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Conversion Practices in Malaysia: Frequently Asked Questions (FAQ)
CONVERSION THERAPY or conversion practices are a collection of harmful practices that aim to change a person’s sexual orientation, gender identity, or gender expression from gay to straight or trans to cisgender. Conversion practices are referred to, for example in Malaysia, as rehabilitation, prevention, or treatment programmes to “cure” and “help” LGBTQ persons “return to the right path”.
This FAQ covers what conversion therapy practices looks like in Malaysia, who runs these practices, how survivors and victims of conversion practices are affected, and what can be done to end conversion practices.
“Conversion therapy” is used as an umbrella term to describe a range of treatments, practices, or sustained efforts that aims to change, repress, or eliminate a person’s sexual orientation, gender identity, or gender expression (SOGIE). These practices target LGBTQ people to change them from gay, lesbian or bisexual to heterosexual and from trans or gender diverse to cisgender.
It is misleading to use the term “conversion therapy” because these practices are not a form of therapy. These harmful practices rely on medically false ideas that LGBTQ persons are sick and need to be cured. The more accurate terms used in advocacy are “conversion practices” or “sexual orientation, gender identity or gender expression change efforts” (SOGIECE).
In Malaysia, conversion practices are disguised as and referred to as
Conversion practices rely on the pathologisation of sexual orientation, gender identity and gender expression (SOGIE). This means classifiying LGBTQ persons’ SOGIE, as a form of mental illnesses in national and international handbooks used by healthcare professionals to diagnose mental disorders.
- “Homosexuality” was classified as a mental illness in the first edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) in 1952.
- Gender identity was not pathologized in the first two editions of the DSM but the DSM-III later included “transexualism” as a diagnosis in 1980. The World Health Organisation followed suit by including it as a diagnosis in the International Classification of Diseases (ICD).
- The latest DSM-5, published in 2013, has removed any diagnostic category related to people’s sexual orientation and eliminated “gender identity disorder” and replaced it with “gender dysphoria”. This change helps facilitate access to healthcare (psychiatric, medical, and surgical treatments) for trans and gender diverse people.
The process of depathologisation of gender and sexual diversity has grown with the DSM and ICD removing diagnosis that pathologises sexual orientation or gender identity. The World Psychiatric Association noted in 2016 that “there is no sound scientific evidence that innate sexual orientation can be changed”, as supported by the growing consensus of health associations globally rejecting the use of conversion practices.
- Medical approaches are based on the belief that sexual or gender diversity is because of an inherent biological dysfunction. In the past, lobotomies or castrations were used but now hormone or steroid treatments are much more widely used. Traditional healers (e.g. ayurvedic, homoeopathic, and other traditional medicine) use “miracle cures” such as pouring oil into vaginas or usage of physical punishment.
- Psychotherapy approaches are based on the belief that sexual or gender diversity is a product of an abnormal upbringing or experiences, emphasizing on past experiences as a child and the role their parental figures played. Common methods include -
- Aversion therapy has become very common - a person is subjected to a painful, negative, or distressing sensation (e.g. electric shocks, nausea-inducing or paralysis inducing drugs) while being exposed to a certain stimulus, to make them associate the stimulus with a negative aversion.
- Encouraging masturbation while fantasising of a different gender, hypnosis, techniques to change a person’s behaviour to be more stereotypically feminine or masculine, and practices to prevent trans young people from transitioning.
- Faith-based approaches are based on the premise that there is something inherently evil in diverse sexual orientations and gender identities. This includes religious counselling, prayer therapy. Other approaches includes treating a person’s sexual orientation and gender identity as an addiction that can be overcome with a spiritual advisor or a 12 step programme. Sometimes, these interventions involve exorcism or rituals to drive the “evil” out, or use celibacy as a way to keep people from engaging in same-sex sexual activities.
In Malaysia, conversion practices are provided for by state and non-state actors, who use a combination of medical-based, faith-based and psychotherapy methods.
