Cover Story

In Armenia, homosexuality is illegal under the country's constitution. Homosexuals are openly abused by citizens as well as by officials. "The police routinely pick them up off the street, beat them, sometimes even rape them and they extort them for money," says Armenian psychologist Sona Markosyan.

As in many countries, Armenia's religion, mental health professionals and its public opinion also revile homosexuality, viewing lesbian, gay and bisexual (LGB) people as outlaws, sinners, mentally ill and immoral.

Hoping to raise awareness of the challenges LGB people around the world face and increase societies' understanding of LGB communities, APA has launched an international effort on the mental health of LGB people. The association's first action was to hold an international conference before APA's 2001 Annual Convention, attended by mental health professionals and students from 20 countries, representing societies as liberal as the Netherlands--the only country that allows same-sex marriage--and as repressive as Armenia.

"The delegates felt extremely fortunate and excited about what they're beginning"--that is, creating a more unified global position on the mental health needs and rights of LGB people, says Armand Cerbone, PhD, who co-chaired the meeting with German psychologist Melanie Steffens of the Association of Lesbian, Gay and Bisexual Psychologies­Europe.

"This was an excellent step toward promoting the mental health of LGB people throughout the world," adds Clinton W. Anderson, the meeting's coordinator and lesbian, gay and bisexual concerns officer in APA's Public Interest Directorate.

During the meeting, participants developed action plans to take back to their countries. They came up with some products, too: An international report will be issued soon, and APA started an international listserv for meeting members devoted to the mental health concerns of LGB people.

In addition, the group discussed holding another international meeting in three or four years, involving even more international leaders, Anderson noted.

Similarities and differences

Despite a range of cultural and political differences among countries' attitudes toward LGB people, delegates noted some commonalities. For instance, mental health practitioners tend to be relatively gay-affirmative in many countries, while conservative religious groups of all stripes often actively oppose homosexuality.

As in the United States, the attitude of the general public in many countries ranges from outright opposition to general acceptance, but overall, many countries appear to be more aware and accepting of LGB people. In China, for instance, Chinese medical and mental health professionals have made great strides in understanding and accepting homosexuality. In fact, the Chinese psychiatric establishment recently struck homosexuality from the Chinese classification of mental disorders. Meanwhile, the government remains silent on these issues--an indication, Chinese delegates ventured, of a tacit acceptance of the trend toward openness, says Chinese delegate Cong Zhong.

But like in the United States, LGB people in China face their own version of the religious right: The Chinese religious group called the Falun Gong touts its belief that God will eradicate homosexuality in the Earth's final days.

In contrast to many countries that are struggling with anti-gay actions, Brazilian delegate Paolo Robert Ceccarelli offers a refreshing view of a "kinder, gentler nation" for LGB people.

"LGB issues are not a problem in Brazil," Ceccarelli says. "We've never had a law that would discriminate against homosexuality as they might in Argentina or Chile, for example. On the contrary, we have many laws that protect homosexuals." The current mayor of Sao Paolo, Marta Suplicy, will likely help the cause: A strong civil-rights advocate and a colorful character in Brazilian politics, Suplicy champions a bill she introduced when she was a congresswoman that would recognize the legal rights of same-sex couples.

Meanwhile, the United States received a lukewarm rating from its own delegates on levels of LGB-friendliness. Although the delegates affirmed that the United States has made strong efforts to pass protective legislation and conducted significant research on LGB issues, the country continues to harbor one of the largest anti-gay lobbies in the world. Even when legislation gains are made, this coalition manages to thwart them on a regular basis, they say.

Taking action

Delegates agreed that the Internet has played a strong role in the ability of LGB people in many nations to connect and get politically active. In China, for instance, there are about 200 LGB Web sites now, compared with two or three in 1997. In keeping with this trend, APA has provided a listserv for the network established among participants: Those interested in subscribing can e-mail Listserv and type SUBSCRIBE INET in the text (not the subject line) of their message.

In the global arena, delegates agreed that another international meeting is in order sometime in the next few years. Proposed sites include South Africa, which would be able to draw participants from the entire African continent; and Australia, which would garner attendees from the Pacific Rim and Asia. Many agree the meeting was too "America-centric," and expressed regrets that more countries weren't able to attend. Delegates also lamented the fact that they weren't able to include transgendered people or issues at the meeting, and debated whether the statement should include a "T" at the end of the "LGB" acronym.

Before the meeting's close, delegates drew up local and regional action plans that were both realistic and specific. The Korean representative, Huso Yi, promised to write a report on the meeting and publish it in a Korean journal. Ugandan representatives said they wanted to identify mental health providers who worked with LGB clients. The South African delegate pondered a plan to give a regional training session on mental health issues for LGB people in neighboring countries. Delegates from a number of nations vowed to translate APA's Guidelines for Psychotherapy with Lesbian, Gay, and Bisexual Clients into their own languages (see Tailoring treatment for lesbian, gay, bisexual clients).

APA is dedicated to further work in the area. "APA has a long-time commitment to progressive policies on sexual orientation," says APA Chief Executive Officer Raymond D. Fowler, PhD. "I don't remember a time in our history that the Council of Representatives wasn't favorable to these issues."

APA Board of Directors member Ruth Ullman Paige, PhD, credits the meeting to a person particularly beloved in APA's LGB community: former APA board member Catherine Acuff, PhD, who died of a brain aneurysm in 2000. Acuff was a "bulldog" about making her vision of the meeting a reality by shepherding it through APA's political process, Paige says.

"This was one of Cathy's last victories, and it was a special victory for her," Paige says. "Her dreams, accomplishments and victories keep her alive for us."

Tori DeAngelis is a writer in Syracuse, N.Y.