What is Sexual Orientation?

Sexual orientation is a term used to refer to an individual’s primary physical, emotional, romantic and sexual attraction to individuals of a specific gender (male or female). The most commonly recognized sexual orientations are heterosexuality, homosexuality and bisexuality.

According to the American Psychological Association (APA) “it also refers to an individual’s sense of personal and social identity based on those attractions, behaviors expressing them, and membership in a community of others who share them”. 

What is Homosexuality?

A sexual attraction to (or sexual relations with) persons of the same sex is known as homosexuality. While homosexuality would technically cover same-sex preferences among both males and females, lesbianism is a term which specially implies female-female preference. Studies in the West have shown that about 4% of men and 2-3% of women are exclusively homosexuals and 10% are bisexuals as they enjoy sex with both the genders.

So far there has been no conclusive scientific evidence to believe that a person is born with a particular sexual orientation. The American Psychiatric Association has stated that, "to date there are no replicated scientific studies supporting any specific biological etiology for homosexuality”. There is no consensus among scientists about the exact reasons that an individual develops a heterosexual, homosexual or bisexual orientation. Although much research has examined the possible genetic, hormonal, anatomical, developmental, cultural and social influences on sexual orientation, no findings have convincingly emerged, that permit scientists to conclude that sexual orientation is determined by any particular factor. The American Psychological Association has stated that "there are probably many reasons for a person's sexual orientation and the reasons may be different for different people". However, the largest group of researchers believe that sexual orientation (Homosexuality, Heterosexuality or Bisexuality) is a result of an ‘unconscious’ choice that a person makes during his growing years, due to various known and unknown factors, often beyond the conscious control of the person.

It is a ‘result’ of various factors such as the basic personality ‘type’, uncensored exposure to sex, parental influence, lack of correct and value-based sex education, experience of direct or indirect child abuse etc. However, if a person ‘truly’ wishes to modify his/her sexual orientation at any age ‘willingly’, it is possible to help such a person. Such modification of course, cannot be imposed on him/her. If imposed, nothing will help! His/her “self-motivation” plays a MAJOR role in therapy.

Irrespective of a person’s homosexual or lesbian orientation, the homosexual or lesbian could very well be mentally sound, emotionally stable, intelligent, sharp, talented, efficient, hard working, faithful, trustworthy and socially well-adjusted like the rest of the (non-homosexual) population.

Is being Transsexual the same as being a Homosexual or a Transvestite?

Not at all! Transsexualism is a condition in which there is a strong and persistent cross-gender identification, i.e. a desire to live and be accepted as a member of the opposite sex.

Homosexuals are sexually attracted to members of their own sex but are contented with their bodies and have no desire to change their body.

Transvestites are men who are preoccupied with cross dressing in women's clothing largely for the purpose of sexual satisfaction. They are generally happy with themselves as men.

What is homophobia?

Homophobia precisely means an ‘irrational’ fear or aversion towards ‘Homosexuality’, but the common usage of this term includes much more than plain simple fear. It is also an attitude of hatred, repulsion, disgust or rejection towards Homosexuals based upon the belief that homosexuality is morally wrong, disgraceful, disgusting and shameful. Homophobia also includes a fear of intimate relationships with the same sex. Unfortunately this term is either loosely used by some ill-informed people (that includes even some gay activists) or then not understood properly out of sheer ignorance.

Equal Human Rights

All human beings have equal worth and therefore straight or homosexual, everyone has the right to live with human dignity. I am all for ‘equal human rights’ for homosexuals, and to not treat them like some inferior species or second-class citizens. They are as much human as anyone and thus deserve to be treated humanely.

Having said that, being a medical practitioner in the field of sexual medicine for over two decades, I have seen severe medical complications arising out of ‘consensual sodomy’ or ‘anal sex’, whether between two homosexuals, or even when it has been compelled on a woman by a man. The physical and emotional trauma of these victims stirs my heart and cannot go unmentioned in the midst of all this debate of ‘de-criminalizing consensual sexual behavior in privacy between two same-sex individuals’.

I fully agree with every scripture that separates the person from the action. Therefore, I reiterate that while all human beings should be viewed and treated ‘equally’ with the same human dignity by law and society, all sexual acts done by anyone homosexual or straight, if causing physical or emotional trauma to another, (whether minor or major), should also be ‘equally’ punished by the law of the land.

Cases

Jagan a 19-year-old illiterate boy from a very poor family from rural India got a job in Mumbai as a domestic servant. His distant relative, a 37-year-old man Prakash who was working as a cook in a rich family, got him this much needed opening. The rich owners of the house would leave the house everyday in the morning and would return at 8 in the night. In their absence Prakash would use cooking oil as a medium and force anal sex on Jagan. Jagan was helplessly dependant on Prakash could never gather courage to resist him and started consenting to the exploitation, till one day he developed a rectal prolapse, bled profusely, and had to be taken to the hospital.

Vinod and Swapnil, two 18-year-old boys were working as office boys in a private office. They would surf the net in the absence of senior employees and watch porn. One day they consensually attempted anal sex with each other and invited a double trouble. While Vinod developed a bad tear in his rectum, Swapnil developed Paraphimosis - a painful surgical condition of the penile foreskin that needs an emergency circumcision surgery without which the penis could be permanently damaged.