The government run programmes can be seen at the Federal and state level. At the Federal level, the government efforts can be seen through 1) Ministry of Religious Affairs, Department for Islamic Development (JAKIM), and the state Islamic Departments, as well as 2) by other ministries.
a) Implementation of support and guidance programmes: This includes the Mukhayyam programmes by JAKIM in collaboration with state Islamic departments and councils, and the Ministry of Health. The programme, listed in the National Strategic Plan to End AIDS 2016-2030, aims to guide and provide spiritual awareness to LGBT persons through religious knowledge, as well as increasing knowledge and awareness on HIV. Through these programmes, the state claims that they have reached 1,769 people since its introduction in 2011. Justice for Sisters research and documentation identifies the following techniques used in the Mukhayyam programme:
- Tactics to induce self-guilt: There are testimonies about practices in the Mukhayyam programme reportedly used to induce fear and self-guilt, as well as reinforce notions about sin, essentialism and gender binary.
- Reinforcement of binary gender ideology: These camps also forced participants to participate in strenuous physical activity, aimed towards primarily transgender women in order to make them more “masculine.” For example, one of the camps subjected the participants to cross-country trekking, climbing, crossing a lake, and running through mud—all on the first day, which surprised many of the participants, who were unsuitably dressed, and resulted in minor injuries for some.
- Deception and violation of privacy: Melati, a trans woman, shared her experience in a Mukhayyam camp in Kuantan jointly held by JAKIM and the Selangor Islamic Religious Council (MAIS) in March 2014, where she found out that the camp had strayed even further from its original objective as an outreach programme. The camp had rebranded itself to a ‘islah mukhayyam’, which roughly translates to “reform camp,” which went beyond her initial expectations.
Besides Mukhayyam, follow up and support programmes are run by JAKIM or the ex-LGBT NGOs such as usrah or monthly religious and spiritual programmes, Quran recitation classes, and start up support for businesses. For example, 525 people who have participated in the Mukhayyam programme received financial aid through JAKIM’s Covid-19 relief Musa’adah fund.
b) Establishment of task force and action plan to address LGBT issues: A task force on addressing LGBT issues was established to support the implementation of Pelan Tindakan Sosial Islam, Jabatan Kemajuan Islam Malaysia (PTSI JAKIM) 2019-2025 (JAKIM’s Islamic Social Action Plan (PTSI JAKIM) 2019—2025), with the aim to address social ills among Muslim persons in Malaysia, including LGBT persons. A five-year action plan, Pelan Tindakan Menangani Gejala Sosial Perlakuan LGBT 2017—2021 (Action Plan to Address Social Ills of LGBT Behaviour 2017—2021), was created to proactively and effectively curb “LGBT behaviour.
c) Establishment of support services: JAKIM’s Family, Social and Community Service centre, or KSKCareCenter at Tuanku Mizan Zainal Abidin Mosque in Putrajaya offers Syarie counselling, Islamic psychospiritual therapy and Illaj Syarie for free.
d) Development of resources: JAKIM consistently produces resources aimed at suppression of SOGIESC and that promotes its goals of rehabilitating LGBTQ persons
- Menelurusi Fitrah Insani (2021), Chapter 5 of the book focuses on factors and implication of LGBT behaviour, features theories and factors that contribute to a person being LGBT, adverse harms of being LGBT to self and society and treatment for LGBT persons.
- Manual Komuniti Hijrah Lesbian dan Gay (manual for ex-lesbian and gay persons). (2022) The manual features understanding your own fitrah as a human being, Islamic perspective on lesbian and gay, how to reach lesbian and gay persons, Islamic psycho therapy, including prayer and zikir therapy to help Muslim lesbian and gay person to lead a better life aligned with Islamic principles.
At the state level, for example, in Selangor, the Selangor Islamic Religious Council (MAIS) runs LGBT related activities under its Al-Riqab Rehabilitation Division, established in 2012. MAIS defines Al-Rihab as “a person who is shackled under a power or situation that is an obstacle to him/her to live a better life. Shackled with perverted lifestyles such as prostitutes, lesbians, homosexuals, trans women or transsexuals, bisexuals, pengkid, tomboys, gigolos and Muslim persons cohabiting with non-Muslims”.
The Division runs three rehabilitation and treatment shelters for LGBT persons who are disowned, have no shelter or income or in need of care for HIV. The shelter provides weekly religious guidance classes and rehabilitation programmes. LGBT persons under these programmes are given financial support to relocate, medical support, or start-up funds for business. According to MAIS, as of 2019, 497 LGBT people have returned to the right path through the support of the funds.
