Conversion therapy refers t0 purportedly psychiatric or psychological "treatment," or spiritual counseling, aimed at changing an individuals' sexual orientation, from homosexuality or bisexuality to heterosexuality.
Conversion therapy can also aim to change gender identity, but this report focuses on sexual orientation change efforts, consistent with the experience of interviewees. Two interviewees who identify as transgender women, Liu Xiaoyun and Li Qi, identified as gay at the time of conversion therapy.
According to the interviews Human Rights Watch conducted, conversion therapy in China involves multiple techniques, including psychiatric consultation, hypnotherapy, medication, aversion therapy, and electroshock treatment. There is now a global consensus among professional medical bodies that conversion therapy with the intent to "cure" homosexuality is ineffective, unethical, and potentially harmful.
Multiple national professional associations globally have affirmed this position see Appendix I. States have taken different approaches to ending conversion therapy. In the United States, nine states and the District of Columbia have laws that limit conversion therapy.
There have been legislative initiatives to ban conversion therapy in Australia, Brazil, Chile, Israel, Switzerland, Taiwan and the United Kingdom, among other countries.
At time of writing, Malta was the only country in the world to impose a nationwide ban on conversion therapy. Homosexuality has been depicted in Chinese arts and documented in Chinese literature since ancient times. One of the earliest notions of homosexuality in Chinese history is the first-century Chinese Emperor Ai of the Han Dynasty 27 to 1 BC , who, upon waking from an afternoon nap, cut off his sleeve so as not to wake his male lover, Dong Xiang, who was sleeping across it.
Historically, social attitudes and public policy toward homosexuality have shifted in different dynasties. However, in recent years, diverse groups seeking to advance the rights of LGBT people have grown and become important sources of information, services, and advocacy in China.
These groups have made tremendous efforts to support equal rights for LGBT people in China, and to raise awareness about the difficulties they face. In the first Lala Camp took place in Zhuhai to encourage a network of lesbian, bisexual, and transgender organizations in China. However, the movement still faces considerable social and legal challenges. While violent and extreme hostility against LGBT persons is not common in China, the government has significantly limited activism on behalf of LGBT rights — part of deepening official hostility towards independent civil society.
This has limited the ability of LGBT groups to operate freely. LGBT organizations face similar difficulties to other NGOs when it comes to legal registration, and most opt to register as private companies, which is costly and fully taxable.
Although some forms of public gatherings are permitted including Shanghai Pride , government-imposed restrictions on LGBT groups are particularly clear with respect to freedoms of expression and assembly, as the following examples attest:.
In July , a transgender man won a labor discrimination case, considered the first such case of its kind in China. Despite such efforts, no such bills have made it to the agenda of the legislature. These cases, and the media attention they received, have raised the public profile of LGBT activism in China. This saying sums up social ideas about traditional family values in China, and the strong emphasis, on getting married, having children, perpetuating the family name, and supporting aging parents.
Family units consisting of same-sex individuals are considered inimical to the goal of passing on the bloodline through biological offspring. The policy increased social pressure for couples to have a biological, and ideally male, child to pass along the family name.
Because same-sex marriage is not legal, and there is no status given to civil partners, same-sex couples cannot enjoy the social benefits that heterosexual married couples enjoy, including adoption. In this societal and cultural context, some believe that being gay can and should be "cured.
Some attention has been paid to sexual orientation conversion therapy in Chinese academic research, contained in several published articles. In a survey of participants conducted by the Beijing LGBT Center, over half the respondents had heard of conversion therapy, and almost 10 percent had considered receiving it. Over 75 percent of respondents had heard about conversion therapy via the internet, where many psychological clinics advertise.
Doctors and psychiatrists justify conversion therapy for different reasons. Some explained to individuals whom Human Rights Watch interviewed that homosexuality could be due to social or family influence, and could therefore be changed.
