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Year : 2014  |  Volume : 60  |  Issue : 2  |  Page : 116-117

Homosexuality and its discontents

1 Professor of Mental Health and Cultural Diversity, Health Service and Population Research Department, Institute of Psychiatry, King's College London, London, United Kingdom
2 Emeritus Professor, Cooper Hospital, Mumbai, Maharashtra, India

Date of Web Publication13-May-2014

Correspondence Address:
Prof. D Bhugra
Professor of Mental Health and Cultural Diversity, Health Service and Population Research Department, Institute of Psychiatry, King's College London, London
United Kingdom
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0022-3859.132303

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How to cite this article:
Bhugra D, Vahia V. Homosexuality and its discontents. J Postgrad Med 2014;60:116-7

How to cite this URL:
Bhugra D, Vahia V. Homosexuality and its discontents. J Postgrad Med [serial online] 2014 [cited 2023 Sep 21];60:116-7. Available from:

The recent Supreme Court judgement upholding a colonial law (section 377) which sees homosexual behavior as illegal has reignited a debate on the role of sexual variation in society. Homosexuality is a feeling of attraction in thought, fantasy, or behavior to the person of same sex. The term is often wrongly used synonymously with sexual act itself. Part of the reason for the confusion is that the word "homosexual" is Greek in origin where it means "the same," and is not from Latin where "homo" means "man." Gender, which is a social construct, thus needs to be differentiated from biological sex. While homosexuality is not a mental illness, it has remained a psychiatric diagnosis for several years.

The word homosexual is both a substantive and an adjective. The seventies saw the use of the word gay being commonly used and seen as a political statement and a reflection of identity of a homosexual person as one who is content with his/her sexual identity. [1],[2],[3] The term gay is mostly used by male homosexuals. Homosexual identity represents sexual orientation, sexual behaviors, as well as coincidental behaviors, [2] whereas gay identity is an affiliation with the gay community at large in a cultural and sociable sense. [2] Homosexual sexual behaviors can also be purely situational, such as seen in boarding schools or prisons. In earlier studies, the prevalence of homosexuality was reported to be around 10% of the population, but subsequently these estimates have been reduced to between 2 and 5%. [4],[5] There is considerable data suggesting that many psychiatric conditions have higher than expected rates in gay men and lesbians. [4],[5]

Whitam, [6] who studied homosexuality in several settings, concluded that homosexual persons appear in all societies and the prevalence of homosexuality remains roughly similar, though obviously the actual homosexual behavior may well differ due to social norms and attitudes. Social norms do not impede or facilitate the emergence of homosexual orientation and all societies produce similar masculine or feminine homosexuals with similar characteristics. In contemporary India, attitudes to homosexuality have tended to be negative. Whereas traditionally Indian cultures were more positive in their approach, this has changed in the past few centuries. [7] Bullough [7] describes sex negative cultures as those where sexual act is used primarily for procreation and not for pleasure. In contemporary India, attitudes to homosexuality have been studied among school, college, and university students, and prisoners. [8],[9],[10],[11],[12],[13] Of late, there have been contributions in a number of fields. [13],[14]

The study by Jethwani et al. is an important one as it adds data on coping by Indian homosexual men vis-à-vis a control group of heterosexual men. [15] The former used negative coping skills with acceptance being the most common and tested for HIV more often than the controls. This is in line with current evidence.

The act or process of coming out is one where the individual rejects the negative connotations of the homosexual label and positively affirms his/her identity, and acknowledges a non-traditional sexual orientation. [16] The process of coming out is a "complicated developmental process which involves at a psychological level a person's awareness and acknowledgement of homosexual thoughts and feelings." [17] Coming out itself is influenced by familial and social attitudes and can lead to both panic and relief. In a culture in transition such as in India, the attitudes of others play a major role. The recent upholding of the colonial section 377 has recriminalized homosexual behavior, thereby putting many homosexuals back into the closet. Also, the recent diagnostic system from the USA, Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), [18] does not include this as a diagnosis. There is no doubt that there will be differences in experiences of coming out between urban and rural areas. Often the individual comes out to friends first, then to siblings, and finally to parents. In a small qualitative study from a gay group in Mumbai, Bhugra [19] reported that only 17/28 subjects were open to others outside their social circle. Several subjects reported that culture was affecting their functioning and happiness. In a similar sample of Asian gay men in London, it was noted that families and religion played a significant role in influencing the actual process of coming out. [20] For the purposes of therapy, it is critical that the therapist is aware of the stage of coming out of an individual.

