Whose paradise? An intersectional perspective on mental health and gender/sexual diversity in Thailand.

Ojanen, Timo T.; Newman, Peter A.; Ratanashevorn, Rattanakorn; Wijngaarden, Jan Willem de Lind van; Tepjan, Suchon

doi:10.1037/0000159-010

Cited by 17 publications

(23 citation statements)

References 23 publications

(33 reference statements)

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“…Among the 76 peer-reviewed articles included, 37% (28) were quantitative studies [ 20 , 23 , 25 – 27 , 29 , 30 , 34 , 37 – 40 , 42 , 43 , 46 , 50 , 56 , 59 – 61 , 65 , 73 , 78 , 79 , 86 , 91 – 93 ], 36% (27) were qualitative studies [ 19 , 22 , 24 , 31 , 32 , 36 , 41 , 44 , 45 , 54 , 57 , 58 , 63 , 66 , 67 , 69 – 71 , 74 – 76 , 83 – 85 , 87 – 89 ], 22% (17) commentaries or descriptive analyses [ 16 , 21 , 28 , 35 , 47 – 49 , 51 – 53 , 62 , 68 , 72 , 77 , 80 , 81 , 90 ], and 5% (4) mixed methods studies [ 33 , 55 , 64 , 82 ].…”

Section: Resultsmentioning

confidence: 99%

LGBT+ inclusion and human rights in Thailand: a scoping review of the literature

Newman

Reid

Tepjan³

et al. 2021

BMC Public Health

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Background Globally, LGBT+ people continue to struggle to achieve full realization of their human rights. Amid reported health and mental health disparities, and economic insecurity, we conducted a scoping review to explore the breadth of the literature, map and summarize the evidence, and identify knowledge gaps on LGBT+ inclusion and human rights in Thailand. Methods We conducted a scoping review in accordance with the methodology developed by the Joanna Briggs Institute and PRISMA-ScR guidelines. We systematically searched 16 databases for peer-reviewed literature, and government and nongovernmental organization websites for grey literature, published in English or Thai from January 1, 2000–August 21, 2020. Two reviewers independently screened studies according to pre-set criteria. We abstracted and analyzed data on publication characteristics and focal populations, and synthesized findings in six domains of LGBT+ inclusion: political and civic participation, education, family, personal security and violence, economic well-being, and health. Results The review captured 3327 results in total, which was scoped to 76 peer-reviewed articles and 39 grey literature sources, the majority published after 2010. Gay men and transgender women were the primary focal populations in the peer-reviewed literature, LGBT+ people as a whole in the grey literature. Health was the predominant domain across publications. Key findings include the absence of generalized antidiscrimination legislation for LGBT+ individuals and lack of recourse for transgender individuals to change their legal gender; multifaceted stigma and discrimination in the educational system; social isolation and exclusion in families; disproportionate prevalence of sexual violence and reluctance to report to police; discrimination and marginalization in employment; and LGBT+ disparities in health and mental health. Conclusions Future research and programmatic initiatives on LGBT+ inclusion in Thailand should aim to address: 1) understudied populations—lesbian and bisexual women, transmasculine persons; 2) underrepresented topics, including constraints to LGBT+ advocacy; 3) strategic policy initiatives around anti-discrimination laws and legal recognition of same-sex marriage and families; and 4) the need for consistent collection of disaggregated data on LGBT+ persons in education, family, economic, personal security/violence, and health domains in order to assess indicators of inclusion and progress in advancing human rights for LGBT+ people in Thailand.

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Section: Resultsmentioning

confidence: 99%

LGBT+ inclusion and human rights in Thailand: a scoping review of the literature

Newman

Reid

Tepjan³

et al. 2021

BMC Public Health

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“…The importance that men place on retaining their ties with their family members was evident, which may be common to primarily collectivistic cultures (Srivastava and Singh 2015) in which exercising individual rights (e.g. to choose one’s sexual or life partner) may be seen as a luxury, if not selfishness (Ojanen et al 2018). Accordingly, some men may give priority to maintaining family harmony by choosing to not to disclose their sexuality or agreeing to family members’ requests that they not disclose their sexuality to others (Chakrapani and Dhall 2011).…”

Section: Discussionmentioning

confidence: 99%

Syndemics and HIV-related sexual risk among men who have sex with men in India: influences of stigma and resilience

