Frequently Asked Questions

The American Psychiatric Association (APA) removed homosexuality from the Diagnostic and Statistic Manual of mental disorders (DSM-IV) in 1973. The World Health Organization also stopped considering homosexuality a disease since 1992. All of these conclusions came after decades of research that lead to the belief that same-sex attraction, by itself, doesn’t cause distress to someone’s life or their well-being. In Lebanon, the Lebanese Psychological Association (LPA) and the Lebanese Psychiatric Society stated that homosexuality is not a disease in 2013 and discouraged the use of conversion therapies considering them harmful.

Cochran, S. D., Drescher, J., Kismödi, E., Giami, A., García-Moreno, C., Atalla, E., … & Reed, G. M. (2014). Proposed declassification of disease categories related to sexual orientation in the International Statistical Classification of Diseases and Related Health Problems (ICD-11). Bulletin of the World Health Organization, 92(9), 672-679.
Abdessamad, H. A Non-Cure for a Non-Malady: “Reparative Therapy”.

Many studies had shown that homosexuality itself doesn’t affect someone’s well-being, and by extension, their health. There were several groups from within the APA and outside the APA who were advocating to de-pathologize homosexuality. Similarly, there were groups who were fighting to keep homosexuality in the DSM. Ultimately the APA took its decision based on scientific studies that showed that homosexuality is not a disease.Psychiatric News – Panelists Recount Events Leading to Deleting Homosexuality As a Psychiatric Disorder From DSM

American Psychiatric Association – Fact and Information Sheet About: American Psychological Association Lesbian, Gay, and Bisexual Concerns Policy Statements.American Psychological Association. (1998). Guidelines for psychotherapy with lesbian, gay, and bisexual clients.
Retrieved from:
http://www.apa.org/divisions/div44/guidelines.htm
http://www.counseling.org/news/updates/2013/01/16/ethical-issues-related-to-conversion-or-reparative-therapy#sthash.IoecY2dn.dpuf

Although sexual behavior and sexual social identity is a choice, sexual attraction or desire is not. People can choose not to act upon their attractions or desires and to keep them repressed but those attractions will always be there. It should be noted that repressing one’s sexual attractions or desires can have a negative influence on one’s mental and physical well-being.American Psychological Association. (2005). Just the facts about sexual orientation and youth: A primer for principals, educators, and school personnel.
APA online.

Although a lot of research has been done on the etiology of sexuality in general, no definite response has been obtained. Researchers do stipulate that sexuality is born out of a combination of genetic, biologic and psychosocial factors.

On the other hand, we know that we don’t look for the etiology of interracial love or love between two people from different religions, neither do we look for reasons of heterosexuality and that’s why there wouldn’t be a purpose to look into causes of same-sex attraction.

Finally, homosexuality is not a disease and should not be taken as one, and thus looking for its “causes” should not be done under that assumption.
Herek, G. M. (2002). Facts about homosexuality and mental health. Online],

Frayer, D. W., Wolpoff, M. H., Thorne, A. G., Smith, F. H., & Pope, G. G. (1994). Getting it straight. American Anthropologist, 96(2), 424-438

Conversion therapy has been condemned by many health organizations such as the World Health Organization, the American Psychiatric Association, and the American Psychological Association. In Lebanon, the Lebanese Psychiatric Society and the Lebanese Psychological Association have both warned in statements released in 2013 that health professionals should refrain from changing a person’s sexual orientation.

Efforts to change someone’s sexual orientation have been proven to have negative outcomes on this person’s mental health and well-being in general. Sexual attraction cannot be changed.

So called “ex-gay” movements, mostly focus on individuals who are behaving in a manner opposite to their attraction. Such acts have also been associated with negative mental health outcomes. Robert Spitzer, a strong supporter of such “therapies”, had sent a letter apologizing for backing such acts and admitting that they are harmful. It should be noted that these movements are almost always motivated by religious beliefs and not scientific research.

Spitzer, R. L. (2003). Can some gay men and lesbians change their sexual orientation? 200 participants reporting a change from homosexual to heterosexual orientation. Archives of sexual behavior, 32(5), 403-417. Carey, B. (2012). Psychiatry giant sorry for backing gay “cure”. The New York Times, 28.

Forstein., M. (2001). Overview of ethical and research issues in sexual orientation therapy. Journal of Gay and Lesbian Psychotherapy, 5(3/4), 167-179. – See more at: http://www.counseling.org/news/updates/2013/01/16/ethical-issues-related-to-conversion-or-reparative-therapy#sthash.IoecY2dn.dpuf

A person who is exclusively attracted to individuals from the same-sex cannot make himself or herself attracted to individuals of the opposite sex.

Someone can act (sexually or romantically) in manners opposite to their attractions, yet this could be harmful to their mental health. Men who fit under this category can get erections and have sex with females while fantasizing about what their attractions truly reflect, which is being attracted to other men. Women who fit under this category could be forcing themselves into having sex with someone they are not attracted to which would decrease as well their sexual pleasure.

