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

Statement from the Lebanese Psychiatric Society (LPS)

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

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