Efforts by other ministries:
- The Ministry of Health’s (MOH) “Guidelines on Dealing with Gender Health Problems in Public Clinics” pathologises and medicalizes LGBTQ person and their identities as occurring due to conflicts with their families, having been sexually abused, or exhibiting aggressive behaviour. The guideline recommends teens with ‘gender issues’ be subjected to physical examinations including a genital examination and recording of sexual history, and medical tests to observe the condition of the pituitary gland.
- Various state funded seminars and programs have been conducted targeting students, school counsellors, parents, volunteers, health staff and representatives of Muslim NGOs, that encourage people to avoid committing ‘LGBT acts’, and encourage others to identify and curb ‘LGBT behaviours’ within their families, social circles, and workplace.
Conversion practices offered by non-state actors take multiple forms. The non-state conversion practices are legitimised by the state’s position on conversion practices, which can be categorised into following categories:
- Healthcare providers. A SUHAKAM research found that 18% of trans and intersex respondents reported that whilst accessing healthcare services, healthcare professionals have suggested religion or other forms of therapy to “cure” their gender identity. The same research also found that 15% of respondents were forcibly sent to see mental health professionals for their SOGIE and 9% were forced to consult religious authorities. Anecdotal evidence and the Galen Centre report, further shows that many LGBTQ persons have been referred to or subjected to mental health practitioners who provide conversion practices. However, these cases are underreported.
- Faith based practices: APTN’s research found that 31% of the 14 trans respondents mentioned they had been subjected to conversion practices either by religious authorities or a religious institution. SUHAKAM’s research found that 18% of trans and intersex respondents voluntary sought help from religious authorities to share their personal issues, inquire regarding their gender identity, study religion and seek advice from religious persons. Islamic medical centres, part of a growing body of Islamic spiritual healing practices, offer treatments to “heal” LGBT persons. For example, the Manarah Islamic Medical Centre published details of his 5 stages of treatment, involving counselling to reframe the subject’s mind to think their romantic partner is the devil or enemy, performing prayers to repent, Islamic reflexology to beat the devil out of the subject’s buttocks among others, which can amount to degrading, humiliating treatment and other forms of abuse.
- Ex-gay ministry or ex-LGBT groups among Christians or komuniti hijrah: Groups set up by people who identify as former LGBTQ persons to help LGBTQ people to overcome SOGIE related discrimination, by practicing celibacy from all sexual activities, and encouraged to date and marry a person of the opposite gender. An ex-LGBT pastor from the Real Love Ministry, an ex-LGBTQ ministry, describes sexual orientation as a sexual “lifestyle” that is changeable and modifiable and how “consuming Christ Jesus” is a cure.
- Academics: There are also academics and groups that advocate for conversion practices as a remedy and right. Academics who lack relevant credentials and expertise publish papers advocating for the use of counselling or religious therapy to cure LGBTQ persons. This includes conservative human rights coalitions in Malaysia.
Research and studies have identified the following factors as significant contributors to increased vulnerability to conversion practices among LGBTQ persons
- Immense societal pressure to change or ‘return to the right path’ by family members, colleagues, intimate partners, employers, friends, and strangers. This pressure manifests in the form of unsolicited advice or disapproval which causes discomfort, stress, and annoyance. For example, being asked when they will change, they are causing pain to their parents by being who they are. The pressure to change ranges from microaggressions to violence, as explained in Question 5. One of the most common phrases that trans women share about how normal it is to be consistently asked questions like “Why are you like this?” and “How long will you be like this?” Parents or family members occupy a unique position as both victims and perpetrators. APTN’s research found that 62% of trans persons reported a parent or parental figure had tried to change their sexual orientation or gender identity. Pressures affect family members who are also shamed, stigmatised, or isolated by people within their circle as being bad parents for encouraging them to become LGBT or not guiding them to return to the right path.
- Internalisation of shame, guilt, blame and violence, resulting in internalised transphobia, homophobia, biphobia. Justice for Sister’s research found that trans women believe that the mistreatment and discrimination they faced is deserved, that they end up taking measures to suppress or change their SOGIE to reduce or avoid conflict amongst family members.
- Protect themselves from experiencing further discrimination or violence such as getting arrested or charged by religious authorities. Sonia, a trans woman shared that at one point of her life, she ‘changed’ her gender expression to avoid further arrest and advised other trans women to change their identity to avoid arrest, “I am not forcing you to change because the heart cannot be coerced. But, change, don’t be a woman. Otherwise, they will catch you and put you in prison”. Some persons who are already in economically precarious positions, may choose to eliminate, suppress or change their SOGIE to ensure job security as a means of survival in an intolerant and discriminatory environment. Research shows experiences of trans women being reprimanded by employers because of their gender identity and expression, forcing them to quit their jobs or change their gender expression.