Others perceive homosexuality as immoral and unhealthy and used humiliating and degrading words against gay or lesbian individuals. In , the Beijing Haidian District Court sided with a young gay man who had undergone conversion therapy in a private clinic.
In June , another gay man from Zhumadian, Henan Province, brought a lawsuit against a public hospital for admitting him against his will and forcing him to undergo conversion therapy. My dad said he did not know how to continue living in this world and facing other family members if people found out I was gay.
He was begging me to go so that he could live… I mean, at that point, what else could I do? It felt like being pinched or having needles stabbing on my skin… Then after a few minutes, my body started trembling… It was not until later did I realize that was an electroshock machine. In addition, interviewees described specific forms of abuse in conversion therapy. Nor were they based on sound medical or scientific knowledge.
In extreme cases, interviewees were physically forced into conversion therapy and held against their will. All interviewees said they were placed in conversion therapy programs under duress. They described intense coercion and even threats from family members and others. Human Rights Watch asked all interviewees whether they would choose to undergo conversion therapy or any other similar practice to try and change their sexual orientation.
All 17 interviewees explicitly and affirmatively said they would not have undergone conversion therapy or any other attempt to change their sexual orientation but for parental, social, and cultural pressure. All interviewees said they went to conversion therapy against their will, typically within days of coming out to their parents. In three cases, individuals said their parents or other family members physically and forcibly took them to facilities.
In other cases, individuals said they did not feel able to withstand the intense family pressure. They said that when their families pressed them to undergo treatment against their will, practitioners invariably sided with their family. Zhu Tianwen who underwent conversion therapy in , at age 15 , who lived in a small town in northeast China, described what happened the night he was physically forced to go to a hospital in Heilongjiang:. Similarly, Zhang Ping, from Suzhou, a city in east China, told Human Rights Watch that his parents forcibly took him to a psychiatric hospital against his will:.
Li Zhi, who was taken to Psychiatric Division of the Nanping City Hospital in Fujian Province, located in southeast coast of China , described how his parents took him to a hospital and made sure he did not try to escape:. Some described intense parental pressure that led them to feel they had no choice but to yield and submit to conversion therapy in hospitals or clinics. The line between forced physical abduction and family coercion can feel like a thin one for individuals who are either forced or feel compelled to undergo conversion therapy.
Of the 17 cases that Human Rights Watch documented, five people were confined against their will at psychiatric hospitals or in the mental illness division of a hospital.
These interviewees described limited access to privacy, space, and communications. Luo Qing, from Shanxi Province, had tried to keep his cellphone to retain contact with friends.
Tian Xiangli, who was confined in a psychiatric hospital for conversion therapy, described feeling uncomfortable in the room he shared with two others, and frightened by the unpredictable behavior of a patient.
He told Human Rights Watch:. Three interviewees told Human Rights Watch that they attempted to escape from the facility. One of them, Zhang Ping, from Jiangsu Province, succeeded:. The other two interviewees' attempts to escape failed. For example, Luo Qing, who was confined in a hospital in Shanxi Province, said:. The ordeal was not over for those who succeeded or attempted to escape; two described being taken to the hospital for "treatment" more than once.
For example, Zhu Tianwen, was twice taken to the same facility, against his will. China's Mental Health Law prohibits forced enrollment of an individual unless there is clear evidence that this individual is likely to pose a danger to himself or others. The detention in hospitals described by interviewees above was arbitrary. Gong Lei, told Human Rights Watch that although he disagreed with the doctor, he felt there was little he could do:.
Seven interviewees told Human Rights Watch that they remained comfortable with their sexual orientation, despite the humiliating characterizations of their sexuality. Zhang Zhikun said:. Zhang Ping, who was taken to psychiatric hospital twice for conversion therapy by his parents and relatives, said:.