So-called “reparative rape” or “corrective rape” is very dangerous. Some lesbian women are subjected to it. Reparative rape assumes that if a person got raped from a person from the opposite sex, they will “become” heterosexuals. This, in addition to the negative health outcomes that are discussed previously, can lead to all the negative effects resulting from rape, such as trauma, post-traumatic stress disorder, and other serious mental health issues.

(Brown, 2012 – same thing about the references). Alessi, E. (2007). Staying put in the Closet: Examining Clinical Practice and Countertransference Issues in Work with Gay Men Married to Heterosexual Women. Clinical Social Work Journal, 36(2), 195-201.Brown, R. (2012). Corrective Rape in South Africa: A Continuing Plight Despite an International Human Rights Response. Annual Survey Of International & Comparative Law, 18(1), 45-66.

Scientific and social sciences studies have showed that homosexuality has always existed. Homosexual acts predate the Greek civilization, therefore it’s not a new trend. Homosexuality is not new to the Arab culture either, since poets from the medieval Islamic civilization like Abu Nawas actually wrote about their same-sex attractions (Jama, 2015).

The most commonly accepted prevalence of LGBT people in the general population ranges from 1 to 10% although no studies can actually prove that number since there would always be a selection bias that disregards non-out LGBT members (Hein & Matthews, 2010). Although this prevalence has not been proved to have actually increased, LGBT people are more present in society these days since they are comfortable coming out in certain social contexts and according to their geographical location. The media is also shedding more light on the presence of LGBT communities in society, which lead to shift the perception around homosexuality (Lapsley, 2008). This same principle applies to Lebanon as well, where more people are now comfortable with coming out and speaking up about LGBT issues in Lebanon , since more awareness and sensitization around homosexuality is taking place due to the efforts of non- governmental organizations working on these issue (LebMASH, 2016).

Jama, A. (2015). 5 Queer Muslims in History – LGBT Muslims.

LGBT Muslims. Retrieved 26 January 2016, from http://islamandhomosexuality.com/5-queer- muslims-history/

Hein, L. C., & Matthews, A. K. (2010). Reparative therapy: The adolescent, the 
 psych nurse, and the issues. Journal of Child and Adolescent Psychiatric 
 Nursing, 23(1), 29-35.

Retrieved from http://search.proquest.com/docview/232968344?accountid=8475

Lapsley, H. (2008). Out in psychology: Lesbian, gay, bisexual, trans and queer perspectives. New Zealand Journal of Psychology, 37(3), 65
LebMASH. (2016). ما بهم شو السبب، المثليّة منّا مرض | LebMASH. Retrieved 26 January 2016, from https://www.lebmash.org/

The rates of sexual abuse during childhood in homosexual men and women were equal to those seen in heterosexual men and women. This proves that being a victim of sexual abuse during childhood doesn’t play a role in someone’s ultimate sexual orientation as an adult (or even adolescent).

Pedophilia is very different from homosexuality. Pedophilia is an attraction to minors regardless of sexual orientation. Pedophilia is considered as a sexual disorder and is illegal in many parts of the world. There is no association between pedophilia and homosexuality. More than 90% of pedophiles are in fact heterosexual. Kali Munro, M.Ed. (2002). Am i gay because of the abuse?

Retrieved from: http://kalimunro.com/wp/articles-info/lesbian-gay/am-i-gay-because-of-the-abuse Adapted from a presentation at the 5th International Conference on Incest and Related Problems, Biel, Switzerland, August 14, 1991. Male Sexual Victimization Myths & Facts. Retrieved from: http://www.malesurvivor.org/myths.html

Homosexual poems and texts exist in Arab history and literature books. Abou Nawas, a famous Arab poet, wrote many poems where he tells stories of him flirting with other men (Jama, 2015). Laws criminalizing homosexuality have been imported (SocialistWorker.org, 2011) from the French colonization in Lebanon (and British colonization of other neighboring countries). Thus homosexuality is not a western import.

Homosexuality has been part of communities for a long time, and, although the West has taken a bigger step in the fight for LGBT rights, it doesn’t mean that such rights should be bound to those countries, just like human rights – many of which are violated in the Middle East – should not be labeled as a Western concept.

Jama, A. (2015). 5 Queer Muslims in History – LGBT Muslims. LGBT Muslims. 
 Retrieved 26 January 2016, from http://islamandhomosexuality.com/5-queer- muslims-history/
SocialistWorker.org. (2011). The LGBT struggle in lebanon. Retrieved from
http://socialistworker.org/2011/02/02/lgbt-struggle-in-lebanon

Banon

Same-sex attractions and identities have been always present. This population is still referred to as a “hidden population” since, in many places in the world, just like Lebanon, people are still afraid to assume their identities and are persecuted.

Gay and Lesbian individuals are becoming more visible in society since more people are having the courage of expressing their sexual orientation and sexual identity. This doesn’t mean that the relative numbers of gay people in the general population are increasing, it’s just that these communities are becoming more visible.

All of the following are present on a spectrum that ranges between two broad concepts. Gender Identity: the gender with which a person identifies. Gender is socially constructed; thus it is society that assigns certain roles to a biological sex.

Identity reflects what the person identifies with psychologically but also in society (how they choose to be referred to). Gender identity can range from female (or woman) to male (or man) and anything in between.