LGBTQ children and young persons are more vulnerable and disproportionately impacted by conversion practices. Children and young people are vulnerable to conversion practices at home and by various actors in school. Research have found that exposure to conversion practices as children has severe health and long-term psychological impacts including suicide attempts, loss of self-esteem, increase in depressive tendencies, school dropout, and adoption of high-risk behaviours and substance abuse.
LGBTQ persons living with HIV; sex workers; LGBT persons living in poverty; elderly persons; students and children; and prisoners, are especially more vulnerable to state funded conversion programmes.
Some may seek or may be perceived as “voluntarily” seeking conversion practices. However, we have to problematise the “voluntary” nature of these conversion programmes by examining the circumstances of why a person may choose to voluntarily participate in conversion practices. As discussed in Question 6, the widespread societal pressures to change their SOGIE forces them to fit or assimilate into in order to be accepted
For example, there are situations where:
- LGBTQ persons voluntarily sought help from religious authorities to share their personal issues, inquire regarding their gender identity, study religion and seek advice from religious persons. The reasons attributed by the respondents suggest that the respondents seek wisdom of professionals or authorities in their social settings to seek information and clarity about themselves and their identity against a context that deeply condemns their very existence. In this context, the service providers and ‘authorities’ have a responsibility to ensure that they provide accurate information, not subject or refer clients to harmful practices.
- LGBTQ persons are unable to provide their informed, voluntary consent to participate in conversion practices. LGBTQ children or young persons in schools or universities who are pressured to change and subjected to conversion practices by their teachers, religious teachers, or counsellors, cannot give consent in the same way adults can. In these circumstances, LGBTQ children or young persons have limited agency and autonomy and become more vulnerable to conversion practices.
- LGBTQ persons are forced to go along with these conversion efforts because they may want to appease their family members, fit in with their peers, or were forced to by their teachers. Incarcerated persons in prisons or detention centres, similarly, cannot give their informed, voluntary consent to join conversion practices.
- LGBTQ persons are misled into joining conversion programmes or activities. These conversion programmes which are typically framed as voluntary, are purposely not clear in their intentions with vague objectives that have no mention of conversion practices. There is an element of deception involved because the objectives communicated to participants are unclear and misleading and there is a hidden objective of converting participants “back to their natural state”. LGBTQ persons may choose to voluntarily participate in these programmes for other reasons and may not be consenting to changing their SOGIE. For example, to receive the participant cash incentives, to learn more and participate in communal religious practices, to meet and socialise with other LGBTQ persons, or to maintain a cordial relationship with the state religious departments to avoid arrest.
The Independent Forensic Expert Group of the International Rehabilitation Council for Torture Victims, a group of preeminent international medico-legal specialists from 23 countries, has declared that offering “conversion therapy” is a form of deception, false advertising and fraud.
8. What happens to survivors or persons who have been affected by or experienced “conversion therapy” practices?
The IE SOGI’s report on conversion therapy practices found that conversion practices can lead to depression, anxiety, shame and guilt, lowered self-esteem, internalised homophobia, intrusive imagery, intimacy difficulty, social isolation, suicidal idation or attempts and post-traumatic stress disorder, as well as physical pain.
There is limited research available on the harms caused from conversion practices in a Malaysian context. Research and reports found that LGBTIQ persons in Malaysia who have been subjected to pressure to change their SOGIE and conversion practices experience anxiety, depression, stress, self-isolation, or suicidal ideation because of the stigmatisation, lack of acceptance by family, and discrimination because of their gender identity, gender expression or sexual orientation. Laila, a trans woman shared how the lack of family acceptance led to them running away from home and suicide attempts,
“If you want me to be a man again, if you want to change my personality, you want to change my inside, you want me to do everything inside out, better I die. If you don’t want to accept the way I am, better I die….I have tried to commit suicide because my parents don’t accept who I am.”