Derogatory terms used by health professionals are not only insulting, they also reflect an unwillingness to acknowledge that homosexuality is not a crime or a mental illness. Human Rights Watch interviewed the mother of one interviewee, Li Qi. Li Qi identifies as female now, which is not known to her mother. Her mother still refers to her by male pronouns. At the time of her conversion therapy, she identified as a gay man and was treated as such.
Human Rights Watch also interviewed a father, who took his gay son age 19 to a hospital for electroshock treatment. The father, Li Waichen, said:. Forced psychiatric intervention, including forced drugging, can constitute torture and other cruel, inhuman, or degrading treatment or punishment, and has been condemned by related United Nations human rights special procedures. Nonetheless, 11 interviewees told Human Rights Watch that they were required, or in some cases, forced, to take pills, and subjected to injections or other forms of medicine as part of their "therapy" or "treatment.
Medical personnel ensured that individuals took the medications even when they resisted, or expressed a preference not to do so. In some cases, where the individuals were not confined in hospitals, parents of these individuals administered the medications. Li Zhi, from Nanping City, still has no idea what pills he took, or what they were supposed to do:.
Even those confined at home had parents enforce the taking of unknown medications, as Xu Zhen described:. Some interviewees were told that they were being given medication to treat specific conditions, although they had not been given a diagnosis nor the opportunity to discuss it. Wen Qi said doctors treated him for anxiety, even though he did not consider himself to be anxious:. Some interviewees told Human Rights Watch that they went to some lengths to avoid taking the medicine, such as pretending to swallow it, before spitting it out and discarding it.
Zhang Zhikun, who was forcibly confined in the psychiatric division of a hospital, said:. Other interviewees told Human Rights Watch that their parents or the nurses at the facilities were strict when examining "patients" to determine whether they had taken their medicine.
For example, Chen Shuolei, who was also forcibly confined in a hospital for conversion therapy and was forced to take medicine daily, said:. A nurse injected nausea-inducing medication while he was watching gay pornography, so that he would associate sexual arousal with nausea:.
Cheng Zhiwen, from Henan Province in north China, explained how he was restrained and forced to take medicine:. Chinese soccer star Li Ying last month became China's first female athelte to come out publicly as gay. When Pride Month arrived, few events were held, and those that were remained largely underground. In recent decades, sexual minorities in China seemed to have received gradual — though uneasy — acceptance by authorities.
China decriminalized homosexuality in and removed it from its official list of mental disorders in But with same-sex marriage still illegal and Chinese authorities banning "abnormal sexual behaviors" from the media in , the impression among many is that LGBTQ people are free to explore their identities — so long as they do so in private.
The ongoing clampdown on LGBTQ spaces appeared to accelerate on July 6, when China's most popular messaging app WeChat suddenly shut down dozens of LGBTQ accounts run by university students, one of the most widespread and coordinated acts of censorship targeting sexual minorities in the country in decades. When several users attempted to access the groups, they received a notice saying, "After receiving relevant complaints, all content has been blocked and the account has been put out of service.
We basically don't engage in any radical advocating anymore," she said. After the shutdown of LGBT WeChat groups on Tuesday, Hu Xijin, editor of the state-owned tabloid Global Times, claimed on his blog that there was "no restriction" from the Chinese government on the "lifestyle choices" of sexual minorities, or "discrimination and suppression" from public opinion.
Hu said if LGBTQ people in China could just accept their country was never going to be on the "forefront" of rights for sexual minorities, they might be happier. Some LGBTQ people have blamed the crackdown on the incorrect impression that homosexuality is a Western import into China, and groups supporting gay rights are liable to infiltration by foreign forces. Chinese President Xi Jinping has increasingly stressed the ruling Communist Party's absolute control over every aspect of society.
Some also suspect a more direct link between the crackdown on LGBTQ rights and top officials' worldviews, which for many were shaped during the Cultural Revolution in the s and '70s, when authorities attempted to purge any "non-socialist" elements — including homosexuality — from Chinese society. Around Asia. Indian Prime Minister Narendra Modi dropped 12 members from his cabinet , including the federal ministers for health and law, in a major reshuffle Wednesday, following fierce criticism over his government's handling of the coronavirus pandemic.
