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Gender in Mental Health: The decriminalization of homosexuality and LGBT mental health in Singapore
Abstract
In Singapore, almost a third of the population (31.7%) may have negative attitudes toward lesbians, gays, bisexuals, and transgender (LGBT) individuals (Manalastas et al., 2017). These negative attitudes may reflect reports that they may be experiencing violence, healthcare and employment discrimination, lack of recognition of marriage, and constrained freedom of expression (Lam, 2022; Manalastas et al., 2017; Wong, 2022; Yuen-C, 2022). Likewise, these behaviors and attitudes are also reflected in its state policy, such as Section 377 A of its Penal Code which criminalizes homosexuality (Manalastas et al., 2017; Wong, 2022; Yuen-C, 2022).
... Singapore is an English-speaking country located in Southeast Asia that, until November 2022, retained male homosexual criminalisation inherited from British colonisation (21). Though Singaporean society may be growing in acceptance of the LGBTQ+ communities, widespread religious resistance and stigma still exist (21), where 57% of Singaporean society remains opposed to homosexuality compared to 13% of British society (22). ...
... Singapore is an English-speaking country located in Southeast Asia that, until November 2022, retained male homosexual criminalisation inherited from British colonisation (21). Though Singaporean society may be growing in acceptance of the LGBTQ+ communities, widespread religious resistance and stigma still exist (21), where 57% of Singaporean society remains opposed to homosexuality compared to 13% of British society (22). Same-sex partnerships remain unrecognised in Singapore, with public policies that fail to affirm LGBTQ+ individuals in the workplace and housing (23). ...
... Religiosity seemed to be linked to lower knowledge levels, corroborating previous European studies (19,20). The high proportion of religious respondents in SG compared to the UK may contribute to the differences seen between students in the two countries since religious resistance and stigma may negatively affect students' perceptions of healthcare (21), where religious beliefs that disapprove of same-sex relations present as a frequent motivator to support conversion therapy (39). This may also explain the many SG respondents that would redirect patients enquiring about conversion therapy to specialist agencies despite the lack of evidence supporting this practice (40) and its harm toward patients (41). ...
Introduction: Lesbian, gay, bisexual, transgender, queer, and other sexual and gender minority (LGBTQ+) individuals have an increased scope of healthcare needs and face many barriers to accessing healthcare. However, LGBTQ+ healthcare education remains scarce, and students' understanding of LGBTQ+ healthcare remains largely uncharacterised. This study investigated the knowledge of and attitudes toward LGBTQ+ healthcare among medical students in Singapore and the United Kingdom (UK), two culturally different countries.
Methods: Medical students in two medical schools, one in Singapore and the other in the UK, completed self-administered cross-sectional surveys using multiple-choice, Likert scale, and free-text questions to explore their ideas, concerns, and expectations about LGBTQ+ healthcare education within their medical curricula.
Results: From 330 responses, students' knowledge levels were moderate overall, with pronounced gaps in certain areas, including terminology, sexual health, and conversion therapy. Deficiencies in knowledge were significantly greater among students in Singapore compared to the UK (p < 0.001), whilst LGBTQ+ students and non-religious students had more positive knowledge and attitudes than students not identifying. At least 78% of students had positive attitudes towards LGBTQ+ individuals, but 84% had not received LGBTQ+-specific medical education. Although junior UK students were more satisfied with the adequacy of teaching by their medical school's incorporation of LGBTQ+ inclusive teaching in a newer curriculum, qualitative analyses suggested that students in both countries wanted to receive more training. Students further suggested improvements to the medical curriculum to meet their needs.
Conclusion: Students in both schools lacked understanding of commonly-used terminology and topics such as sexual healthcare despite affirming attitudes towards LGBTQ+ healthcare. Although sociolegal contexts may affect students' perspectives, differences were less than thought, and students were equally keen to provide affirmative care to their patients. They emphasised a need for more formal teaching of LGBTQ+ healthcare professions to overcome healthcare disparities in these communities.
... Recently, there has been a movement in the region toward ending the criminalization of homosexuality. For example, in 2022, LGBT individuals in Singapore celebrated their government's move to abolish the colonial-era 377A law, which criminalizes sex between men (Alibudbud, 2022b;Wong, 2022). The Singapore government's reason for the move was the friendlier and more accepting public attitudes toward LGBT individuals (Alibudbud, 2022b;Wong, 2022). ...
... For example, in 2022, LGBT individuals in Singapore celebrated their government's move to abolish the colonial-era 377A law, which criminalizes sex between men (Alibudbud, 2022b;Wong, 2022). The Singapore government's reason for the move was the friendlier and more accepting public attitudes toward LGBT individuals (Alibudbud, 2022b;Wong, 2022). Thus, other countries in the region may also reassess their citizens' attitudes to guide them toward gender-inclusive policies. ...
This perspective piece focuses on and analyzes several lesbians, gays, bisexuals, and transgender (LGBT) individuals' rights and their limitations in the Association of Southeast Asian Nations (ASEAN) region, including the limited recognition of self-determined gender identity, limited legal provisions for LGBT marriage, inadequate anti-discrimination policies, and the criminalization of homosexuality. These inadequacies in LGBT rights may stem from colonial, religious, and cultural factors. Moreover, these limited LGBT rights and their societal repercussions may contribute to the minority stress of LGBT individuals, leading to their higher rates of mental health problems. Thus, there may be a need to uphold, recognize, and protect LGBT rights as the region pursue equitable mental health. Toward this pursuit, the region may possibly benefit from culturally adapting gender-affirming practices, increasing their social support, opposing the practice of conversion therapy, and decriminalizing homosexuality. It may also be necessary to explore, analyze, and study the intersection of LGBT identity and mental health, especially longitudinal and interventional studies.
... In Southeast Asia, prevailing negative attitudes toward LGBTQ+ individuals are shaped by religious beliefs, cultural norms, colonial legacies, and laws criminalizing homosexuality (Alibudbud, 2022;Manalastas et al., 2017;Tan & Saw, 2023). Studies in this region have confirmed a heightened incidence of mental health issues, particularly depression, self-harm, suicidal ideation, and suicidal attempts, among LGBTQ+ communities (Tan & Saw, 2023). ...
Introduction
No study to date has reviewed the evidence base concerning prevalence and correlates of depression, anxiety, non-suicidal self-injury, and suicidality amongst LGBTQ people in Southeast Asia.
Method
We carried out a systematic review of quantitative articles (n = 25) identified through electronic databases.
Result
Heightened prevalence of mental health difficulties and minority stressors were found amongst Southeast Asian LGBTQ people which included significant effect size differences relative to cisgender and heterosexual people.
Conclusion
This review underscores the need for a more nuanced understanding of minority stressors and protective factors to inform mental health prevention efforts.
How are sexual minorities like lesbians, gay men, and their sexualities viewed in the different societies of Southeast Asia? Previous studies have been limited by the reliance on data from university students and other non-representative samples, with little comparability across countries in the region. This research brief addresses this gap by comparing attitudes toward lesbians and gay men and about lesbian and gay sexualities in six Southeast Asian countries using nationally representative survey data. Combined data from the World Values Survey (total n = 9,182 respondents from Indonesia, Malaysia, the Philippines, Singapore, Thailand, and Vietnam) indicated that many Southeast Asians reject lesbians or gay men as neighbors, with the most homonegative attitudes to be found in Indonesia (66%) and Malaysia (59%), compared to
Introduction:
Previous studies showed that Filipino young women have higher rates of certain mental disorders than men, while LGBT+ individuals have higher mental disorders rates than heterosexual cisgender individuals. These differences may be due to their unique social experiences. Despite these, studies that directly compare the rates and social factors of mental health conditions among men, women, and LGBT+ individuals including depression, anxiety, and stress, remain sparse.
Objective:
This study aimed to compare the rates and social factors of depression, anxiety, and stress among young adult Filipino heterosexual cisgender men and women and LGBT+ individuals.
Methods:
This study utilized a sociodemographic questionnaire, the Daily Discrimination Scale, and the Depression, Anxiety and Stress Scale-21 (DASS-21) to determine the difference between the rates and social factors of depression, anxiety, and stress among the respondents. A total of 959 young Filipino adults completed the questionnaire. Afterward, logistic regression, chi-square, and descriptive statistics were done.
Results:
LGBT+ respondents experienced the highest rates of significant depression (92.0%), anxiety (93.8%), and stress (81.3%). Discrimination had the largest effect size among men and LGBT+ individuals. While age may be a risk factor for anxiety among heterosexual cisgender males, it was protective for stress among LGBT+ individuals. Working, studying, and living with peers had protective effects against anxiety and stress among heterosexual cisgender men and women.
Conclusion:
Rates and factors of depression, anxiety, and stress varied according to gender. This variation may be accounted for by unique social experiences and contexts including violence, discrimination, cultural expectations, and social roles. Thus, gender-sensitive mental healthcare may need to extend beyond binary views limited to men and women.
Support for Section 377A drops as attitudes towards same-sex relationships shift, survey finds
- Yuen-C
Yuen-C, T., 2022. Support for Section 377A drops as attitudes towards same-sex relationships shift, survey finds. Strait. 〈https://www.straitstimes.com/singapore/
politics/support-for-section-377a-drops-as-attitudes-to-same-sex-relationships-s
hift-survey-finds〉.
Court of Appeal Dismisses Challenges to Section 377A, Law Criminalising Sex between Men to Stay
- L Lam
Lam, L., 2022. Court of Appeal Dismisses Challenges to Section 377A, Law Criminalising
Sex between Men to Stay. Channel News Asia. 〈https://www.channelnewsasia.com/
singapore/court-appeal-dismisses-challenges-377a-law-criminalising-sex-men-2524431〉.
377A: Singapore to End Ban on Gay Sex
- T Wong
Wong, T., 2022. 377A: Singapore to End Ban on Gay Sex. BBC News. 〈https://www.bbc.
com/news/world-asia-62545577〉.