Same-Sex Marriage Equality Is Not Just an Issue of Rights but Also Mental Health

The mental health indicators of the LGBTQ community are significantly worse than those of the rest of society. This can partially be eased if queer marriage is legally recognised.

Solid arguments usually rest on more than one pillar. Such as the argument in favour of marriage equality, currently being heard by the Supreme Court of India. It is supported by many pillars: the LGBTQ community’s legal rights, the case for fairness in such an important arena of life, and the emotional need for acceptance of a minority group by mainstream society. 

Mental health is an equally important, if perhaps less visible, pillar on which this case rests. How many of us know that the mental health indicators of the LGBTQ community are significantly worse than those of the rest of society? These indicators include levels of stress, anxiety, depression, suicidal tendencies and substance abuse, attributable to LGBTQ-related discrimination, and the lack of acceptance, especially from family, loved ones and workplaces. The absence of the right to marry – and its associated legal outcomes – is a critical factor responsible for much of this discrimination, and many of these mental health challenges.

A swathe of data, all from overseas, supports this contention. “… a research study by Hatzenbuehler et al found in 2004 that LGB adults who lived in areas that banned same-sex marriage experienced significant increases in mood disorders, alcohol dependency, and in generalized anxiety disorders, versus LGB adults who lived in areas without marriage bans. In another study Hatzenbuehler et al found the first state in the USA to pass a same-sex marriage law saw improvements in the health of gay men with significant reductions in depression, hypertension and stress disorders, all within 12 months of the law being passed. 

This can allow one to posit that affirmative policies addressing structural forms of stigma may improve health indicators, whereas institutional, policy and law based stigma can negatively impact health indicators,” writes Raj Mariwala, the director of the Mariwala Health Initiative (MHI), in Reframe: Unpacking Structural Determinants, the December 2021 edition of the  MHI journal. Mariwala is one of India’s most respected mental health philanthropists and commentators. 

Another study on the impact of discrimination in the US by the American Psychological Association presents a distressing comparison of stress levels. The study found that adults who are LGBT, who have experienced discrimination, have average stress levels of 6.4, compared to 6.0 for LGBT adults overall. Among adults who are non-LGBT, stress levels are 5.5 for those who have experienced discrimination, and 5.0 for non-LGBT adults overall – a significant difference. 

Stories breathe life into these numbers. Whether it is gay, lesbian or trans doctors, entrepreneurs or corporate employees in India, the narrative is singular and shocking: of mental suffering due to discrimination, lack of acceptance, and deprivation of legal rights. 

“Those of us who identify as LGBTQ+ are more likely to develop problems like low self-esteem and depression. I personally have been suffering from anxiety, including social anxiety leading to eating problems and self-harm. Throughout my adolescence and young adulthood days I have battled suicidal tendencies and have self-harmed,” says Zainab Patel, 42, a transgender woman who now leads diversity and inclusion for a corporate and is also a petitioner in the Supreme Court case. Raga D’Silva, 53, an author, host and LGBTQ+ activist, says she was “shunned by her mother” who threatened her with a knife when she found out her grownup daughter was lesbian, an experience that filled her with “guilt, shame and a sense of failure.”

For Prateek, a 26-year-old gay man working in publishing, discrimination due to a lack of acceptance of his identity started early on. “It happens at home at dinner tables. You have to pretend to be interested and sit through a cricket match with your dad. Pretend to be interested in girls while one’s in college or even unwillingly date them. Just to fit in a box because it tends to make life easier. One has to pretend all the time to just fit in and this pretence in the longer run turns into anxiety, self-doubt, confused identities and so on. Personally for me, during therapy, most of the issues date back to these times. Schools don’t have forums to enable self-discovery and there are no healthy environments that I was privy to at a young age where I could probably engage without feeling judged or misunderstood.” 

Others struggle with the legal repercussions of not being married. Aneesh Sheth, a 41-year-old scientist-entrepreneur who got married to his husband outside the country, says, “I think the discrimination we face is mostly from the legal system. I cannot add my husband as a nominee in a lot of my assets without further documentation because the legal system only allows for ‘immediate family’. Something as simple as transferring money becomes a challenge because we will be double taxed. This is obviously not good for my mental health. We definitely feel like second-class citizens in the eyes of the government. Clearly, this plays on our psyches and is often exhausting and trying.”

These are elite members of our society – it is unimaginable what happens to those without privilege! 

All are united in saying that same-sex marriage equality will lead to healthier outcomes. Dr Prasad Dandekar, 45, an oncologist and a gay man who has been living with his partner of 19 years, observes, “We haven’t seen a huge change in societal attitudes since decriminalisation [of consensual homosexual intercourse] in 2018. What we are seeing is: ‘You are not criminal, so we will tolerate, but you are not one of us, you are not amongst us. You don’t have the same rights.’ One of the big game-changers is the right to marry. We can’t buy a house together. We can’t get a loan together. On paper, my partner is just a friend. Integrating marriage rights will significantly change the common man’s perception. The sense that we are ‘less’ will reduce, that will have a huge impact on the mental health of the LGBTQ community.” 

“If we are granted rights, it will be a huge relief for us. Being able to be recognised as a family in the eyes of the law, in our own home country will allow us to feel safe and not have to think about ways to protect each other,” adds Aneesh Sheth. Surely not a big ask in the 21st century. 

Aparna Piramal Raje is a writer, educator and public speaker and the author of Chemical Khichdi: How I Hacked My Mental Health. Her close relative, Radhika Piramal, is one of India’s few openly gay corporate leaders.

With research inputs from Kriti Krishnan.

If you know someone – friend or family member – at risk of suicide, please reach out to them. The Suicide Prevention India Foundation maintains a list of telephone numbers (www.spif.in/seek-help/) they can call to speak in confidence. You could also refer them to the nearest hospital.