June is Pride Month and amid the celebrations it is also the time to remember that the LGBTQIA++ community continues to battle discrimination everyday. In India, it is estimated that there are approximately 45.5 million people who identify as queer.

The LGBTQIA++ community, despite being accepted by the law, has had to face stigmatisation, social rejection, victimisation, homophobia and transphobia. It can lead to an individual trying to deny or conceal their sexual orientation and gender identity, which can cause long-term mental health issues and distress.

Institutionally, the queer community is one of the 12 least represented in public health equity research. In the 2018 Supreme Court verdict striking down Section 377 of the Indian Penal Code that criminalised “unnatural” sex, Justice DY Chandrachud had written about the responsibility of mental health professionals in providing support and advocacy to LGBTQI++ communities.

Yet, there remains a gap in services and access, and little or no public conversation or information about the mental health of queer folks.

A conversation

What is required is a public discourse on queer mental health. The first step is to have a public conversation within the community as well as broader society on discrimination, stigma and queer mental health.

Ensuring proper representation, dissemination of factual information and portrayal of diverse, queer narratives is the first step towards creating a more inclusive discourse.

This can be done through social media, mainstream news channels, and the art and culture industry. Panel discussions, interviews and articles must not be limited to the English-speaking but should be in vernacular languages as well, creating an inclusive space for all narratives.

Such a discourse must begin early. For many LGBTQIA++ individuals, dealing with sexuality in their families, communities, and even educational institutions is difficult. The most severe abuse and discrimination happens within these close spaces.

A space to ‘come out’

The lack of familial and community acceptance still leads to fears over “coming out”. Mental health professionals agree that in any manner, way or form, “coming out” is an important psychological step for the LGBTQIA++ community.

Without this, proper mental healthcare with a focus on issues particular to the community is almost impossible to provide. The question is, how can a safe space be created for individuals to come out without risking discrimination and prejudice?

Educational institutions at all levels play an important role in creating safer spaces and sensitising parents and children. They have the opportunity to build community spaces where members of the queer community can come together and discuss and resolve challenges.

Institutions should ensure teaching methods are queer-sensitive, thereby normalising diverse family structures, sexualities and gender orientations. Everybody must be trained to use inclusive language and make sure stereotypes are not used.

At the school level, parents and children must be made to participate in sensitisation programmes. Parents need to be given the tools to be able to talk to their children about sexuality and identity in a sensitive and empathetic manner. They need to be taught that being queer is normal, and even if they feel uncomfortable about the idea, that they need to support their children.

Some schools in a few cities have consciously incorporated such efforts. Studies have shown that queer folk, whose parents do not accept their sexuality and gender, are more prone to suicidal ideation, depression, anxiety, gender dysphoria and other issues. This toxic cycle needs to be broken.

Affirmative healthcare

With the Covid-19 pandemic, this need for parental support has become critical. Children, youth and adult queer folk have been cooped up at home with their parents, many of whom are either unaccepting of their child’s sexuality and gender, or unaware of what it means. The LGBTQIA++ community has therefore become a home for many, providing support and strength to its members.

With the pandemic, this support has become harder to provide, leading to a rise in mental health issues due to the isolation and fear.

Social networks, group chats, and other forms of online socialisation can provide a sense of comfort to the community despite being unable to meet physically. Yet, what of those who do not have access to these resources?

The past two years have reinforced the need for proper, affirmative mental healthcare to all sections of the LGBTQIA++ community.

Affirmative counselling within communities, especially at the grassroots, through inclusive narratives, can help a queer individual in accepting, discovering and constructing their identity. Such initiatives need to be delivered through educational programmes at the grassroots in local languages.

Bias in mental health

Even the mental health community is often biased and non accepting. Counsellors should be educated on LGBTQIA++ affirming treatment and the lived realities of a queer individual as a result of stigma and prejudice.

Private counselling over the telephone should be provided for those who may not have access to in-person care, while ensuring the privacy of individuals who live in dangerous or unsettling circumstances. Additionally, mental healthcare should be accessible to those who do not have the financial resources.

Little research has been done in India about the queer community and that has added to the lack of available mental healthcare. The Raahat Project aims to bridge this gap by engaging with LGBTQIA++ youth on mental health and self-care.

The idea behind the project is to create a multilingual Mental Health Youth Awareness, Literacy and Self-Care programme led by the LGBTQIA++ youth for whom this is intended.

There is an urgent requirement for India to act on LGBTQIA++ mental health. Community led and focussed programmes, and institutional awareness are required to ensure that the toxic cycle of prejudice is broken.

Open conversations today can help build an inclusive society tomorrow where one’s identity does not define their place in the world.

Samragni Dagupta, is a theatre artist, queer writer and public policy professional associated with the The Rahaat Project.

Chapal Mehra is Director at The Rahaat Project and a Public Health specialist.