org/en/regionscountries/countries/lebanon/ .
2. Impact of HIV-related stigma on treatment adherence: systematic review and meta-synthesis. Katz, I.T. et al (2013) ‘’. 2013, JIAS 16, p. (Supplement 2) : 18640 .
3. (2009) ‘HIV-related stigma and psychological distress: the harmful effects of specific stigma manifestations in various social settings. Stutterheim, S.E. et al. 2009, AIDS, p. 23:17.
4. Combating HIV/AIDS-related Stigma in Egypt: Situation Analysis and Advocacy Recommendations. Egyptian Anti-Stigma Forum. 2012.
5. Are HIV Epidemics among Men Who Have Sex with Men Emerging in the Middle East and North Africa?: A Systematic Review and Data Synthesis. Mumtaz G, Hilmi N, McFarland W, Kaplan RL, Akala FA, et al. 2011, PLoS Med , p. 8(8): e1000444.
6. A Qualitative Exploration of Sexual Risk and HIV Testing Behaviors among Men Who Have Sex with Men in Beirut, Lebanon. Wagner GJ, Aunon FM, Kaplan RL, Rana Y, Khouri D, et al. 2012, PLoS ONE, p. 7(9):e45566.
7. Global HIV/AIDS Response: Epidemic update and health sector progress towards Universal Access: Progress report 2011. World Health Organisation. 2011.
8. Can Lebanon’s new plan end stigma of HIV/AIDS? Kullab, Samya. 2015, Al Jazeera, pp. http://www.aljazeera.com/news/2015/12/lebanon-plan-stigma-hivaids-151202083548675.html.

On this International Day Against Homophobia and Transphobia, the Lebanese Medical Association for Sexual Health (LebMASH) would like to take the opportunity to remind government officials, Lebanese police and security forces, policy makers, health care professionals, and the public in general that persecution and marginalization of Lesbian, Gay, Bisexual, and Transgender (LGBT) people and other minorities have serious and detrimental direct and indirect consequences on health.

Numerous studies have shown a direct link between the stress induced by persecution and marginalization and negative mental health outcomes such as depression, anxiety, substance abuse, and suicidality. Also, living in fear and isolation can lead to engagement in risky relationships which could include abuse and unsafe sexual practices, which ultimately has a negative impact on public health.

Persecution and marginalization of LGBT people enforces the taboo that surrounds all issues related to LGBT health making training of health care professionals on LGBT issues difficult. Also, discrimination against LGBT people can lead to loss of employment and lack of social support, both crucial in obtaining health care services and maintaining one’s health.

The Trans community bears the brunt of this discrimination as they deal with additional stressors and more severe forms of persecution leading to much worse health outcomes.

LebMASH is especially distraught that at the basis of this persecution and discrimination is the penal code 534 which states that “all sexual intercourse against nature can be punishable with up to 1 year in jail.”The reality is that homosexuality is a natural variation of human sexuality. The Lebanese Psychiatric Society (LPS), the Lebanese Psychological Association (LPA) and the World Health Organization (WHO) have affirmed on numerous occasions that homosexuality is not a mental disorder. The medical community has agreed that homosexuality is not a physical disease either. Therefore, article 534 does not apply to homosexuality and LebMASH is very encouraged by the recent ruling in Metn by judge Hisham Qantar that confirmed this understanding.

We believe that each one of us in a unique individual and that people in Lebanon differ greatly from each other. Groups of people can differ as well significantly when it comes to certain attributes like religion, sex, age, and socioeconomic status. People are all the same however in one thing: we all share the same right to health and well-being. To achieve this right, we need to put an end to persecution and marginalization.

Sincerely, Omar Fattal, MD, MPHPresident, LebMASH

To whom it may concern

We have been reading lately in newspapers about arrests and abuse of homosexuals in Lebanon. We also became aware of some positions taken by professionals regarding homosexuals and ways to treat them psychologically.
The Lebanese Psychiatric Society would like to state its position regarding homosexuality.
Homosexuality was once thought to be the result of troubled family dynamics or faulty psychological development. Those assumptions are now understood to have been based on misinformation and prejudice. Currently there is a renewed interest in searching for biological etiologies for homosexuality. However, to date there are no replicated scientific studies supporting specific biological etiology for homosexuality. Similarly, no specific psychosocial or family dynamic cause for homosexuality has been identified, including histories of childhood sexual abuse.