Examples: Transgender women, Transgender men, Cis-gender (people whose gender identity aligns with their gender at birth), Gender-queer, gender non-conforming. This is not an exhaustive list, individuals may identify with many other gender identities.

Sexual Orientation: Sexual orientation consists of three concepts. The first is attraction: who is the person attracted to. The second is behavior: who does the person engage in relationships (sexual or non-sexual) with. The third is identity: what communities does the person identify with. Examples: Lesbian, Gay, Bisexual, queer, heterosexual/straight. This is not an exhaustive list, individuals may identify with many other sexual orientations.

Gender Expression: the expression that a person uses in public or in day-to-day life. This refers to clothing items and accessories that the person uses as well as their attitudes in society Gender expressions vary according to countries and cultures. For example, a skirt may be considered women’s wear in Lebanon but is considered men’s wear in Scotland. Also, a robe is considered both men and women’s wear in Saudi Arabia while it refers only to a female’s gender expression in the United States.

Gender Roles: roles that society creates and imposes on people of a certain gender. These vary according to cultures but also change historically (Killermann, 2016). For example, in Lebanon, women used to typically assume the role of housewives but this has changed over the years and women now can assume all kinds of jobs and roles in society.

Biological sex: Sex that you are born with / assigned at birth. Biological sex also falls on a spectrum since individuals can be born with both male and female genitalia or have parts of either other sex. Intersex individuals encompass people who have external genitalia and/or internal genitalia or parts of external/internal genitalia that correspond to both sexes.

Killermann, S. (2016). Breaking through the binary: Gender explained using continuums | It’s Pronounced Metrosexual. It’s Pronounced Metrosexual. Retrieved 26 January 2016, from http://itspronouncedmetrosexual.com/2011/11 /breaking-through-the-binary-gender-explained-using-continuums/

nal sex and male homosexuality are not synonymous. Some argue that oral sex and mutual masturbation are more common sexual practices among gay men than anal sex. Also, anal sex is not restricted to male homosexual relationships. Some heterosexual couples engage in anal sex. And some heterosexual men enjoy stimulation of the anal area as it is knows to be very rich with nerve endings and a very sensitive area.

“And while many people stereotypically view anal stimulation as a homosexual male act, anal sex is a sexual behavior, not tied to a group of people whether they describe themselves as homo-, bi-, or heterosexual. Physical, emotional, social, and sexual attractions, not behaviors, are key factors in a person’s understanding of his or her sexual orientation.” (Alice, 2011)

Alice. (2011). Not all gay men have anal sex. Retrieved November 10, 2016, from http://www.goaskalice.columbia.edu/answered-questions/not-all-gay-men-have-anal-sex

Sexual orientation and gender expression/role and masculinity/femininity are not always aligned in a predictable way. A man can be perceived as feminine by others and can be heterosexual and a man can be perceived as masculine by others and be gay. The same is true for women. A woman can be feminine and lesbian or can be masculine and straight.

Society tends to have rigid and binary classifications in regards to gender and masculinity and this sets certain expectations on LGBT people. Discrimination and societal pressure can lead to depression and anxiety.

Lippa. (2005). Sexual orientation and personality. Annual Review of Sex Research, 16, 119-153.

n a recent study done in the UK, 1.6 % of males identified themselves as gay, whereas only 0.7 % identifying as lesbian (UK – Office for National Statistics, n.d.). So gay men might be more prevalent than lesbians but, on the other hand, lesbians might be less willing to reveal their sexual orientation and less willing to be portrayed in the media (Telegraph, n.d.). In Lebanon, we do not have any statistics on the percentage of people in the population who are gay or lesbian.

Telegraph. (n.d.). Young lesbians: where are they all? Coming out in an era of lesbophobia. Retrieved from http://www.telegraph.co.uk/women/wo mens-life/10452313/Young-lesbians-where-are-they-all-Coming-out-in-an-era-of-lesbophobia.html

UK – Office for National Statistics. (n.d). Sexual identity. Retrieved from https://www.ons.gov.uk/peoplepopulationandcommunity/culturalidentity/sexuality/bulletins/sexualidentityuk/2015

Marriage if often seen as an indication of social and legal equality.

Also, for many couples, whether heterosexual or homosexual, marriage is an important expression of the bond between them and an important phase of their relationship.

Philpot, S. P., Ellard, J., Duncan, D., Dowsett, G. W., Bavinton, B. R., Down, I., & … Prestage, G. (2016). Gay and bisexual men’s interest in marriage: an Australian perspective. Culture, Health & Sexuality, 18(12), 1347-1362. doi:10.1080/13691058.2016.1184314

Studies show that more than half of homosexual couples are monogamous (Parsons et al., 2012). Statistics are similar for heterosexual couples (Mark, Janssen & Milhausen, 2011) revealing that rates of satisfaction with just one partner are similar irrespective of orientation and that this shouldn’t be a reason to deny homosexuals, or heterosexuals, from getting married.

When attempting to tackle the topic of the potential term of a homosexual relationship, as well as, possible reasons for its termination, three factors have to be taken into consideration: gender similarities, stages and health of the relationship.      