Chakrapani

Kaur

Newman

et al. 2018

Culture, Health & Sexuality

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Using syndemics theory as a framework, we explored the experience of men who have sex with men in India in relation to four syndemic conditions (depression, alcohol use, internalised homonegativity and violence victimisation) and to understand their resilience resources. Five focus groups were conducted among a purposive sample of diverse men along with seven key informant interviews with HIV service providers. Participants' narratives suggested various pathways by which syndemic conditions interact with one another to sequentially or concurrently increase HIV risk. Experiences of discrimination and violence from a range of perpetrators (family, ruffians and police) contributed to internalised homonegativity and/or depression, which in turn led some men to use alcohol as a coping strategy. Stigma related to same-sex sexuality, gender non-conformity and sex work contributed to the production of one or more syndemic conditions. While rejection by family and male regular partners contributed to depression/alcohol use, support from family, regular partners and peers served as resources of resilience. In India, HIV prevention and health promotion efforts among men who have sex with men could be strengthened by multi-level multi-component interventions to reduce intersectional/intersecting stigma, address syndemic conditions and foster resilience - especially by promoting family acceptance and peer support.

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“…Volunteers and general practitioners add entry points to services but may have limited mental health competence (Lotrakul & Saipanish, 2006). Specialists in state hospitals, especially psychiatrists, usually have heavy client loads and little time for discussion; private-sector services are less crowded but often prohibitively expensive (Ojanen et al, 2020). Counseling is also available at universities, addiction services, mental health hotlines, and nongovernmental organizations (Tuicompee et al, 2012).…”

Section: Mental Health Services In Thailandmentioning

confidence: 99%

“…Cultural beliefs related to mental health in Thailand include Buddhist explanations about karma and merit, animist notions (e.g., loss of khwan [life spirit]), and possession by ghosts or spirits (Burnard et al, 2006). These cultural beliefs need attention in mental health services in general and sometimes play a role in how LGBTIQ issues are explained and treated by clients and their families (Ojanen et al, 2020).…”

Section: Mental Health Services In Thailandmentioning

confidence: 99%

“…In a national study, over 50% of LGBT secondary students reported having been bullied for being LGBT over the past month (Mahidol University et al, 2014). Owing to experiences of stigma, discrimination, and violence, LGBTIQ individuals in Thailand suffer from additional mental health problems, as predicted by Meyer's (2003) minority stress model (Ojanen et al, 2020). Kittiteerasack et al (2020) demonstrated that selected key elements of the minority stress model (general stressors, victimization, discrimination, identity concealment, & coping style) correlated with depression scores among 411 Thai LGBT adults.…”

Section: Thai Lgbtiq Groups and Their Mental Healthmentioning

confidence: 99%

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Defining Mental Health Practitioners’ LGBTIQ Cultural Competence in Thailand

Ojanen

Phukao

Boonmongkon

et al. 2020

JPSS

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This study investigated what competencies are crucial for mental health practitioners’ culturally competent practice with LGBTIQ clients in Thailand. The study used two-round Delphi methodology to aggregate views of mental health practitioners with expertise on LGBTIQ issues (n = 14), and of LGBTIQ individuals who had used mental health services (n = 13). Participants proposed competencies in Round 1 through interviews or an online questionnaire, and rated these competencies’ importance in another online questionnaire in Round 2. Forty-one knowledge competencies, 35 awareness/attitude/belief competencies, 14 skill competencies and 35 action competencies were rated. Among key themes were understanding gender/sexual diversity as well as issues affecting LGBTIQ people and their families, and being able to assist on these issues; accepting gender/sexual diversity, respecting clients’ self-determination, and communicating this to clients; being aware of the impact of one’s beliefs, attitudes, identities and values; recognizing and rejecting stereotypes; being open, humble, and willing to learn more; knowing how to use feminist counseling techniques and other specific techniques; refraining from offending actions; social justice action; and obtaining information sensitively. Developing these competencies is likely to improve mental health services’ appropriateness for LGBTIQ clients and should be included in mental health practitioners’ training in Thailand.

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Whose paradise? An intersectional perspective on mental health and gender/sexual diversity in Thailand.

Cited by 17 publications

References 23 publications

LGBT+ inclusion and human rights in Thailand: a scoping review of the literature

LGBT+ inclusion and human rights in Thailand: a scoping review of the literature

Syndemics and HIV-related sexual risk among men who have sex with men in India: influences of stigma and resilience

Defining Mental Health Practitioners’ LGBTIQ Cultural Competence in Thailand

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