Gaps in responses to LGBT issues in Thailand: Mental health research, services, and policies

Abstract

Focusing on Thailand, we give a historical overview of LGBT identities and issues, highlight psychological, psychiatric and nursing research on LGBT mental health and services, and review LGBT-related policy statements of professional associations and state-affiliated instances dealing with mental health. Our review demonstrates that stigma, victimisation and familial rejection in Thailand are linked to stress, depression, substance use and suicidality among Thai LGBT people. Research has insufficiently covered transgender men, bisexuals and intersex people. Access to mental health services and their appropriateness are impeded by generic factors (e.g. overcrowded services, stigma, and confidentiality concerns) and low practitioner knowledge of LGBT issues, stereotyping of LGBT clients, and anticipation of practitioners not being accepting or understanding LGBT identities. LGBT-related policy statements have been issued by state-affiliated bodies, but not by professional associations. While sometimes supportive, many policy documents have used stigmatising terminology and perpetuated anti-LGBT prejudice. LGBT-specific counselling and health services have been established, therapeutic strategies have been investigated and information on LGBT issues has been disseminated, but LGBT sensitivity remains to be mainstreamed in Thai health and counselling services. Providing training on LGBT issues, publicising the Yogyakarta Principles and getting professional associations engaged with LGBT issues are among the ways forward.