Most relationships, whether homosexual or heterosexual, have common dynamics and features. An important feature is one that concerns gender: gender differences in heterosexual relationships and gender similarities in homosexual relationships. In a heterosexual relationship, we see notable differences in gender roles that are prominently reinforced by culture and society. Be it a marriage or a committed relationship, the man usually assumes the masculine roles (usually termed “breadwinning”) and the woman is usually assigned the feminine roles (usually identified as “caregiving”). On the other hand, in homosexual relationships, and as the relationship evolves, we see an absence of gender roles, mainly because of the belongingness of both partners to the same gender. Therefore, the roles of each partner in the relationship or marriage diverge from a gender basis for role distribution (for example: Who does which chores? Who cooks? Who takes care of finances? Etc…). This divergence allows more value and achievement for equality in the relationship.

In addition to the establishment of gender role equality in a homosexual relationship, it is important to consider how stages of the relationship contribute to its duration. Most relationships go through 6 stages: blending (year 1), nesting (years 2 to 3), maintaining (years 4 to 5), building (years 6 to 10), releasing (years 10 to 20) and renewing. Each stage is characterized by a theme that should occur in order for the relationship to move forward, otherwise the relationship may be in jeopardy and in risk of a break up. For example, in the first stage (blending), gender equalization and unification process takes place in order for homemaking to occur in the second stage (nesting). It is important to know that a break up can occur for reasons other than unresolved stages, for example: infidelity, drifting apart, etc…

The health of a relationship is important for its evolution. It is essential to be able to acknowledge the difference between a healthy relationship and an unhealthy or destructive one. A healthy relationship includes: mutual respect for gender pronouns and names partners choose to identify with, mutual respect for sexual boundaries and consent, ability to express emotions freely, emotional security and comfort, trust, fair conflict resolution, privacy, independence, etc… Many relationships tend to become toxic because of the absence of many of these qualities which can also have an effect on its duration.

(n.d.). Retrieved from Iowa State University Department of Psychology: http://public.psych.iastate.edu/madon/socialpsychology280/extrareadings/gayrelationshipdevelopment.htm

Clarke, V., Burgoyne, C., & Burns, M. (2005, June). Comparing lesbian and gay, and heterosexual relationships: For love or money? Retrieved from The British Psychological Society: https://thepsychologist.bps.org.uk/volume-18/edition-6/comparing-lesbian-and-gay-and-heterosexual-relationships-love-or-money

Healthy vs. Unhealthy Relationships. (n.d.). Retrieved from Hall Health Center: https://www.tacoma.uw.edu/studentaffairs/SHW/documents/Health%20topics/Healthy%20vs%20Unhealthy%20Relationships.pdf

Many members of the LGBT community establish cover marriages that are heterosexual in nature. In the following, we are going to define what a cover marriage is, explain the reasons people go through with it and the potential consequences.

A cover marriage or informally, a lavender marriage is a heterosexual mixed-orientation marriage (MOM) where one or both partners belong to the LGBT community.

People establish cover marriages for many reasons such as: to lessen or eliminate same-sex attraction (internalized homophobia and unacceptance of one’s sexual orientation), family pressures to marry from the opposite sex, desire to have a family and children, religious pressures, and most importantly, a culture that opposes gay marriage and its legalization.

The most striking motive behind cover marriages is the pressing need to hide one’s sexuality from family and society. Sexuality is part of one’s self and identity and hiding it can have many adverse effects. These effects are detrimental to one’s cognitive, emotional and physical functioning. On the cognitive level, concealment could cause a burden and preoccupation with having to hide and monitor and regulate one’s thoughts, verbal and physical behavior, social circles, etc… Some people start to behave in hypermasculine or hyperfeminine manners in order to conform with the heterosexual image and remove all doubt of being homosexual. On the emotional level, what is called “minority stress”, which is the stressful internal and external environment living in constant stigma, prejudice and discrimination causes; is now more intense when having to conceal one’s orientation. On the physical level, concealment can have adverse health consequences and sexual frustration from being unable to express one’s sexuality.

Meyer IH. Prejudice, Social Stress, and Mental Health in Lesbian, Gay, and Bisexual Populations: Conceptual Issues and Research Evidence. Psychological bulletin. 2003;129(5):674-697.

Zimmerman, Kevin John, “Maintaining commitment in long-lasting mixed-orientation relationships: Gay men married to straight women” (2013).Graduate Theses and Dissertation. Paper 13464.

Homosexuality is still considered a social taboo in Lebanon. The lifestyle of gay and lesbian people in Lebanon is dichotomous. On one side, certain freedoms are afforded to a certain affluent social class, especially within the capital, Beirut. On the other hand, life can be very difficult for gay and lesbian people living outside Beirut or for those coming from less affluent socio-economic groups.In the past 10 years or so, Lebanon has seen a significant growth in the number and activity of NGOs working on advancing LGBT rights. The tolerance of these organizations by the government has been nonetheless ambiguous: it refuses to give Helem, the first LGBT rights organization in Lebanon a registration number but works on the ground with LGBT organizations through the National AIDS Program.

