Bangkok has an image of a gay-friendly city, but LGBTI still face discrimination.
At the forum, "Hearts Matter", held recently at Samyan Co-Op, Samyan Mitrtown, which was organised by Save the Children (Thailand) Foundation and the Department of Mental Health, two young representatives -- Pornthip Rungrueng and Sukit Sooksumpan -- spoke about their difficulties being LGBTI. Pornthip is an ethnic Shan person while Sukit is hearing-impaired. Because they both are LGBTI and members of minority groups, their problems are more complicated.
"I am a Shan migrant without Thai citizenship. Before I came to this forum, I had to submit a request to a state agency for permission to leave the Shan community. Also, people in the Shan community have their own culture and have certain stereotypes about men and women. My parents told me that a woman should marry a rich man who can support her. My family also tried to change my LGBTI identity. There are many limitations as a Shan and LGBTI," said Pornthip.
Sukit said hearing-impaired communities lack knowledge and understanding of LGBTI.
"Nobody educated us about LGBTI in schools. We lack learning resources. We cannot read like other people because our method of communication is different. Thus, we cannot catch up and understand new words and concepts that are created almost every day. When we have to communicate with people in other places like hospitals, there is no sign language interpreter for us. Many hearing-impaired people feel frustrated at work and some commit suicide. I hope other people will help us communicate with the outside world," said Sukit.
The forum also presented the research paper, Mental Health And Well-Being Of Children And Youth With Diverse SOGIESC In Thailand, conducted this year by Save the Children (Thailand) Foundation, Thammasat University and Srinakharinwirot University. (SOGIESC is an acronym for Sexual Orientation, Gender Identity and Expression, and Sex Characteristics). Participants in the research were 15 to 24 years old and LGBTI. Some 3,094 participants filled in the online survey and 38 participants were interviewed.
The result of the research revealed that most young LGBTI experience mental health issues. According to the research, 42.4% of respondents were pressured to change their gender identity to conform to the norm. This included being pressured to marry, dress and style their hair as appropriate to their sex at birth, play sports, and join the military. Mostly, the pressure came from their own family. In terms of violence, 31.4% faced physical abuse, 53.4% were sexually harassed online, 57.9% were sexually harassed offline, and 75.8% were ridiculed.
Some 58.2% of the respondents considered suicide, while 15.6% actually attempted to kill themselves and 25% reported inflicting self-harm. The population groups with the highest level of suicidal thoughts are young transgender men and transmasculine people.
Since many young LGBTI experience violence and discrimination, they seek help from mental health experts. According to the research, 57.3% felt that they required mental health services, but only 21.4% actually received such services. Fortunately, 68.4% of those who received the service reported they felt better, with attributing factors being care providers treating them with respect and understanding of their struggles with gender identity.
During the forum, Dr Jiraporn Arunakul, adolescent medicine specialist at Ramathibodi Hospital, Sakol Sopitarchasak, lecturer at Thammasat University and member of the research team, and Pornthip Rungrueng, vice-president of the Ethnic Youth Development Network (EYDN) -- spoke about obstacles that LGBTI people encounter. Sakol said people should normalise the LGBTI community.
"One research interviewed parents of LGBTI. When parents know their child is LGBTI, they worried their child would face discrimination. They believed that LGBTI couples would not have long-term relationships. They were afraid that their child would end up alone. If LGBTI can marry legally, we will see more LGBTI couples. Society should reduce bias towards LGBTI people and treat them the same way that we would treat anyone else," said Sakol.
Dr Jiraporn -- a founder of Gen-V Clinic, or the Gender Variation Clinic at Ramathibodi Hospital -- said before the clinic opened in 2014, she had to fight the conservative attitude of older generations who have power in the hospital.
"A psychiatrist questioned where LGBTI people should sit in the clinic. That psychiatrist was worried that LGBTI people would be a bad example for other young patients in the hospital. I told the psychiatrist that I wanted LGBTI people to be an example. Other young people would learn that if they were LGBTI, they could be themselves and come to Gen-V Clinic for health services, so LGBTI people can sit in the same area as others," said Dr Jiraporn.
Currently, the Gen-V Clinic is available in major cities such as Bangkok, Chiang Mai, Khon Kaen and Songkhla. Dr Jiraporn said there is no Gen-V Clinic in the East because executive hospitals do not approve of it. Other problems with healthcare services for LGBTI groups are a shortage of physicians and a lack of social health insurance coverage for gender-affirming hormones.
"In Thailand, there are no specialised physicians in LGBTI. Hence, physicians from other fields come to work at Gen-V Clinic after their regular work hours. Since social security health insurance does not cover gender-affirming hormone therapy, it is difficult for many LGBTI people to receive this kind of treatment. Also, adolescents still need parental permission for undergoing hormone therapy. If health-related government officials think gender-affirming hormone therapy is in the best interest of underage people and try to push a law that will allow young people to receive hormone therapy without parental approval, this will help many young LGBTI. Before undergoing hormone therapy, all young patients must be evaluated by physicians that they are mature enough to make their own decisions," said Dr Jiraporn.
Dr Jiraporn explained that not all gender-diverse people need hormone therapy. Only people who are uncomfortable with their physical appearance want to undergo hormone therapy. Moreover, transgenders want gender reassignment surgery more than homosexuals. Although many homosexuals do not want treatment related to a sex change, they experience mental health issues and want mental health services," said Dr Jiraporn.
During the research, Sakol discovered that some LGBTI successfully overcame their difficulties because of their self-reasoning skills and were able to adjust their mental state to accept their reality.
"There is no lesson about positive mental health literacy in schools. Positive mental health literacy are skills that help people have good mental health. Moreover, some schools won't allow LGBTI students to run for student council president or even apply for a scholarship. Schools should be a gender-neutral place, so that there are no gender stereotypes in schools. This may help to reduce discrimination against LGBTI students," said Sakol.
Dr Jiraporn ended the talk forum by saying that parents should be a safe space for their children.
"Many research states that the most important factor that helps LGBTI people live happily and successfully is their safe space that can strengthen their confidence and self-esteem. Being the first person who accepts LGBTI children is the best gift that parents can give to their children. Also, I would like to ask people in society to be kind to LGBTI people and treat them like others. This will help their families feel comfortable to have their LGBTI children in society," said Dr Jiraporn.