Homosexuality should be seen as a natural variation of sexuality. It is vital that the society understands this variation and urges lawmakers to change the laws so that equality under the constitution can be upheld. It is important that doctors as well as other health professionals are aware of their own prejudices and discriminatory attitudes which may affect their clinical practice. In addition, the study by Jethwani et al. underlines the importance of health professionals, taking into account the role sexuality may play. [15] It is imperative that clinicians take into account sexual orientation of the patient firstly to engage them and give a clear message that they are not being discriminatory and secondly to ensure that patients receive the best and most suitable treatment. Health professionals should advocate this change in order to reduce discrimination and secrecy, so that gay and lesbian patients can access health care easily without fear of punishment, criminalization, or marginalization.

 :: References Top

1.Humphreys L. Out of the Closets: The Sociology of Homosexual Liberation. Englewood Cliffs, NJ: Prentice Hall; 1972.  Back to cited text no. 1
2.Warren CA. Identity and Community in the Gay World. NY: John Wiley & Sons; 1974.  Back to cited text no. 2
3.Weeks J. Coming out: The Politics of Homosexuality in Great Britain. London: Quartet; 1977.  Back to cited text no. 3
4.Cabaj RP, Stein TS. Textbook of Homosexuality and Mental Health. Washington, DC: APA Press; 1996.  Back to cited text no. 4
5.Levounis P, Drescher J, Barber M. The LGBT Casebook. Washington, DC: APA Press; 2012.  Back to cited text no. 5
6.Whitam FL. Culturally invariable properties of male homosexuality: Tentative conclusions from cross-cultural research. Arch Sex Behav 1983;12:207-26.  Back to cited text no. 6
7.Bullough VL. Sexual Variance in Society and History. Chicago, IL: Chicago University Press; 1976.  Back to cited text no. 7
8.Dwivedi KN. Psychosexual attitudes of resident students in an Indian University. Br J Sex Med 1979;6:34-40.  Back to cited text no. 8
9.Srivastava SP. Social profile of Indian homosexuals in an Indian male prison. East Anthropol 1973;26:313-22.  Back to cited text no. 9
10.Srivastava SP. Sex life in an Indian male prison Indian. J Soc Work 1974;35:21-33.  Back to cited text no. 10
11.Srivastava SP. The feel of imprisonment. Indian J of Criminology 1974;2:46-54.  Back to cited text no. 11
12.Sultan. Breaking free. Bombay Dost 1990;1-2.  Back to cited text no. 12
13.Vanita R, Kidwai S, editors. Same Sex Love in India. NY: St Martins Press; 2000.  Back to cited text no. 13
14.Vanita R, editor. Queeering India. NY: Routledge; 2002.   Back to cited text no. 14
15.Jethwani KS, Mishra SV, Jethwani PS, Sawant NS. Surveying Indian gay men for coping skills and HIV testing patterns using the internet. J Postgrad Med 2014;60:130-4.  Back to cited text no. 15
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16.Hanley-Hackenbruck P. Psychotherapy and coming out process. J Gay Lesb Psychother 1988;1:21-40.  Back to cited text no. 16
17.Cohen C, Stein T. Reconceptualising individual psychotherapy with gay men and lesbians. In: Gonsiorel J. A guide to psychotherapy with gay men and lesbians. Ny: Plenum; 1986.  Back to cited text no. 17
18.DSM-5. Diagnostic and statistical manual of mental disorders. Washington, DC: APA; 2013.  Back to cited text no. 18
19.Bhugra D. Experiences of being a gay man in urban India: A descriptive study. Sex Marital Ther 1997;12:371-5.  Back to cited text no. 19
20.Bhugra D. Coming out by south Asian gay men in the United Kingdom. Arch Sex Behav 1997;26:547-57.  Back to cited text no. 20


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