Besides the long lasting psychological and physical harm, conversion practices violate a person’s right to freedom of expression, personal integrity and bodily autonomy, and right to sexual and reproductive health. The IE SOGI’s report on conversion therapy practices concluded that all conversion therapy constitutes cruel, inhuman, or degrading treatment when it is conducted forcibly or without an individual’s consent and may amount to torture depending on the circumstances, namely the severity of physical and mental pain and suffering inflicted.
LGBTQ persons have limited recourse and support for the harms and human rights violations they experienced from conversion practices, whether it be within their family, workplace, schools, or community spaces. As a result, they are unable to share their experiences and report the harms caused by conversion practices through government agencies, national human rights institutions, or healthcare professional bodies.
- Justice For Sisters’ research found that trans women’s access to justice is low due to prejudice and stereotypes against trans women and criminalisation of LGBTQ persons. Trans women who attempted to seek help from the police for cases of violence against them had negative experiences, such as their reports not being entertained with urgency, being ridiculed, victim-blamed or subjected to name-calling and derogatory terms.
This is also made more complicated by their relationship with perpetrators. For example:
- Where conversion practices are facilitated by family members or people close to them, it is important to note that LGBTIQ persons' relationship with their family members, which may be volatile because of their perceived SOGIE, voluntary or involuntary disclosure of their SOGIE, among others change over time. As such, LGBTQ persons may not also want to revisit a time where their relationship with their family members were hostile, especially if they are in a better place.
- Where conversion practices are run by the government, those who have attended government programmes are less inclined to speak up against the state programmes. This is because
- they may see hope in the change in attitude and approach by the state religious department, which were previously hostile, and now indebted by incentives,
- they may feel a genuine sense of acceptance in spite of the government’s intention to change them.
In Malaysia, currently, there is little redress available through human rights or medical bodies for survivors of conversion practices. Unlike public statements by medical associations and the national human rights insitution globally, such institutions in Malaysia have not issued an evidence and rights based statement on conversion practices and its inconsistency with fundamental ethical principles and professional duties of health professionals despite its pervasive promotion in Malaysia.
Conversion practices are normalised in Malaysia because they are fuelled by the
This is made worse by problematic media representation and narratives on LGBTQ people normalises and promotes the use of conversion therapy practices in Malaysia. For example, portrayal of ‘repented LGBTQ’ persons creates misinformation and has a causal link with the pressure LGBTQ persons face by family members and others.
In the context of criminalization, it is easier for various human rights violations, misinformation, against LGBTQ persons to take place with impunity. Between 2020 and 2022, a number of members of Parliament and Senate called for further arrest, detention and rehabilitation of LGBTQ persons and establishment of special detention center for LGBT persons which have negative impacts. Research shows elevated fear of possibly being fined or arrested, increased stress, anxiety, among trans women regardless of ethnicity, religion and geographical locations.
- Introduction of new national, provincial or regional level legislations to ban conversion practices: Brazil, Ecuador, and Malta have enacted nationwide laws that restrict or criminalise those found practising conversion therapies.
- Use of existing legislations under the Penal Code, anti-discrimination laws, child protection laws, and anti-fraud laws: Some LGBTQ persons have used anti-fraud laws to seek legal recourse, as conversion practices are deemed as a ‘deceptive practice’, given the harm and lack of efficacy of the ‘therapy’.
- Regulation of healthcare professionals: Argentina, Uruguay, Fiji, Nauru, Samoa, and Taiwan have enacted indirect bans through mental health laws that prohibit diagnosing patients exclusively on the basis of sexual orientation and/or gender identity.
- Banning advertisements on conversion practices: In July 2020, Facebook and Instagram announced a ban of conversion practices on its social media platforms given the fact that many conversion practices are promoted online.
There are four urgent measures the Malaysian government should take:
- 1.Undertake a comprehensive review of conversion practices in Malaysia with the aim to end all forms of state funded anti-LGBTQ conversion programmes and activities.
- 2.Introduce new or use existing laws to restrict conversion practices
- 3.Establish adequate, accessible, and survivor-centred protection for LGBTQ persons who have experienced conversion practices.
- 4.Lastly, strengthen access to LGBTIQ affirming redress, services, and information
This FAQ is produced by Justice for Sisters through the Gender Equality Initiative (GEI) in Malaysia with ARROW and FRHAM. The initiative is funded by the European Union (EU). Production team includes Nicole Fong, Aiman Azahari, Zaza, thilaga and Sulastri Ariffin