The rumor spreads through the corridors, the rooms, the operating rooms… No one knows the story very well, no one wants to hurt, but everyone comments; perhaps to kill boredom or because it is “humane” to do so. Today we talk about Dr. Ismael — let’s call him that, after the famous narrator of Moby Dick— It is about a young doctor, father of a family, who had to assume an administrative responsibility until it became known that he was homosexual and “what happened happened”. The person who told me about “his case of him” told me that “at first he couldn’t believe it, but an acquaintance confirmed it”. “He did it wrong,” he continues, “he could have bided his time.”
The little scandal that concerns us, occurs on the 53rd anniversary of the riots in Stonewal, NY, United States, which marked the beginning of the homosexual liberation movement; also when a lesbian kiss in a long-awaited animated film shocks the world —unbelievable!— and the debate on the families code in our country it is with “low flame”, which does not prevent sparks from flying from time to time. As happened a few weeks ago when three LGTBIQ+ activists had a run-in with a group of protesters. The incident, then, was maximized in the networks and was talked about for a while; however, beyond what happened and what was said to have happened, it is evident that there is a confrontation between those who are committed to “all rights for all people” and those who would prefer that things continue “as they have always been”, and the medical environment does not escape this.
Dr. Ronny, a practicing Christian, tells me that “as a doctor” he considers homosexuality to be a psychological disorder and doubts that it has a genetic origin because “…scientists have not found the long-awaited gay gene…”. The issue of why some people “prefer” those of the same sex is currently under debate. The opinions of the experts are divided between those who point to sociocultural reasons —education, upbringing, social influence…—, although these groups are losing more and more followers, given the growing evidence, from experiments on animals, that “The masculinization” or “feminization” of the brain is a consequence of the levels of testosterone, which is the male sex hormone par excellence, at different times in prenatal life. From there, it would be impossible for anyone to “choose” her sexual orientation. On the other hand, there are researchers who argue that sexual identities are “social constructions” and rely on the fact that homosexuality in other times was different. The biggest criticism leveled at this theory is that, although it may have had distinct features, the basic phenomenon—same-sex attraction—has always existed.
A psychiatrist tells me that personally she is totally in favor of freedom and “all that that implies”. On the part of psychiatry, she explains, the tendency is for homosexuality to stop being considered a pathology; since 1973 the North American Psychiatric Association (APA) decided to eliminate homosexuality from the category of “sexual deviations”. The foregoing caused enormous controversy because it opened the doors for other organizations to do the same — such is the case of the WHO, which made a similar decision on May 17, 1990, and contributed to changing deeply rooted visions and paradigms.
However, despite these transformations, the issue of publicly “assuming” is still complex. A gay colleague, who asked me not to mention his name, told me that, although for a long time he feared rejection from his classmates and his professors, he did better than he expected “as long as the medical environment is discussed.” . As for his family, his parents are the only ones who “truly” know about it and they asked that no one in the town find out, “deep down, they don’t accept it.” Being very young he thought that he could be “cured”, that when he had a girlfriend “he would forget about men”. But the opposite happened: he realized that what he has “is not a disease”, that there was no cure, that “he was like that and was going to be like that for the rest of his life”, so that “he had to accept himself and find a way for his family and society to accept him.”
The idea that it was possible to “cure homosexuals” occupied medical science for much of the 20th century. Various methods were tried, such as castration, testicle transplants, hypothalamotomies —a surgical procedure that consisted of injuring an area of the brain where the cause of “the disease” was supposed to be—, passing through hormone replacement therapies. A paradigmatic example of the above is that of Alan Turing, an English mathematician, precursor of computers and artificial intelligence, who in 1952 was accused and convicted of “flagrant indecency” and ended up committing suicide in 1954 due to the adverse effects of hormones. .
Returning to our country, Dr. Andrade, an imaging specialist and also a religious practitioner, explains to me that a long time ago his opinion was aligned “with the word of God.” For him, according to the Bible, homosexuality is a sin” and therefore has a solution, “like any other sin”. He adds that the news speaks of numerous marches in American cities of former homosexuals who have been “restored by the power of God.” The solution to sin is Jesus Christ, “prayer to God helps, because God says it is a weapon” and to conclude he quotes me from the holy book: “… because the weapons of our warfare are not carnal but powerful in God for destruction of strongholds” (2 Corinthians 10:4).
Fifty years after the historic decision of the APA, and largely due to the influence of evangelical churches, “sexual reorientation” therapies are gaining strength in the world. According to the association that brings together American psychiatrists, these are “pseudo-scientific methods” that seek to “cure homosexuality through faith.” A French journalist who managed to infiltrate these congregations explains that these practices consist of “…public confessions, endless prayers, humiliations and degrading rituals…”. Testimonies of people who define themselves as “victims” of these practices and rituals, describe that among the long-term results are depression, anxiety and other mental health problems. At least 700,000 people have been subjected to these techniques in the United States alone and there is news of them in more than sixty countries. What could be more worrying is that “patients” begin to frequent these spaces during their adolescence, when they are not yet in a position or capacity to decide for themselves. Although the subject is handled discreetly in our midst, I have heard from people who hope to cure their homosexuality “in the churches”.
Personally, discrimination based on sexual orientation and gender identity seems unacceptable to me. It is not about “tolerating” or even accepting anyone, but about understanding that part of the beauty of humanity —regardless of the entity that gave rise to it— resides in its diversity, as well as in the limit to freedom of each is clearly marked in absolute respect for the rights and freedom of the other. Likewise, even when I understand that it is a very rough topic, where the scientific is mixed with political, religious, philosophical criteria… from the clinical point of view there are no reasons to understand homosexuality as a disease. That is why the introduction in our environment of sexual reorientation therapies, one of the last redoubts of the pathologization of homosexuality, is so worrying. The ethical principle of primum non nocere —first do no harm— that has governed medicine for centuries, must also prevail in this matter. It is very dangerous when an institution, any institution, assumes functions that go beyond its expertise, especially when that work is oriented towards minors. This is one of those issues that I hope will be included in the new health law in Cuba.
On the Island, discrimination based on sexual orientation and gender identity has been constitutionally prohibited since 2019 and, as I said at the beginning, a new Family Code is being discussed that would mean an important leap. However, there is still a lot to be gained in education, in respect for people’s right to privacy so that cases like this are no longer a reason for more or less malicious gossip, people must stop chasing “the great blue whale” . In the meantime, Dr. Ismael has moved on with his life and although the gossip seems not to have made much of an impression on him, he chose to go to work somewhere else where he might be happier.