Sexuality, Society and Psychiatry: The Medicalization of Homosexuality in India

By Rianna Price

Within the studies of medicalization of deviant same-sex desire, the landmark removal of homosexuality as a disorder from the DSM-II  (Diagnostic and Statistical Manual of Mental Disorders) is often seen as a watershed moment for changing medical attitudes. What was once a sin had become a crime before being treated as a disease and, with the removal from an American Psychiatric Association-approved manual, seemed to become a normal expression of sexual desire. Whether this was the paradigm-shifting event it appears to be is open to debate. However, the suggestion that it was, indeed, paradigm shifting is ostensibly curated around the Western experience. 

Predominantly, the texts on medicalization, focus extensively on North America and Europe as focal points for both medicalization and demedicalization. In comparison to studies in the West, the medicalization of homosexuality in geographies such as India are almost non-existent. Although there has been work done, especially by those critiquing the psy-disciplines, on contemporary medicalizations of homosexuality, the history is often neglected. There is a multiplicity of reasons for this, from the Indian government’s assertion that homosexuality does not exist in India to scholars arguing that medicalization could not take root in India due to religious beliefs. Furthermore, medicalization literature neglects the influence and impact of British Colonialism in India, through which homophobic legislation and attitudes were imported and cultivated. My research contends thathomosexuality became a psychiatric concern in the 1970’s and has been largely unchallenged until recently. The decriminalization of homosexuality in 2018, by the Indian Supreme Court, has allowed for a more public space to combat the negative role psychiatry and medicine has had on Indian LGBTQI* peoples. 

However, my research does not seek to suggest that the medicalization of homosexuality in India occurred in the exact same ways that it manifested in the West. Although Indian psy-disciplines often utilised methods created in the West, such as Aversive Deconditioning (otherwise known as Aversion Therapy), they often adapted them in their own practice. In order to disentangle the methods of British, European and North American practitioners from those of their Indian counterparts, I have created a specific methodology. To understand which Western ideas are present in Indian psychiatric texts, I have used in-text citations and bibliographical references to understand where certain methods were obtained. To understand how they differ, I read the original text and note the differences in method. , So far, I have observed that while aversive techniques were imported, other methods (such as Fading) were discarded if they proved less effective.  The methods used were Western in nature, but Indian practitioners would try multiple methods, including Behavioural Therapies, in order to get the desired results. The use of Freudian understandings of sexuality were also pivotal in shaping treatment for Indian patients, as many cited works are from Freudian thinkers. There have been, and in some areas still are, commonalities in thought, practice and attitudes which transcend the global divide. However, the fundamental difference between practitioners in the West and India, especially when it comes to the historical treatments for homosexuality, is the differing ambitions of practitioners and the motivations of the patients. 

The Indian Journal of Psychiatry and the Indian Journal of Clinical Psychology were the starting point for my research, although there is not an overabundance of material prior to the decriminalisation of homosexuality. Although aversive techniques in these Indian journals are recorded as early as 1962 in the treatment of homosexuality, as well as for other issues such as alcoholism and writer’s cramp, it is not until 1979 that aversive therapies for homosexuality are written about in detail. Interestingly, during this period there are also uses of aversion therapy to ‘cure’ other so-called deviations such as transvestism and transsexuality. Overwhelmingly, this suggests a pivot in Indian psychiatry that, from the latter part of the 1970s, concerns itself with non-normative sexual and gender behaviours. The reason for this is made explicit and is closely linked to both patient motivations and psychiatric ambitions, namely societal pressure. As early as 1982, practitioners were commenting that cultural attitudes towards homosexuality were overwhelmingly ‘condemnatory’ and that the ‘desire for social conformity’ drove people with same-sex desires to practitioners who could offer ‘relief from their distress.’ These short quotes provide poignant and integral insight into three important aspects of the period; negative social attitudes to homosexuality, how these pressures impacted patients and how practitioners viewed their role in relation to societal norms. In other Indian psychiatric journals, there are references to marriage and its importance in Indian culture and society, as well as procreation. The importance of marriage and children can not be overstated, as it provides the largest contrast between Indian and Euro-American psychiatric literature. Practitioners such as MacCulloch and Feldman are more concerned with the removal of same-sex desire, whereas Indian practitioners such as Rangaswami are deeply invested in altering desire so that patients become heterosexually inclined. The necessity of cultivating opposite-sex desire and practice could explain why Indian practitioners experimented with methods and implemented behavioural therapies as well. It was not enough to just remove homosexual desire, there needed to be a creation or diversion into heterosexual desire and practice in order to truly conform to societal expectations and cultural assumptions. 

It is important to understand the deep-rooted historical instances of aversive therapies, as they have a long-lasting legacy that has survived into the present. One of the most troubling examples of this was the suicide of Anjani Harish, a 21-year-old bisexual woman who attributed her suicide to the psychological impact of aversion therapy. The colonial imposition of homophobic legislation, the transnational psychiatric links and general societal opprobrium to homosexuality have all contributed to a legacy of medicalization in India. To combat these unethical, flawed and outdated psychiatric methods, it is pivotal to understand the social and cultural underpinnings that contribute to them. It is of paramount importance for the safety of all LGBTQI* peoples across the globe that efforts to change sexual orientation or gender identity are banished to the past. 


Author’s Bio: Rianna Price is a current History PhD at Lancaster University. Her thesis looks at the medicalization of ‘deviant’ sexual desire in postcolonial India and the different ambitions of practitioners in India and the rest of the world. She has written on this topic in the En-Gender Journal and also for The Conversation. Alongside her studies, she is also the Global History Editor for EPOCH, a  Postgraduate history magazine.

Twitter – @Rianna_Price


Further Reading

Arondekar, Anjali R., For the Record: On Sexuality and the Colonial Archive in India (Durham: Duke University Press, 2009).

Boyce, Paul, ‘Moral Ambivalence and Irregular Practices: Contextualizing Male-to-Male Sexualities in Calcutta/India, Feminist Review, 83 (2006), pp.79-98

Foucault, Michel, The Will to Knowledge: The History of Sexuality: Volume 1, trans. by Robert Hurley (London: Penguin Books, 1990).

Kidwai, Saleem and Ruth Vanita (ed.), Same-Sex Love in India: Readings from Literature and History (London: St. Martin’s Press, 2000).

Seabrook, Jeremy, Love in a Different Climate: Men Who Have Sex with Men in India (London: Verso, 1999).

Stoler, Ann Laura, Race and the Education of Desire: Foucault’s History of Sexuality and the Colonial Order of Things (Durham and London: Duke University Press, 1995).

Vanita, Ruth (ed.), Queering India: Same-Sex Love and Eroticism in Indian Culture and Society (New York and London: Routledge, 2002).


Feature Image: