Byline: Gurvinder. Kalra, Susham. Gupta, Dinesh. Bhugra
Sexual variation has been reported across cultures for millennia. Sexual variation deals with those facets of sexual behavior which are not necessarily pathological. It is any given culture that defines what is abnormal and what is deviant. In scriptures, literature and poetry in India same sex love has been described and explained in a number of ways. In this paper we highlight homosexual behavior and the role of hijras in the Indian society, among other variations. These are not mental illnesses and these individuals are not mentally ill. Hence the role of psychiatry and psychiatrists has to be re-evaluated. Attitudes of the society and the individual clinicians may stigmatize these individuals and their behavior patterns. Indian psychiatry in recent times has made some progress in this field in challenging attitudes, but more needs to be done in the 21 [sup]st century. We review the evidence and the existing literature.
Sexual variation is sexual behavior which varies from the usual heterosexual intercourse; the behavior includes alternative sexual orientation such as homosexuality and bisexuality. Its description in various forums has been well known across the globe for millennia. A recent term, which has been used extensively, is 'Men who have Sex with Men' (MSM). Gender roles and gender role identities may fluctuate, as does the sexual behavior, depending upon the availability of sexual partners and opportunities.
Although the data on sexual variation are extremely limited, especially from India, in this paper we propose to highlight some of the conceptual issues. We aim to describe some of these behavior patterns in historical accounts and raise issues related to managing these in clinical settings.
In this paper, we focus on bisexuality and homosexuality. Sexual orientation refers to a person's preference for sexual and emotional relationships with a particular sex. [sup] Sexuality is not just sexual, but also has an emotional component and impact. Sexual behavior should not be equated with sexuality. Societal attitudes influence this behavior and whether individuals carry these out openly or in secret. For bisexuality, the male role takes on a different dimension. In a patriarchal society such as India the roles of fathers, brothers and husbands may be threatened by variations in sexual behavior.
However, sex and gender are often confused. The sex of an individual is determined biologically, whereas gender may be influenced by social factors. Bullough [sup] described societies as 'sex positive' or 'sex negative'. Sex positive societies celebrate sexual activity and the sexual act is seen as meant for pleasure, whereas the main function of sex in sex negative societies is seen as for procreation. In addition, a further complicating factor in individual sexual behavior is not only personality and orientation, but also whether they meet social expectations, which are likely to be affected by kinship and socio-centric traditions of the society they come from. India, by and large, remains a traditional socio-centric society rapidly moving to an ego-centric society as a result of urbanization, industrialization under the overall impact of globalization. In this paper we do not propose to cover other variations, such as pedophilia, but the aim is to focus on homosexuality and bisexuality. We will discuss the notion of hijras in India, their role in society and associated attitudes. Historically, psychiatry as a profession has placed itself in treating these conditions sometimes primitively and sometimes without adequate safeguards as agents of social control. However, in the West this approach has been discredited, though it continues in parts of the world, including India.
The attitudes to bisexuality and homosexuality in India have been ambivalent to say the least. …