On the other hand, article 534 of the Lebanese penal code that criminalizes any “unnatural” sexual act is still used as a mean of threat, torture and punishment to members of the LGBT community in Lebanon, particularly communities from low and middle socio-economic status and vulnerable groups such as migrants and refugees.

When it comes to health services, the LGBT community faces discrimination from most of the health care workers with a big proportion of the health care population still perceiving homosexuality as a mental illness that can be treated. There are very limited health care services that the community can access and receive without any discrimination. Marsa sexual health clinic is one of the few and unique clinics in that area.

Socially, there is still discrimination against the LGBT community through media outlets and through employment opportunities. A recent survey conducted by the Arab Foundation for Equality showed that rejection was the most common reaction to people whose family member would tell them that their gay, while the majority of the same sample said that it would try to help a family member who came out as transgender, showing feelings of empathy . This proves that the Lebanese society looks at homosexuality as an unaccepted behavior but tolerates more transsexualism by pathologizing transgender communities.

In summary, when compared to the Arab region, Lebanon gives sexual minorities a broader outlet of freedom, but is still far from reaching the goal of protection and safety to LGBT communities.

Al Kak “Homophobia in Clinical Services in Lebanon: A physican survey” 2010.
Nasr Nour and Tarek Zeidan. As long as they stay away. Exploring Lebanese Attitudes towards sexualities and gender identities. 2015

It is too early to discuss the topic of same-sex marriage or gay adoption in Lebanon, a country that still uses its laws to jail people who engage in same-sex relationships. Also, Lebanon still does not allow civil marriage, or the right to allow women to pass their nationalities to their children.

Scientifically speaking, research has proven that same-sex marriages have the same rates of divorce and success as heterosexual marriages. Children who are raised to same-sex parents have also proved to be as successful and healthy as children raised by heterosexual parents. Also, legalizing same-sex marriage was shown to have a positive effect on the health of the concerned LGBT individuals. Patterson, C. J. (2000). Sexual orientation and family life: A decade review. Journal of Marriage and the Family, 62, 1052 – 1069

Patterson, C. J. (2006). Children of lesbian and gay parents. Current Directions in Psychological Science, 15, 241 – 244.

Gartrell, N., Deck, A., Rodas, C., Peyser, H., & Banks, A. ( 2005). The National Lesbian Family Study: 4. Interviews with the 10-year-old children. American Journal of Orthopsychiatry, 75, 518 – 524.

Erich, S., Leung, P., & Kindle, P. (2005). A comparative analysis of adoptive family functioning with gay, lesbian, and heterosexual parents and their children. Journal of GLBT Family Studies, 1, 43 – 60.

Adopted by the APA Council of Representatives July 28 & 30, 2004. Reaffirmed by Council Aug. 11 & 15, 2010. Sexual Orientation & Marriage. Retrieved from: http://www.apa.org/about/policy/marriage.aspx

American Psychological Association (APA), March 1 [2013], No Scientific Basis for Prohibiting Same-Sex Marriage, Key Associations Argue. Retrieved from: http://www.apa.org/news/press/releases/2013/03/same-sex-marriage.aspx

SocialistWorker.org. (2011). The LGBT struggle in lebanon. Retrieved from
http://socialistworker.org/2011/02/02/lgbt-struggle-in-lebanon

Hatzenbuehler, M. L., O’Cleirigh, C., Grasso, C., Mayer, K., Safren, S., & Bradford, J. (2012). Effect of same-sex marriage laws on health care use and expenditures in sexual minority men: A quasi-natural experiment. American Journal of Public Health, 102(2), 285-e7. doi:10.2105/AJPH.2011.300382
Murphy, T. F. (2011), Same-Sex Marriage: Not a Threat to Marriage or Children. Journal of Social Philosophy, 42: 288–304. doi: 10.1111/j.1467-9833.2011. 01534.x

Article 534 of the Lebanese penal code that criminalizes any “unnatural sexual act” is still used to persecute homosexual men. Within the past few years, many men have been subject to arrests because they were “accused” of being gay. Such men also tend to be from lower Socio-economic status, which inflicts more discrimination in this category of individuals.

A landmark to note in legal issues would be that of the ban of anal-tests performed in police stations. These tests are a violation of any person’s basic rights, are a method of torture and don’t even have any medical proof .

Transsexuals (and to a lesser extent transgender populations) have been granted the right to change their sex on their legal documents, to fit their desired gender, by the Lebanese court with a landmark ruling by the court of appeal (higher court ruling) of granting a transgender man this right based on the respect of the right to privacy (Makhlouf).

Makhlouf Youmna. The respect of the desire to change their sex in the legal courts. The Legal Agenda. January 11th 2016.

Human Rights Watch – “It’s part of the job”Ill-treatment and Torture of Vulnerable Groups in Lebanese Police Stations. June 26 2013

It is up to you to lead the change in your social circles about perceptions towards homosexuals and transsexuals/transgender people. You can take the first step by being more vocal about the rights of such people and by discussing these issues with people you think discriminate against these communities. Listen to their arguments and present to them counter arguments that are based on common sense, logic, and the scientific literature. Educate yourself about LGBT issues. Keep in mind that it has been shown over and over that people tend to change their views regarding LGBT people in a positive way once they meet and get to know LGBT people on a personal level. Finally, feel free to contact us with your debate topics but also for help with resources.

