For decades, Lebanon—a small Arab country with a strong clerical tradition—has been in the headlines for all the wrong reasons. However, a refreshing change appeared on July 18. The Lebanese Psychiatric Society (LPS), a body of doctors affiliated with the official Lebanese Order of Physicians and representing the majority of the country’s psychiatrists, released a statement favoring homosexual rights. The LPS declared that homosexuality is not a mental illness and that homosexuals do not require treatment for their sexual orientation.
The statement was a response to two prior events in Lebanon. The first was the widespread public denunciation of acts of abuse by semiofficial bodies against LGBT groups. The second was the television broadcast of psychologists and psychiatrists repeatedly asserting that homosexuality was an illness they could cure.
The LPS’s statement was noted in the international press, with articles appearing in publications such as the Los Angeles Times, Huffington Post, and the Economist. Commentaries were widely circulated on the web, with some praising the move, while others questioned its timing and effect.
Lebanese law punishes individuals for homosexual acts, which accords with even harsher punishments inflicted on homosexuals across the Arab and Muslim world. The statement’s impact on the attitudes of health professionals toward homosexuals and the human-rights struggles of the wider public in the Middle East is unclear. This is a region where psychiatry and psychology are still in their infancy, struggling for acceptance as means of explaining and shaping social behavior. Indeed, there is hardly unanimity on this political hot potato among psychiatrists in Lebanon and within the LPS, and it is unlikely to go away.
The core debate within the Lebanese psychiatric community is whether they should restrict their public statements to the issuance of scientific facts or assume the role of advocacy. A proposed compromise might be to restrict their advocacy role to support the advocacy campaigns of other specifically dedicated organizations in Lebanon (such as the very active Helem organization). The purpose of such an approach would be to maintain the psychiatrists’ credibility as an unbiased source of scientific opinion, which might otherwise be compromised, were they perceived as militant advocates.
Lebanon’s diverse population and relatively liberal society are atypical among Arab and Muslim countries. Yet its media and entertainment sectors make it a regional sociocultural beacon, so any debate starting in Lebanon might well be aired in other Middle Eastern countries. The validation and protection of LGBT rights in Lebanon and the region will remain aspirational, for sure, but this intervention by psychiatrists may nonetheless bring immediate benefits. For example, it may curtail attempts to convince a gay person or his family of the benefits of “sexual orientation change efforts,” a practice that has been declared ineffective and potentially harmful by APA and flagged by the United Nations as a potential form of human-rights abuse.
The example set by our colleagues in Lebanon holds an example for other psychiatric societies to follow. It highlights the important role of psychiatry as the medical discipline with the broadest sociopolitical influence on the general public. The statement of the LPS not only refutes that homosexuality is a disease, but also it carries implications regarding civil society’s definitions of citizenship, equality, and human rights. Since WHO defines health as “complete physical, mental, and social well-being, and not merely the absence of disease or infirmity,” our role shouldn’t be limited to treating mental illness, but should also include advocating for better mental well-being for all individuals.
People all over the world pay attention to what happens in the United States. The psychiatric community in the United States has a long history of advocating for LGBT rights, and the LPS would benefit from the mutual support of APA and the World Psychiatric Association on this issue. We hope this letter will serve to draw attention to the current situation unfolding in Lebanon.
Joseph El-Khoury, M.D.
Andres Barkil-Oteo, M.D., M.Sc.
New Haven, Conn.
Joseph El-Khoury, M.D., is a consultant adult and addiction psychiatrist with the Department of Psychiatry and Clinical Psychology at St. George’s University Medical Centre and an assistant professor of psychiatry at the School of Medicine at the University of Balamand in Beirut. Andres Barkil-Oteo, M.D., M.Sc., is an assistant professor of psychiatry at Yale School of Medicine. ■