Homosexuality per se implies no impairment in judgment, stability, reliability, or general social or vocational capabilities. In addition, all major professional mental health organizations have gone on record to affirm that homosexuality is not a mental disorder. In 1973 the American Psychiatric Association’s Board of Trustees removed homosexuality from its official diagnostic manual, The Diagnostic and Statistical Manual of Mental Disorders, Second Edition (DSM II). The action was taken following a review of the scientific literature and consultation with experts in the field. The experts found that homosexuality does not meet the criteria to be considered a mental illness.

The following year, the American Psychological Association declassified homosexuality as an illness. Since then, every major medical and mental health organization has come to embrace this view. The World Health Organization (WHO) declassified homosexuality in 1990. WHO states: “In none of its individual manifestations does homosexuality constitute a disorder or an illness and therefore it requires no cure.” Therefore, homosexuality per se requires no treatment.

In fact, there is no published scientific evidence supporting the efficacy of “reparative therapy” as a treatment to change one’s sexual orientation. More importantly, altering sexual orientation is not an appropriate goal of psychiatric treatment. Some may seek conversion to heterosexuality because of the difficulties that they encounter as a member of a stigmatized group. Clinical experience indicates that those who have integrated their sexual orientation into a positive sense of self-function at a healthier psychological level than those who have not.

A position statement adopted by the American Psychiatric Association’s Board in December 1998 said:
The American Psychiatric Association opposes any psychiatric treatment, such as “reparative” or “conversion” therapy, which is based upon the assumption that homosexuality per se is a mental disorder, or based upon a prior assumption that the patient should change his/ her homosexual orientation.”
We urge mental health professionals in Lebanon to rely solely on science whenever they express opinion or provide treatment.

The LPS Executive Committee July 2013
Addendum – November 2015
The Lebanese Psychiatric Society would like to state its position regarding the legislation concerning homosexuality and demands that the article 534 of the Lebanese penal code that prosecute homosexual activities be abolished.
The LPS Executive Committee

Link to the original document

An original decision by the Lebanese court had denied a transgender man (born with female genitalia but identifies with male gender) the right to change their sex on their legal documents. Following this decision, the Court of Appeal in Lebanon represented by judge Jeanette Hanna reinstated this right considering that it is linked to three main human rights that cannot be violated: the right to a better health (by alleviating the suffering of this man), the right to seek care and finally the right to privacy ⁽¹⁾.

The Lebanese Medical Association for Sexual Health (LebMASH) views this ruling as a positive step towards better recognition of transgender community’s rights in our society, addressing their health needs and advancing their health status. There is an ample amount of work ahead of us to fight stigma, educate healthcare providers, regulate private surgeries and investigate abuse cases and hold perpetuators accountable.

Transgender individuals are individuals whose gender identity (man or woman) conflicts with their sex assigned at birth ⁽²⁾ (male or female). Transsexuals are individuals who seek sex-reassignment surgery ⁽²⁾. Not all transgender individuals seek sex reassignment surgery⁽³⁾ since some prefer hormonal therapy while others just reaffirm their gender without any additional treatment.

Although no data exists on the transgender population in Lebanon, studies in other countries show that this population is at an extremely higher risk for HIV ⁽⁴⁾ and suicide ⁽⁵⁾ among other mental health outcomes. All of this has been linked to the stigma that society enforces on these communities ^{(4 and 5)}. Not having legal documents that align with their current gender identity had been associated with being denied care in many other countries as well as the fear of these populations to seek care ^{(6, 7 and 8)}.

