COMMENT The recent decision of the Court of Appeal on the legitimacy of Section 66 of the Negeri Sembilan Syariah Criminal Enactment has not only caused some upheaval but also brought a broad display of utter ignorance and idiocy.

Such is displayed by not only religious authorities but also some members of the members of professional bodies such as medicine.

Besides lamenting the ills and the possible consequences of the condition (GD/GID), these ‘authorities’ are now claiming a definite cure for the condition and the possibility of conforming to the gender identity associated with the sex at birth.

The consequences, according to these ‘authorities’ are namely moral decay, increased rate of sexual crimes (associated with men dressing up as women, and prey on them in public toilets), and increase occurrence of natural disasters (as God’s apparent punishment for condoning/accepting the transgender way of life).

Before going further to present my thoughts on the ‘quacks’ claims, let us take a peek at the definition/ description of the condition based on the latest Diagnostic and Statistical Manual of Mental Disorders -5 (DSM-5).

It describes the condition as follows:  “Gender dysphoria refers to the distress that may accompany the incongruence between one’s experienced or expressed gender and one’s assigned gender.

“Although not all individuals will experience distress as a result of such incongruence, many are distressed if the desired physical interventions by means of hormones and/ or surgery are not available.” 

Claims of cure misleading

It also noted that the previous term (GID) focused on the dysphoria as a clinical problem rather than the identity per se.

The risk factors associated with this condition are genetic, physiological , temperamental and environmental (with the last two being less common factors).

The claims of cure for the above condition as many would have heard or read recently, are incorrect and misleading.

Beyond that, it also borders blatant disregard to ethical and evidence-based treatment modality as stipulated or recommended by the world governing bodies.

The governing bodies include the World Health Organisation (WHO), American Psychiatric Association (APA) and American Psychological Association.

A review of 83 articles (published between 1960 and 2007) on the efficacy of sexual orientation/gender identity change efforts revealed that the long lasting change to an individual sexual orientation and gender identity were unlikely.

Such efforts usually results in exponential increase in depression, suicidality, anxiety and other forms of psychological distress (APA, 2009).

Appropriate evaluation vital for treatment

The best treatment approaches as suggested by these governing bodies includes gender identity affirmative therapeutic interventions, empirically supported treatment (EST) and evidence based approaches to psychotherapy (EBPP).

The APA also strongly recommends medical and surgical gender transition treatments for appropriately evaluated transgender and gender variant individuals.

Thus, the call for conversion therapy/change therapy by the religious authorities, some mental health professionals and in complete oddity an ear, nose and throat surgeon recently, is totally unethical and unacceptable.

It is high time for relevant local medical and mental health association such as the Malaysian Psychiatric Association and Malaysian Psychological Association (PSIMA) to play an active role in educating the public, policy makers, and healthcare and mental health service providers on the said issues, based on internationally accepted treatment modalities as listed above.

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VIGNESWARAN VEERAMUTHU, MEd Psych. is a psychologist and currently  completing his doctoral training.

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