Amit was a 20-year-old frail boy from a poor family. His father was dead and his mother was old & ill with two younger sisters at home to support. He got a job of a peon in a private office after a lot of struggle and a long wait. His boss, a 46-year-old rich married man fancied anal sex. He pressurized Amit to have anal sex with him after office hours in the privacy of his cabin. Amit felt helpless as this job was vital for him. He consented to the demands of his boss. A few months later, when he approached a doctor, he had developed infected painful fissures at his anus, and had partially lost control on the sphincter mechanism of the anal opening which was not functioning due to the injuries during anal sex. He had lost his job and had no courage to approach the police as he felt he had neither the moral right nor the legal standing as he was ‘major’ and had ‘consented’ to this act in ‘privacy’.

Amol, a 32-year-old married government employee was a bisexual. He would indulge in anal sex with some of his male office colleagues ‘consensually’ for mutual pleasure. His wife was completely oblivious to this side of her husband. Amol also never felt that his secret parallel life would ever affect his marriage. During the second pregnancy of his wife, the obstetrician detected that she was not only HIV positive, but her tests for Syphilis, Hepatitis-B and Genital Herpes were also found positive. Amol too was tested positive for these four STDs. It was obvious that Amol had contracted all these STDs from his multiple homosexual contacts and now his wife and unborn child were also victims of these life threatening infections.

In all the four cases above, the involved individuals were ‘adults’ and were engaging into anal sex with ‘mutual consent’ in ‘privacy’. These are just a few classical examples. Incidents such as these are rampant. Doctors get to see several such cases in their private practice as well as in general hospitals. I wish all those who are critical of section 377 of the Indian Penal Code (1860) need to give serious consideration to their demands. The legal experts, social activists, gay organizations and the media cannot afford to be ignorant about possibilities such as these.

It also needs to be noted that as per Section 377 of the Indian Penal Code, ‘anal sex’ is a punishable offence, even when it is happening between husband and wife with mutual consent.

Medical Facts related to Anal Sex

Anal sex is commonly practiced by homosexual partners, probably as a substitute for the vagina. Some heterosexual partners also practice it, with or without mutual consent. Any sexual activity is strictly a matter of personal choice, but should be with genuine mutual consent (which has not been extracted under any kind of pressure). It is strictly your personal choice to indulge in any act you enjoy as long as you are not causing any physical or psychological harm to each other.

As a medical expert, I would like to enlighten the readers about some medical facts related to anal sex. Medical science regards anal sex as “high-risk behavior”. Physiologically, the anus is not designed for penetration by any hard object. The anal sphincter tightens ordinarily if stimulated, as a protective reflex action, and any attempt at penile insertion may be distressing, even if done slowly and gradually. If the penis is forced into the anus, injury is possible. The lining (mucus membrane) of the rectum is very thin, tears easily, does not heal fast and therefore is vulnerable to infections. Also, the tears can enlarge to a fissure or a crack leading to the outside of your body. These are painful and slow to heal. There is also a possibility that a fistula could open up, allowing faeces to re-route into the abdominal cavity or into the vagina. This can cause serious surgical complications. One may loose the control over the anal sphincter causing continuous involuntary leakage of faecal matter. There is also the increased risk of hemorrhoids, which are quite uncomfortable. Rectal prolapse - wherein the walls of the rectum protrude through the anus and hence become visible outside the body - is another surgical emergency that is seen resulting out of anal intercourse.

Some of the micro-organisms that are normally present in the anus of even a healthy individual, are known for causing severe urinary infection if they enter the urethra and urinary tract. During anal sex the urethra actually enters the rectum, inviting infective bacteria into the urethra and thus the urinary tract. Repeated urinary infection can cause serious problems such as renal damage and even kidney failure.

Masters & Johnson in their book on ‘Sex and Human Loving’ warn, that because bacteria are naturally present in the anus, anything that has been inserted into the anus if subsequently put into the vagina, can cause severe vaginal infections. Therefore moving from anal intercourse to vaginal intercourse is extremely hazardous.

The rate of transmission of HIV (and other STDs) through anal sex is much higher compared to other penetrative sexual acts. It will be enlightening to know that the condom, which is thought to be a means of ‘so-called safe sex’, is not designed for anal sex by the manufacturers. Anal sex involves a totally different kind of pressure dynamics, and the latex or polyurethane condoms are not manufactured keeping these pressure dynamics in mind. The condom is far more likely to get torn during anal sex (thus paving the way for the transmission of HIV/AIDS and other STDs). Therefore I reiterate that anal sex even with the use of a condom is definitely a ‘high risk behavior’.

Finally, I would like to conclude by saying that as a society we need to learn to accept all ‘persons’ with equal human rights irrespective of their choices, but we do reserve the right to reject certain ‘behaviors’ that are injurious to the health of those persons or others connected to them. Those choosing to be in loving same-sex relationships are no less human, and do not deserve any less respect, than anyone else. In fact, the homosexuals I have known are very warm, loving, talented, creative, and extremely intelligent persons. Talking in condescending terms to them or of them, or mollifying/placating them, both, re-inforce a discriminatory attitude towards them. Therefore, an equal human approach must be adopted by the moral keepers of our society and by the law of our land in this regard.

Dr. Rajan Bhonsle, M.D. is a senior Sex Therapist and Counsellor from Mumbai. He is an Hon. Professor and Head of the Department of Sexual Medicine at Seth G. S. Medical College and K.E.M.Hospital, Mumbai.