Mental health professionals from across Africa, including Kenya, Uganda, Cameroon, Nigeria and South Africa, have signed a declaration against conversion practices that are used to forcibly change the sexual orientation, gender identity or expression of LGBTIQ+ people.
The declaration unambiguously rejects any attempts by mental health professionals to use conversion. The declaration has already been officially endorsed by expert organisations, such as the Professional Association for Transgender Health; the Psychological Society of South Africa (PsySSA) endorses it in principle and will do so officially soon.
Unfortunately, the practices described in the declaration are included in the 2023 Anti-Homosexuality Bill proposed by Uganda’s parliament. Ugandan lawmakers have proposed to “rehabilitate” people who are sexually or gender diverse. PsySSA president, professor Floretta Boonzaier, has described the bill to me as “an attack on human dignity, well-being, autonomy and self-determination”.
Yet they are widely used across the continent. Research conducted in three African countries in 2019 found that half of the respondents suffered some form of conversion. These included talk therapy, exorcism, drinking herbs, healing prayers, beatings or sexual assault.
Two examples illustrate this. Firstly, psychologists will be expected to breach confidentiality if a client discloses that they are (or may be) LGBTIQ+. Professionals who don’t report these clients to the police risk six months imprisonment. Secondly, psychologists, and presumably other health workers, will be expected to “rehabilitate” LGBTIQ+ people.
Pierre Brouard, the acting director of the Centre for Sexualities, AIDS and Gender at the University of Pretoria, said in an email conversation that
this climate of fear would be a betrayal of everything our profession stands for. It is unthinkable that any mental health professional could work in this climate, and we call on all in our profession to condemn this attack on us, and the clients we serve. Reporting clients to the authorities would be harmful, would inhibit wellness, would invalidate trust, would lack integrity, would be inherently unjust and would damage any relationship of confidentiality.
No scientific grounding
Uganda’s president Yoweri Museveni has requested a science-informed response to the bill. But he has ignored evidence-based critiques that have been presented to him over the years, dating back to 2010 and 2014. Brouard has said the bill
is anti-science and represents a backward step in contemporary understanding of human nature.
For example, in 2015, The Academy of Science in South Africa, in collaboration with the Uganda National Academy of Sciences, concluded in a comprehensive review of the evidence, that
contemporary science increasingly recognises the wide range of natural variation in human sexuality, sexual orientations and gender identities
there is no justification for attempts to eliminate people who are not heterosexual from society.
The bill is an assault on already vulnerable sexual and gender minorities.
Professor Kopano Ratele, an acclaimed African psychology scholar, said via email that
the bill is, at its core, inhuman. Contrary to the sentiment of homosexuality as unAfrican, the bill expresses an unAfrican spirit. It seems that the bill is essentially about some people desiring to control the bodies, relationships, and the inner lives of others. What is so frightening about people loving others?
LGBTIQ+ people are consistently at a higher risk of developing mental health disorders. This is due to homophobia, transphobia and prejudice against their very identities.
The bill goes beyond criminalising sexual behaviour between consenting adults. Dr Jarred Martin, a senior lecturer in the Faculty of Humanities at the University of Pretoria, said (via email):
It criminalises identity by prescribing prosecution for how people think, feel, identify, and, ultimately, who and how they love. This attempt to criminalise love is something that South Africans are all too familiar with, having lived under colonial and apartheid era laws which cast love in legal terms as moral or immoral.
Similar anti-LGBTIQ+ efforts are underway in other African countries. Kenya is currently targeting people under a Family Protection Bill. And in Tanzania, castration is being touted as a punishment for gay men.
Christian evangelical churches from the US have been directly linked to current anti-LGBTIQ+ ideologies in African countries.
The next steps
The message is clear: all psychologists, but especially those of us based on the African continent, should stand together in condemning Uganda’s Anti-Homosexuality Bill.
The PsySSA Sexuality and Gender Division, for example, has been at the forefront of leading a science-informed critique of the Ugandan bill. In 2017, PsySSA published a pioneering set of practice guidelines for psychology professionals working with LGBTIQ+ people. This was a first in Africa and has been translated and used in other African countries as a global mental health resource. Psychologists, therefore, can and should show leadership in promoting human rights and LGBTIQ+ wellbeing.
Suntosh R Pillay, Clinical Psychologist, University of KwaZulu-Natal