LebMASH would like to stress the following:

1. Any transgender citizen should have the right to change their sex on official documents to affirm their gender. The ruling should not be limited to post-operative transgender individuals.
2. Allowing transgender individuals to correct their sex on official documents removes only one of many barriers to competent and dignified healthcare that all citizens deserve. The medical community in Lebanon should work on advancing their knowledge on the topic to build competence in delivering care to this population. Transgender health should be included in medical school curricula, in residency programs, in budgets allocated for research and in medical conferences around the country.
3. To advance the health outcomes of any population, societal stigma should be alleviated. This is a role the media can play in approaching the topic of gender identity in a scientific and well-researched manner. Civil Society Organizations can also play a role in raising awareness about the topic.
4. To advance the health outcomes of any population, legal protections should be instated to prevent and punish verbal, physical, emotional and sexual abuses that individuals might be exposed to. This is a role the government and police authorities can play by awareness campaigns among their employees.

References:

1. ايفا الشوفي- محكمة الاستئناف تؤكد جق الفرد في تغيير جنسه مقال صادر في جريدة الأخبار يوم 13-1-2-16
2. Johnson CA. Off the map: how HIV/AIDS programming is failing same sex practicing people in Africa. New York: International Gay and Lesbian Human Rights Commission, 2007. http://www.iglhrc. org/cgi-bin/iowa/article/publications/reportsandpublications/4. html (accessed Nov 28, 2012).
3. Carroll, L., Gilroy, P. J., & Ryan, J. (2002). Counseling transgendered, transsexual, and gender‐variant clients.Journal of Counseling & Development, 80(2), 131-139.
4. Baral, S. D., Poteat, T., Strömdahl, S., Wirtz, A. L., Guadamuz, T. E., & Beyrer, C. (2013). Worldwide burden of HIV in transgender women: a systematic review and meta-analysis.The Lancet infectious diseases, 13(3), 214-222.
5. Haas, A. P., Eliason, M., Mays, V. M., Mathy, R. M., Cochran, S. D., DAugelli, A. R., & Russell, S. T. (2010). Suicide and suicide risk in lesbian, gay, bisexual, and transgender populations: review and recommendations.Journal of homosexuality,58(1), 10-51.
6. Baral, S., Beyrer, C., & Poteat, T. (2011, July). Human rights, the law, and HIV among transgender people. InThird Meeting of the Technical Advisory Group of the Global Commission on HIV and the Law.
7. Law, G.C.o.H.a.t., (2011), Selected Submissions from the Global Commission on HIV & the Law – Asia-Pacific, Caribbean, Eastern Europe & Central Asia and Latin America, in Regional Dialogues, U.H.A. Practice, UNDP: Port of Spain, Trinidad.
8. Riascos-Sanchez, V.P., et al., (2008), ID cards that reflect gender identity can play role in reducing vulnerability of transgender sex workers (MOAD0305), in XVII International AIDS Conference, IAS: Mexico City.

The Lebanese Medical Association for Sexual Health (LebMASH) has recently learned that a Forensic physician in Lebanon, Dr. A. M. has conducted anal tests on several individuals to determine their sexual orientation.

LebMASH is extremely concerned to hear that this practice, “the anal test”, continues to take place in Lebanon especially given that:

• This test is antiquated and does not yield any useful information about a person’s sexual orientation or behavior.
• This test can be harmful physically and psychologically to the person receiving it.
• The order of physicians in Lebanon banned this test in an official Memo in 2012.
• The test is unethical, violating a major component of the Hippocratic Oath: non-maleficence or first, do no harm.

Before we discuss the anal test itself, it’s important to understand that male homosexuality has three different aspects to it:

1. Sexual orientation: the sexual and/or emotional attraction to another person of the same sex and the desire to be with this other person.
2. Sexual behavior: the actual sexual acts that involve two men and can include kissing, body contact, oral sex, mutual masturbation, anal stimulation, and anal intercourse.
3. Sexual identity: identifying socially as being homosexual or gay.

A person can have a homosexual sexual orientation but not engage in sexual behavior with other men and without identifying as gay. Another person can have a homosexual sexual orientation and engage in sexual behavior with other men but not identify socially as gay. And finally, a person can have homosexual sexual orientation, engage in sexual behavior with other men, and identify socially as being gay.
The so-called anal test for homosexuality involves the insertion of a metal object into a man’s anal canal through the anus allegedly to find out if this person is homosexual. Homosexuality, just like heterosexuality, is a very complex construct and can’t possibly be determined by a simple test.

The only “medical” reference to the use of the anal test in relation to homosexuality is a paper published by a French medico-legal expert named Auguste Ambroise Tardieu back in 1857. Tardieu claimed that “chronic sodomites” have certain specific penile and anal physical characteristics that are unique to them.

Today, over 150 years later, we know that what is mentioned in Tardieu’s study is not true. Adult men who engage in consensual anal intercourse do not have any permanent penile or anal characteristics that are unique to them. Therefore performing an anal test on them is futile.

The anus is the external opening of the anal canal, which is the terminal part of the human colon. The anus has 2 sphincters: the internal anal sphincter that is an involuntary muscle and the external anal sphincter that is a voluntary muscle (i.e. can be opened and closed at will by the person).

If we examine the report of Dr. A. M. more closely, we can see in more details how misguided he is about both normal anal anatomy and homosexuality. In his report, Dr. A. M. mentions that there was “no evidence of accumulation, tear or redness”. Normal homosexual anal intercourse between two consenting adults does not lead to “accumulations, tears or redness”. Even if there was evidence of any of these findings on an anal exam, these findings can be attributed to a number of medical conditions such as an anal abscess, an anal fissure, constipation or hemorrhoids all of which can cause changes in the anal mucosa.

Dr. A. M. also mentions in his report that “the anal sphincter is functioning normally”. Adult men who engage in consensual anal intercourse, even if it is on a regular basis, do not have abnormalities in the functioning of their anal sphincters. The anal sphincters have the natural ability to expand when needed (for example to receive anal intercourse) and return to their normal size and tone afterwards. This is seen every day when passing a bowel movement. The internal anal sphincter relaxes naturally and the external sphincter is voluntarily relaxed to allow for defecation. However, following this, both sphincters return to their normal tone and functioning.

Performing an anal test on someone to find out information about someone’s sexual orientation or behavior is not only futile, but can also be very harmful physically and psychologically.

Physically, inserting a metal object into an anal canal in an uncontrolled location such as a police station can place the person at risk for infections such as Human Papilloma Virus (HPV) and Hepatitis, to mention a few. Inserting an object as small as a finger into one’s anal canal by a Forensic doctor can cause excruciating pain and/or tears, even for someone who regularly engages in anal intercourse. The difference is that when engaging in normal anal intercourse, the individual has the chance to gradually and voluntarily relax the anal sphincters, as well as many muscles that exist in the perineal area, in order to receive anal intercourse, that is perceived as pleasurable by this individual. On the other hand, and similar to being raped, inserting an object as small as a finger into someone’s anal canal without their consent and without giving them the chance to gradually relax their muscles will lead to the opposite scenario, i.e. to further contracture of the anal sphincters and perineal muscles, and therefore will lead to severe pain and possible injury.
Psychologically, subjecting someone to this anal test discussed here can lead to severe psychological trauma similar to the trauma that individuals can endure after being raped. In addition to the shame and humiliation, the individual subjected to this cruel procedure is at risk of developing Post Traumatic Stress Disorder (PTSD) and possibly sexual dysfunction by being unable to receive normal consensual anal intercourse or even anal stimulation in the future.

LebMASH calls on the Lebanese Order of Physicians (LOP) to take responsibility for the actions of one of its members by enforcing disciplinary measures on Dr. A.M. to reinforce LOP’s ban on these tests issued on Aug. 7, 2012.

LebMASH reiterates its position regarding homosexuality being a normal variation of human sexuality and therefore not a medical or psychiatric condition that requires diagnosis or treatment.
LebMASH is happy to provide LOP members and especially to Dr. A.M. cultural competency training and consulting for issues related to sexual orientation and gender identity.

LebMASH urges the LOP to issue an official statement, similar to those issued in July of 2013 by the Lebanese Psychiatric Society and Lebanese Psychological Association, asserting that homosexuality is not a disease and that homosexuality is a normal variant of human sexuality.

We also call on the law enforcement agencies in Lebanon to abide by Lebanon’s commitment to the Universal Declaration of Human Rights, especially Article 5 the part relating to humane treatment of people in custody. We call on those agencies to respect people’s right to the integrity of their bodies.