Prior to 1974, in the West the prevalent view was that homosexuality is a mental illness.  This encouraged judgment and punishment of homosexuals (Robinson, 2014). However, in 1973, due to research by Hooker and others, in addition to changing of social norms and the development of a politically active gay community in the United States, the American Psychiatric Association removed homosexuality from the Diagnostic and Statistical Manual of Mental Disorders (DSM) (Herek, 2012) . “Lesbian, gay, bisexual, transgender (LGBT) people face tremendous difficulties growing up in a society where heterosexuality is often presented as the only acceptable orientation and homosexuality is regarded as deviant” (Subhrajit, 2014).

In Lebanon, in 2013, the Lebanese Psychiatric Society and the Lebanese Psychological Association issued statements reaffirming that homosexuality is not a mental illness and therefore requires no treatments and condemned the practice of conversion therapy.

“The religiously conservative stance generally considers homosexuality to be an abomination — a serious, immoral, changeable, abnormal, and unnatural addiction that is hated by God and is destructive to the individuals who choose to follow the lifestyle. It is generally chosen after puberty” (Robinson, 2014). “Muslim condemnations of homosexuality, like those in Christianity, are based mainly on the story about God’s punishment of Sodom and Gomorrah which is recounted in the Qur’an as well as the Old Testament. In essence, the biblical and Qur’anic versions are very similar.”

When religion introduces sexual orientation as a choice, we see marginalization of the LGBT community. Especially when heterosexuality is seen as the “norm” and therefore homosexuality can be seen as a form of rebellion.

And despite being de-classified as a mental illness in the West, by the World Health Organization (WHO), and in Lebanon, homosexuality is still stigmatized.

Herek, G. (2012). Homosexuality and Mental Health. Retrieved November 14, 2016, from http://psychology.ucdavis.edu/rainbow//html/facts_mental_health.html

Robisnon, B.A. (2014). Two definitions & six interpretations about homosexuality and bisexuality. Retrieved November 13 2016, from http://www.religioustolerance.org/hom6beli.htm

Subhrajit, C. (2014). Problems Faced by LGBT People in the Mainstream Society: Some Recommendations. Retrieved November 13 2016, from http://www.ijims.com/uploads/cae8049d138e24ed7f5azppd_597.pdf

Several Arab countries have been the subject of criticism for persecuting LGBT people by fines, imprisonment and death. However, some places in he Middle East have developed more tolerant social attitudes and taken some steps to protect LGBT people. Jordan, Bahrain and Iraq are some of the few Arab countries where there are no laws against homosexuality. On the other extreme, some Middle Eastern countries do not allow an LGBT community to exist. Countries such as Saudi Arabia, Kuwait, and United Arab Emirates criminalize same-sex sexuality, cross-dressing and any expressed support for LGBT rights.(n.d., 2010) In Ira, one can be executed for being gay. This is also true for Saudi Arabia, Sudan, Yemen and Mauritania, where sodomy is also punishable by death.   No accounts of executions have been reported for at least 10 years. (Whitaker, 2016)

Shortly after homosexual marriage was legalized in the United States of America, “the privately run Talaee Al-Noor school in Riyadh happened to have a rooftop parapet painted with rainbow stripes. According to the kingdom’s religious police, the school was fined 100,000 riyals ($26,650) for displaying “the emblem of the homosexuals” on its building, one of its administrators was jailed and the offending parapet was swiftly repainted to match a blue rainbow-free sky.” (Whitaker, 2016)

Whitaker, B., (2016). Everything you need to know about being gay in Muslim countries. Retried November 22, 2016, from https://www.theguardian .com/world/2016/jun/21/gay-lgbt-muslim-countries-middle-east

LGBT in the Middle East. (n.d.). Retrieved November 22, 2016, from https://en.wikipedia.org/wiki/LGBT_in_the_Middle_East

Homosexuals in Lebanon still face stigma, especially in conservative societies. On the other hand, more and more individuals are coming out as LGBT and some parts of society like the media for example have shifted their view on homosexuality to a more positive one.

To be accepted, gay marriage must be framed as a necessity for equality rather than a threat to religious and societal beliefs (Baunach, 2011). However, Lebanon is not ready to discuss gay marriage as the priority in Lebanon is the legal protection of LGBT individuals.

Baunach. (2011). Decomposing Trends in Attitudes Toward Gay Marriage, 1988–2006. Social Science Quarterly, 92(2), 346-363. doi: 10.1111/j.1540-6237.2011.00772.x

Anal examinations are forcibly conducted in some parts of the world in an attempt to prove anal sexual acts especially on homosexual men. As far as medicine is concerned, there are no scientific studies that have proven the validity of anal examination in the detection of anal intercourse. Forcibly conducted anal exams can lead to subsequent and significant physical pain in addition to significant psychological suffering such as humiliation, shame, guilt, and worthlessness (Long, 2004). The Lebanese order of physicians has banned these tests in 2012.

