Ugandan LGBTI activists and doctors disagree over mental classification of homosexuals

Gay rights activists in Uganda want the government to declassify homosexuality as a mental health disorder in the country’s Statistical Manual of Mental Disorders (DSM). The Ugandan DSM was adopted from the US many years ago.

At a validation meeting in Kampala on preliminary findings on lesbian and MSM health survey, the activists expressed concern that most health workers interviewed said homosexuals were mad people deserving psychiatric intervention.

However two prominent mental health practitioners in Uganda disagreed with the activists saying that homosexuality was no longer classified as a mental health disorder. They could not however say why health workers in still insist it is a mental disorder.

Dr Margret Mungherera, a leading mental health expert told Behind the Mask Tuesday in Kampala that Uganda now uses the current American Psychiatric Association diagnostic manual.

“We are not allowed to discriminate any one as health workers. Even if you are a criminal in custody, we treat you with dignity,” Dr Mungherera said. Dr Alexis Bisangwa, a senior psychiatric expert in Uganda also agreed with Mungherera saying, “It (homosexuality) is not there anymore,” he said referring to the DSM. In the US, homosexuality was removed from the DSM in 1973.

The survey, whose final findings shall be published soon also found that many health workers use their personal values – religious, culture or upbringing when dealing with homosexual treatment in health centres, contrary to the code of ethics that emphasizes non discrimination.

The project undertaken by Freedom and Roam Uganda (FARUG), a lesbian rights group also indicates that health workers are afraid of treating homosexuals in the wake of the infamous Anti Homosexuality Bill 2009 for fear of being arrested. Although the bill has not yet been passed, many Ugandans believe it is already law given the massive media attention to it.

Junic Wandya, the FARUG project coordinator said, “This is fuelling self medication especially among transgender people who are stigmatized because of their physical appearances.”

Wandya however said Uganda’s health system needed to accommodate treating lesbians and MSM with dignity; and that gay people need to divulge ailment history to the health workers without fear of reprisal ridicules and arrests.

The FARUG project is a first in Uganda to specifically focus on lesbian women’s health in detail. It also encompasses the entire gay community’s health, health seeking behaviour and wellbeing with particular emphasis on Women who have Sex with Women (WSW).

Activist Jay Abang of FARUG said there is so little information about lesbian health and prevention of infections. She said most literature tends to concentrate on MSM health, without addressing the needs of lesbians.

“For example, how many of us use condoms on our dildos?” Abang wondered. Abang noted that apart from government’s deliberate move to deny lesbians information on how they can protect themselves from HIV and other infections, FARUG’s project was also intended to reach out to high levels of policy and decision making.

Abang said personal hygiene and other basic needs including dental dams and finger coats should be widely availed and consistently and correctly used to deter infections.

In Uganda, the Department of Psychiatry and Mental health units are run by Psychiatrists, a Medical Sociologist, social workers, Clinical Psychologists, Psychiatric Clinical officers, Nursing officers, Medical Health assistants and other support staff. The unit works in close collaboration with the Butabika Mental Hospital and other institutes, including the Institute of Psychology and Makerere University Institute of Social Research. The common mental health challenges in Uganda include substance dependence and abuse (e.g. alcohol dependence) and mood disorders.

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