LebMASH calls on lawyers and judges to stop using Article 534 of the Lebanese penal code to criminalize homosexuals since the sexual act between two consenting adults of the same gender is not “against nature.”

On July 21st 2013, a “Concerned Lebanese”  left the following comment on our post: Response to Dr. Khoury’s interview about homosexuality.

My apologies if I come across as belligerent, but I have some criticism of this article (Which I believe to be poorly researched)

Did you know that this “world leader on mental health” was actually bullied by gay activists for 3 years before they declassified homosexuality as a mental disorder?

Moreover, did you know that two FORMER PRESIDENTS of the APA (Robert Perloff & Nicholas Cummings) have accused it of being a biased organization that is swayed by lobbying? Pretty serious stuff.

Dr. Khoury seems to know about the political correctness running through the veins of the APA and other “objective” organizations. You, on the other hand, came across as naive. (Sorry, but it’s true)

Btw, I am not attacking homosexuality. I am instead hoping you would see the flaws in your arguments.

Executive Board Member of LebMASH, Omar Fattal has written an official response to the above concern:

Dear concerned Lebanese,

Thank you for your interest in our page and for your feedback.

In our reply to Dr. Khoury, we mention the American Psychiatric Association and not the American Psychological Association. Dr. Perloff and Dr. Cummings are both former presidents of the American Psychological Association and not the American Psychiatric Association.

The American Psychiatric Association (APA) is the official association that updates the DSM (Diagnostic and Statistical Manual of Mental Disorders) and they do so periodically. For example, in May of 2013, the APA came out with the DSM-V (five) which is the most recent version of the DSM.

The process of revising the DSM is an extremely complicated process. Just to give you an idea, the DSM-V Task Force and Work Groups were made up of more than 160 world-renowned clinicians and researchers who reviewed scientific literature and sought input from many advisors as the basis for proposing new draft criteria. Eventually, all proposed changes and revisions had to be approved by the board of trustees. Similarly, in 1974, the American Psychiatric Association went through a very complicated process to revise the DSM at that time.

The APA has several interest groups within its membership that does influence its policies and the organization does respond to external lobbying as well. However, the APA or any other professional organization for that matter is subjected to pressures from interest groups representing all points of views given a specific topic such as homosexuality. In the same way that there were groups in the years preceding 1974 asking the APA to remove homosexuality from the list of mental illnesses, there were other groups asking the APA to keep homosexuality on the list of mental illnesses.  Also, just because a decision was made partially due to pressure from certain groups does not mean that the decision itself is not a valid one.  The APA made its decision to remove homosexuality from the list of mental illnesses in the context of strong evidence that was supportive of the fact that homosexuality was common and that homosexuals did not have psychological issues due to homosexuality itself.

This evidence came from research done by Kinsey in the late 1940s and early 1950s showing for the first time that homosexuality was much more common than previously thought.

In 1951, Clellan Ford and Frank Beach’s showed that homosexuality was common across cultures and existed in almost all nonhuman species. Their work supported the notion that homosexuality was both natural and widespread.

There was also strong and ground-breaking research done by Evelyn Hooker in the mid 1950s. Her study, which other researchers subsequently repeated, showed that there was no detectable difference between homosexual and heterosexual men in terms of mental adjustment.

Since 1974, hundreds of professional mental health organizations across the world have come out with statements confirming that homosexuality is not an illness and requires no treatment. The renowned World Health Organization (WHO) which includes members from all over the world, deleted homosexuality from the list of illnesses in 1991. Most recently, the Lebanese Psychiatric Society (LPS) and the Lebanese Psychological Association (LPA) came out with strong public statements confirming that homosexuality is not a mental illness and requires no treatment. To our knowledge, the WHO, the LPS and LPA where not “bullied” by anyone to come out with these statements.

Almost 40 years have passed since the APA’s decision to remove homosexuality from the list of mental illness and the DSM has been revised several times since then. These four decades would have given anyone plenty of time to prove that homosexuality in itself is a disorder, however, this has not happened.