Long, S. (2004). When Doctors Torture: The Anus and the State in Egypt and Beyond. Health and Human Rights, 7(2), 114. doi:10.2307/4065350

A political refugee is a “A refugee from an oppressive government” (Oxford Dictionaries, nd). When it comes to the issue of homosexuality the laws of the Middle East are still rather oppressive in nature. Many organizations have tried over that past years to suggest changes in policies and worked with lawmakers to reach a better level of acceptance and protection of rights for the LGBT community. A lot of Lebanese LGBT individuals leave Lebanon and decide to live in countries that offer protection for LGBT people and afford with equal rights as other members of society.

Oxford Dictionaries (nd). Oxford Dictionaries | Political Refugee. Retrieved from https://en.oxforddictionari es.com/definition/political_refugee

Lebanon still uses article 534 of the Lebanese penal code to jail homosexuals, considering it an “unnatural” sexual act. Also, civil marriages are not conducted in Lebanon. Hence, it’s early to even discuss gay marriage. The priority should be to legalize homosexuality without any ambiguity.

There isn’t any clear evidence to support the claim that homosexuals are more violent than the general population. There is however, a proven increase in suicide rates among members of the LGBT community; the suicide statistics among the youth is particularly of concern. In Lebanon, someone commits suicide every 3 days (Van Vliet, 2015). Lesbian, gay, bisexual, transgender and questioning youth are four times more likely to attempt suicide than their heterosexual peers (Tracy, 2013). This is often linked to experiences of homophobic victimization (e.g. bullying, verbal and/or physical abuse), as well as a high level of rejection by loved ones and especially family members.

Tracy, N. (2013). Homosexuality and Suicide: LGBT Suicide – A Serious Issue – HealthyPlace. Retrieved November 10, 2016, from http://www.healthyplace.com/gender/glbt-mental-health/homosexuality-and-suicide-lgbt-suicide-a-serious-issue

Van Vliet, V. (2015). Every 3 days, someone commits suicide in Lebanon. Retrieved November 10, 2016, from https://lebmash.org/every-3-days-someone-commits-suicide-in-lebanon/

It is quite hard to report death threats or file complaints in Lebanon as a homosexual as he/she will have to out themselves to the authorities. Reuters cited a lawyer who indicated that the legally compromised position of homosexuals minimized the legal recourse available to them when they were themselves victims of abuse. HELEM corroborated the opinion that homosexuals cannot rely on police protection for fear of being abused by the police (Responses to Information Request, 2004).

Responses to Information Requests. (2004). Retrieved November 05, 2016, from http://www.irb-cisr.gc.ca/Eng/ResRec/RirRdi/Pages/index.aspx ?doc=429448

The media might be hesitant to discuss homosexuality due to several reasons. Homosexuality is still a taboo to a certain extent in our region. Fear of backlash especially from religious authorities is another important factor (Pellot, 2012). Sometimes, the media avoids the topic under the umbrella of preserving “cultural sensitivities” and to avoid any legal issues especially with the government. However, when the topic is mentioned in the media, it’s usually portrayed in a negative way and there is affirmation of stereotypes which only reinforces society’s negative attitudes towards homosexuality.  (Calzo & Ward, 2009) in the past decade or so, Lebanon has witnessed a shift in the handling of this topic by the media from a mostly negative manner to a mostly positive one.

Calzo, J. P., & Ward, L. M. (2009). Media Exposure and Viewers’ Attitudes Toward Homosexuality: Evidence for Mainstreaming or Resonance? Journal of Broadcasting & Electronic Media, 53(2), 280-299. doi:10.1080/08838150902908049

Pellot, B. (2012). (Not) reporting homosexuality in the Middle East. Retrieved from http://freespeechdebate.com/en/case/not-reporting-homosexuality-in-the-middle-east/

When it comes to HIV, the risk among the LGBT community varies and should take into account different factors. It is important here to stress on the fact that homosexuality itself is not a perpetrator of HIV, nor is HIV a punishment to this community. Fighting stigma that faces both sexual minorities and People Living with HIV (PLHIV) is essential not only in improve the fight against the virus but also in protecting the rights of PLHIV and value their contributions to society.

Men who have sex with Men (MSM) are still one of the populations that are most at risk for HIV. This vulnerable group accounts for the highest incidence and prevalence of HIV in different countries, particularly in the United States. Data on MSM is not reliable in Middle Eastern countries, or in countries that criminalize same-sex acts in general. Such countries usually either don’t report data on MSM or report it based on models developed on smaller surveys, with all the bias that results from stigma associated with this community.

Transgender communities are a very high risk population for HIV as well, and this is mostly due to few prevention programs focusing on the Trans* community in general. Research among trans* populations has shown that stigma has been a barrier for job opportunities which often forces this population to reside to survival sex work which increases their risk of HIV transmission.

Beyrer, C., Baral, S., Kerrigan, D., El-Bassel, N., Bekker, L., & Celentano, D. D. (2011). Expanding the space: Inclusion of most-at-risk populations in HIV prevention, treatment, and care services. JAIDS Journal of Acquired Immune Deficiency Syndromes, 57 Suppl 2(Suppl 2), S96-S99. doi:10.1097/QAI.0b0 13e31821db944 Mumtaz, G., Hilmi, N., McFarland, W., Kaplan, R., Akala, F., & Semini, I. et al. (2011). Are HIV Epidemics among Men Who Have Sex with Men Emerging in the Middle East and North Africa?: A Systematic Review and Data Synthesis. Plos Med, 8(8), e1000444. http://dx.doi.org/10.1371/journal. pmed.1000444 Operario, D., Yang, M., Reisner, S. L., Iwamoto, M., & Nemoto, T. (2014). stigma and the syndemic of hiv‐related health risk behaviors in a diverse sample of transgender women. Journal of Community Psychology, 42(5), 544-557. doi:10.1002/jcop.21636

Any healthcare provider should aim at improving all health outcomes of their patients. Asking a patient about their sexual orientation should come in the context of assessing all aspects of a patient’s identity. Also, some health conditions are more prevalent in the LGBT community. Knowing a patient’s sexual orientation or identity will help the health care professional screen for these conditions. This could also be the door to many patients to open up about any discomfort they might be feeling with regards to their sexual orientation, and therefore a door to refer or offer support in this field. Asking about sexual orientation is also important for sexual health counseling.
It is important to note that asking about such information should be done in an environment that is confidential and that assures the privacy of the patient.

Cahill, S., & Makadon, H. (2014). Sexual Orientation and Gender Identity Data Collection in Clinical Settings and in Electronic Health Records: A Key to Ending LGBT Health Disparities. LGBT Health, 1(1), 34-41. http://dx.doi.o rg/10.1089/lgbt.2013.0001

Research suggest that parental negative responses may be associated with emotional distress including anxiety, depression and low self-esteem, high risk sexual behavior, substance abuse, and even suicidality (Rothman et al, 2012). Interestingly, studies of parental rejection or acceptance and their impact on a child’s health, does not differentiate between heterosexual or homosexual children. The impact was similar in both populations. While some health professionals agree that coming out to one’s parents is an important milestone to an LGB youth and is important to a general healthy well-being, others have argued that it might not be the best course of action for LGB individuals due to the potential non-responsiveness and abuse by parents (Carnelly, et al., 2011).

Rothman, E. F., Sullivan, M., Keyes, S., & Boehmer, U. (2012). Parents’ Supportive Reactions to Sexual Orientation Disclosure Associated With Better Health: Results From a Population-Based Survey of LGB Adults in Massachusetts. Journal of Homosexuality, 59(2), 186-200. doi:10.1080/00918369.2012.648878

There are many reasons that extend beyond the individual’s personal acceptance of his/her sexuality that factor in when suicide ideation is present. Most common are the category of social/inter-personal problems which represents more than half of suicide attempts among homosexual individuals. Problems with the individual’s family are among the most usual causes. These have been significantly linked to a higher intent to die and have been shown to aggravate the severity of the suicide attempt. Love/Relationship problems are also included in this category (Wang et al, 2015).  In 2004, these problems were proven to be four times more likely to be a cause for suicide among LGBT individuals than among the general population (Skerret, Kolves & De Leo, 2014). Research continues in this particular field because finding the crucial issues remains a challenge to mental health authorities offering assistance to the LGBT community.

Skerrett, D.M., Kolves K., and De Leo D. (2014). Suicides among lesbian, gay, bisexual, and transgender populations in Australia: an analysis of the Queensland Suicide Register. Asia Pac Psychiatry. 6(4): p. 440-6

Wang, J., et al. (2015). Understanding Suicide Attempts Among Gay Men From Their Self-perceived Causes. The Journal of Nervous and Mental Disease. 203(7): p. 499-506.

Transgender individuals are individuals whose identity is opposite to their sex that is assigned at birth. A transgender woman is someone who is born male but who identifies as a woman (also referred to as Male to Female –MTF transgender). Transgender men or women may identify as men, women or transgender, which should be an important consideration in asking someone how they identify and what pronouns they would like use.

Transgender individuals may choose to pursue hormone therapy of the opposite sex: for example, a trans-man would take exogenous testosterone. This would be used for the goal of changing physical appearance but also as a method of adapting to someone’s identity.

Transgender individuals may also choose to pursue sexual reassignment surgery. Such surgeries reconstruct penises or vaginas from prosthetics or other sources of tissue. And this is the difference between transgendered people and transsexual people.

Transgender people can choose to live and identify as the opposite gender, without undergoing surgeries that changes their genitals. For example, a transgender women for example can remove their breasts, but choose to keep their female genitalia but perform and “pass” as male gender.

It is important to note that not all transgender individuals end up pursuing surgery or hormone therapy. A person might identify as transgender and not want (or even not have the option to) access such interventions. This just reinforces the fact that an identity depends on what the person identifies with and not what their genitals are what their level of hormones reflect.

There is a lot of debate on pathologizing transgender identities. The current Diagnostic and Statistical Manual for mental disorders (DSM V) includes transgenderism under Gender dysphoria referring to people who are unhappy with their assigned sex and who want to change their sex but does not consider it as a mental disorder in itself (DSM5.org, 2013).

Dsm5.org,. (2013). Gender Dysphoria Fact Sheet | APA DSM-5. Retrieved 8 February 2016, from http://www.dsm5.org/Pages/Default.aspx