A self-identified homosexual in India gets used to being judged and condemned through three morality-tinted glasses: religion, law and medicine. Religion demands guilt, law pronounces guilt and medicine reinforces guilt.

This brings us to a fundamental question: why is medicine so obsessed with 'curing' homosexuality? If life for the homosexual is limited to choices between prayer, punishment or therapy, where's all the good stuff?

In the US, the homosexual movement that emerged in the mid-20th century sought to wrest control from psychiatry, by demanding deletion of homosexuality from the list of diseases that needed cure. Having achieved this in 1973 in America, the movement gradually took on debates around gay marriage, adoption rights and other issues. Now, therapy and cures for homosexuality find major backing largely from religious groups.

In India, however, the homosexual movement is still very young. Here, health professionals in many places still offer behavioral therapy - going by names like aversion therapy and conversion therapy - to homosexuals. (In aversion therapy, for example, the 'patient' is shown same-sex nude images with an electric shock being administered whenever the patient feels aroused. When images of the 'desired' gender are shown, no shock is administered. The therapist hopes that the person will eventually associate pleasure with cross-gender attraction - and pain with same-sex desire - and thereby become 'normal'.)

Other therapies co-exist with behavior therapy. Many homosexuals speak of being provided psychiatric drugs used routinely for schizophrenia or epilepsy in order to 'cure' their homosexual desire. Male homosexuals who are considered effeminate have been given hormone medication to increase their 'masculine' behavior. Religious therapy, where prayer and faith alone are used to 'convert' homosexuals also finds several takers.

The move to control or alter human sexual desire is not a recent phenomenon. While religion and law compete with each other every year to reach newer and more sophisticated levels of moral control, medicine has a more complicated history. Richard Krafft-Ebbing's classification of various sexual desires as perversions and diseases in the 1890s and Sigmund Freud's more ambivalent attitudes are beginning points. Then Sandor Rado and Irving Bieber, in the mid-1900s, took a more vehement stance against homosexuality, believing it to be caused by pathogenic families or as a result of phobic responses to heterosexuality.

With this began decades of experimentation to treat homosexuals of their 'condition'. This included transplanting testicular tissue from heterosexual men into homosexual men (who had been castrated); hypothalamatomies, part or complete removal of the hypothalamus; and hormone treatments, since homosexuals were considered to be either inadequately masculine or overly masculine. Of course, none of these therapies were successful and resulted in either individuals whose sense of self-value was completely destroyed or those who were permanently physically and physiologically mutilated.

But it was physiologist Pavlov's experiment on 'classical conditioning' - the source for behavior therapy - that gained a hegemonic status in the 20th century. We have all read about Pavlov's dog, which salivated when a bell rang though no food was provided, after being conditioned to that response by repeated exposure to food while a bell was rung. This was the concept used by psychiatrists and counsellors to treat homosexuality.

Behavior therapy revolves around one fundamentally uncontested assumption: the normality of heterosexual desire. To study homosexual desire with heterosexuality as the frame-of-reference - and then find homosexuality abnormal - is not a scientific conclusion based on scientific methods. It is simply heterosexism in practice.

And it is this pathologisation of homosexuality that has led to numerous problematic responses from the Indian medical sector. A short study on the medicalisation of homosexuality conducted in Bangalore with various mental health professionals - including psychiatrists, clinical psychologists, sexologists and lay counsellors - recorded several such responses. (Arvind Narrain and Vinay Chandran, 'It's Not My Job to Tell You, It's Okay to be Gay' (Research supported by Sarai, New Delhi), 2003)

When these practitioners, restating public opinion, describe homosexuality as immoral and unnatural, it betrays their connections with religion that has colored their personal opinion. Believing that there is a natural process of sexual development, pre-ordained by a higher force (whether God or Nature) that should be enforced, conflicts with an essential need for medical objectivity.

When homosexuals visit mental health professionals bearing the burden of a society that refuses to acknowledge their desires, their distress is not settled with reassurance and empathy. Instead, there is a reaffirmation of social morals from the counsellors. One response by a Bangalore-based psychiatrist represents the attitude that most counsellors display in such a setting. When asked why a cure for homosexuality was being offered, he responded that it was not his job to tell his patient that it was okay to be gay, and that a homosexual who came to him with distress over his identity obviously needed his help. There is no examination of the cause of that distress. If social values oppress the homosexual, why should the homosexual be the one to change and adapt to society? Why can't the oppressive values of society be changed?

In the last few years, however, science has shifted its focus. Instead of attempting to redefine and understand the history of the word 'normal', it attempts to read the origins of homosexuality in our genes, throwing up a whole new twist and struggle within the gay rights movement.

The most striking theories came from a couple of psychiatrists in the Bangalore study. These professionals mentioned that there were possibilities of discovering which gene in the human DNA sequence determined sexual preference. Once this is discovered, by scientific means much like suppression of other genetic flaws, this 'gay-gene' too could be suppressed. But the dangers of such a theory are easily foreseen. We can imagine a future where the creation of the ideal man or woman includes the suppression of 'socially unwanted' desires, reminiscent of so many sci-fi theories.

Is it all gloom and doom, though? Admittedly, the movement has taken many steps forward, and there is hope in the way mental health professionals have been reacting. Many professionals proactively update themselves on advances in the world on gay and lesbian rights and know both the futility and danger that aversion therapy can bring to homosexuals. They advocate the removal of homosexuality as pathology from mental health.

In addition, homosexual support groups have emerged as part of the larger movement, offering safe spaces for men, women and others to become comfortable with their identities. Rather than pathologising their lives, support groups offer homosexuals a space to express thoughts and feelings without making them feel like they need to change. This is where the good stuff is; it is really from these spaces that homosexuals can draw hope.

It is time we abolished the prayer, punishment and therapy framework to all things sexual. It hasn't worked before, and it never will.

(Vinay Chandran is Executive Director of Swabhava Trust, a Bangalore-based NGO that works to provide lesbian, gay, bisexual and transgender populations with access to support services.)    

By arrangement with Women's Feature Service