In future studies, it would be useful to investigate causal relations among perceived discrimination and identifying as LGBT using scales with good psychometric properties. In conclusion, this study is an innovative national investigation of the discrimination faced by members of the Chinese LGBT community in various personal and community settings. In order to reduce discrimination, it is important for future studies to discover the underlying reasons for discrimination against LGBT individuals by some heterosexual individuals.
Moreover, it is critical for government policies and services to be more tolerant towards the LGBT community, and to provide the legal e. Burki T. PubMed Article Google Scholar. LGBT older adults at a crossroads in mainland China: the intersections of stigma, cultural values, and structural changes within a shifting context. Int J Aging Hum Dev. J Gay Lesbian Psychotherapy. Article Google Scholar. Ren Z, Yuan C. J Gay Lesbian Mental Health.
Parkin S. LGBT rights-focused legal advocacy in China: the promise, and limits, of litigation. Google Scholar.
Becker AB. Employment discrimination, local school boards, and LGBT civil rights: reviewing 25 years of public opinion data. Int J Public Opinion Res. Xie Y, Peng M. Attitudes toward homosexuality in China: exploring the effects of religion, modernizing factors, and traditional culture.
J Homosex. Hu X, Wang Y. LGB identity among young Chinese: the influence of traditional culture. A cross-sectional study of associations between casual partner, friend discrimination, social support and anxiety symptoms among Chinese transgender women.
J Affect Disord. Legge J. The Chinese Classics: Vol. Wong FY. In search for the many faces of community resilience among LGBT individuals. Am J Community Psychol. Suicidal ideation and attempted suicide amongst Chinese transgender persons: national population study.
Fertility rate, total births per woman. Stud Fam Plan. DiStefano AS. Stigma, discrimination, and mental health of sexual minorities in Japan. Youn G. Attitudinal changes toward homosexuality during the past two decades — in Korea.
Lancet Public Health. Shame, internalized heterosexism, lesbian identity, and coming out to others: a comparative study of lesbians in mainland China and Hong Kong. J Couns Psychol. Health care and mental wellbeing in the transgender and gender-diverse Chinese population. Lancet Diabetes Endocrinol. Stigma, mental health, and resilience in an online sample of the US transgender population. Am J Public Health.
Mapping cultural tightness and its links to innovation, urbanization, and happiness across 31 provinces in China. Proc Natl Acad Sci. Front Psychol. The relational orientation framework for examining culture in Chinese societies. J Culture Psychol. Family acceptance in adolescence and the health of LGBT young adults. J Child Adolesc Psychiatr Nurs.
Klein A, Golub SA. Family rejection as a predictor of suicide attempts and substance misuse among transgender and gender nonconforming adults. J LGBT health. Meyer IH. Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: conceptual issues and research evidence. Psychol Bull.
The social and economic imperative of lesbian, gay, bisexual, and transgendered supportive organizational policies. Ind Organ Psychol. Self-reported rates of abuse, neglect, and bullying experienced by transgender and gender-nonbinary adolescents in China. Download references. The funding sponsors had no role in the design, conduct, analysis or write-up of the article. You can also search for this author in PubMed Google Scholar.
All authors read and approved the final version of the manuscript. Correspondence to Jianjun Ou or Runsen Chen. All participants were informed of the objective of the study and completing the survey implied consent to participate in the study. The other authors declare no conflict of interest. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder.
Reprints and Permissions. Wang, Y. BMC Public Health 20, Download citation. Received : 02 October Accepted : 03 May Published : 12 May Anyone you share the following link with will be able to read this content:. Sorry, a shareable link is not currently available for this article. Provided by the Springer Nature SharedIt content-sharing initiative.
0コメント