One of the key problems faced by the LGBTQ+ community in Iran is the lack of equal access to medical services, medical resources, and well-placed psychologists and psychiatrists.
Not being able to see a well-trained and knowledgeable specialist makes it harder for Iranians with different sexual orientations and gender identities to cope with external pressures, such as social, personal and legal barriers.
In many cases, they are referred to physicians without an adequate understanding of LGBTQ+ issues, who will nonetheless attempt to counsel them. This can lead to patients receiving poor or inappropriate advice, or even being on the receiving end of unprofessional behaviour and prejudice in what ought to be the safest of spaces: the doctor’s room.
Trans Iranians, in particular, often have to argue their case to an astonishing degree in the face of state-designated psychologists who do not fully understand their position. One such person is Arad, a trans man who recalls attending counselling sessions with a well-known psychologist, along with his partner.
“Aside from the fact that we had to pay astronomical amounts of money for each hour of counselling,” he says, “we encountered transphobic behavior that was frankly unbelievable to us. When the psychologist found out I was trans, he blamed me for all my partner's problems.
“Because I am a trans man, he said he did not consider our sexual relationship a ‘successful’ one. He accused my partner of lacking self-confidence, just because he had chosen a trans man as his emotional and sexual partner instead of a biological male.
“Unbelievably, he used the insulting word ‘homo’ to describe my partner's sexual orientation. We really did not expect to hear such a word from someone who describes himself as a psychologist. It was such a bad experience for us that we no longer trust any psychologists in Iran, because we assume they won’t do their jobs properly, without prejudice or personal considerations."
Arad's experience is similar to that of hundreds of other trans and LGBTQ+ people in Iran. In recent years, with the flourishing of social media and better information-sharing on issues of sex and gender, many more stories about prejudiced medical practitioners have unfortunately come to light.
Some of these clinicians take a dim view of the LGBTQ+ community in general and will actively attempt to “treat” their patients by “changing” their sexual orientation. At the same time, the very high costs many of them charge make it practically impossible for most would-be patients to seek out appropriate care, as many LGBTQ+ Iranians are cut off – both emotionally and financially – a from their families and struggle to find work.
Counsellor: My Colleagues Have Misunderstood Their Role
Faraz, a psychologist and sexual health consultant, has been providing counselling to LGBTQ+ Iranians for about five years now. He told IranWire that pervasive ignorance in the medical community at large is a consequence of the nature of education in Iran.
“Among the root causes,” he says, “is the dominant culture and the non-scientific standpoint of most people in Iranian society. Even experts show resistance to concepts they have not been trained for, and practice according to personal tastes that are nowhere defined in the ethical and scientific principles of psychology."
The first principle of counselling, he says, is the provision of unconditional service, regardless of gender, sex, sexual orientation, religion and the client's personal tastes. In addition, all of the psychologist's own ideas, tastes, and lifestyle choices should be left at the door.
The practitioner’s only role is to provide the services needed to support the patient’s mental health, from a completely unbiased viewpoint, focusing on the client's needs and without any judgment. "Psychology today is multifaceted,” he adds, “and there is no preset definition. Each person will have specific needs.”
In turn, he says, people in the LGBTQ+ community must be made aware of their rights before stepping into the consulting room. “No-one, anywhere,” he says, “is allowed to insult, humiliate or abuse them. They must be vigilant and, if it happens, make a complaint, and if possible try to seek help from experienced lawyers.
“Secondly, the psychologist is not allowed to reveal the client's confidential information to anyone elsem under any circumstances. Furthermore, no health professional is allowed to ‘treat’ a person’s sexual orientation or gender identity, because these are no longer considered diseases or disorders.
"I suggest that our LGBTQ+ friends do their research thoroughly before going to see a psychologist. If possible, seek out the experiences of other friends before being referred to a doctor, and refrain from seeing those psychologists who suffer from homophobia, transphobia, or fear of the LGBTQ+ community."