Does the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders propose that there are twenty-two forms of "sexual orientation"? The Islamic Republic of Pakistan (and Focus on the Family) want you to think so.
In the several years I've been working around the United Nations, he's been a treasured source of free entertainment for me, the inadvertent star of an Andy Kaufmann–routine version of himself. The only way to listen to his deadpan, ploddingly loopy soliloquies without withering in vicarious embarrassment or despair at human folly is to assume that they are part of an act of long-form satire that will eventually end in relieved applause.
As ever, representative Marghoob Saleem Butt was doing Pakistan proud.
I caught his act in New York in early February during a meeting of the Committee on Non-Governmental Organizations, a group of nineteen UN member states that considers the applications of NGOs wishing to affiliate themselves with the Economic and Social Council. Pakistan and the other so-called Islamic states in its international coalition, the Organization of the Islamic Conference (now renamed the Organization of Islamic Cooperation), were still worked up over a major symbolic defeat they suffered in June 2011 when the UN Human Rights Council passed a resolution condemning discrimination and violence on the basis of sexual orientation and gender identity.
OIC v. LGBTQ
Introduced by South Africa—to the great consternation of the other members of the African group—the non-binding resolution expresses the Council's “grave concern at acts of violence and discrimination, in all regions of the world, committed against individuals because of their sexual orientation and gender identity.” Astonishingly, this was the first time in its history that the UN’s human rights body had addressed violence and discrimination against sexual minorities.
Before the vote in June, Pakistan spoke on behalf of the OIC to chastise the Council for discussing “controversial notions” of sexual orientation and gender identity, questioning “the attempt to introduce to the United Nations some notions that have no legal foundation in any international human rights instrument.” Contrary to this protest there is a twenty-year-old legal precedent holding that the protection against discrimination on the basis of “sex” contained in Articles 2 and 26 of the International Covenant on Civil and Political Rights extends to sexual and gender minorities.1
In a 14 February 2012 letter to the president of the Human Rights Council, Pakistan's Ambassador Zamir Akram repeated the complaint, saying, “We are even more disturbed at the attempt to focus on certain persons on the grounds of their abnormal sexual behavior.” Then, most OIC members boycotted a 7 March UN panel on “Discrimination and Violence based on Sexual Orientation and Gender Identity,” which had been called for by the June 2011 resolution. Meanwhile, at the Committee on NGOs, Pakistan was working hard to prevent any LGBTQ–rights group from gaining formal affiliation with the UN. At this particular session, the lightning rod was the Vienna-based Homosexuelle Initiative Wien, a group focused on equal rights for gays and lesbians in Austria. In tandem with the representative of Morocco, Butt trained his crypto-absurdist wit on the organization’s use of a medical scientific conception of homosexuality in describing their work.
They say there is some kind of scientific, you know, dictionary on which you can consult the definition of sexual orientation. I can quote a number of other scientific research [sic] in which this—there are different, I would say definitions of, let’s say, sexual orientation. I was just going through one which comes as the definition provided by American Psychiatric Association diagnostic. And they are giving twenty-two possible, I would say, forms of sexual orientation. I would really like to know, does this organization really attest to all of those twenty-two types of sexual orientation? Some of them are really even disgusting to read. Anyway, that’s beside the point. . . .
To say of this mental discharge even that it was beside the point would already be too unkind to the point. But the talk I heard coming out of the delegate from Pakistan was, I learned, representative of a new rhetoric being deployed across the board by the OIC at the UN. Interestingly for those who patrol the borderlands of science, the argument turns on a willful misreading of an already problematic and politicized publication, the Diagnostic and Statistical Manual of Mental Disorders, or DSM.
The DSM, published by the American Psychiatric Association (APA), may be the closest thing to a trusted practical guide for clinicians, hospitals, insurers, and regulators as they plumb the human soul. A flippant skeptic might say that it answers to a deep need to know which of all of the weird things that people do are eligible for reimbursement by a medical insurance company. As it happens, the plenary sessions of psychiatric conventions are already quaking with debates over the preparation of the next revision, DSM-V, scheduled for release in May 2013.
For some perspective on the politics of the DSM, consider the fact that its 1917 predecessor had twenty-two psychiatric diagnoses in total. The current edition, DSM-IV-TR (text revision), put out in 2000, has 350. The most notorious change came in 1974 when the APA determined by majority vote among its members that homosexuality is not a mental “disorder” and revised subsequent editions accordingly. The vote was 5,854 to 3,810, inviting one to conclude that non-hetero people are roughly 35 percent screwed up, like everyone else.2
The prevailing version of the DSM does not contain diagnostics for bisexuality, homosexuality, and heterosexuality as such. It does contain numerous conditions labeled Paraphilias, which are “characterized by recurrent, intense sexual urges, fantasies, or behaviors that involve unusual objects, activities, or situations and cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.”3 Among these are the familiar forms of sexual deviance (“paraphilia” is preferred by some as a purportedly less value-laden term than “sexual deviation”) along with some forms that were, there’s no shame in reporting, unfamiliar to this author. The list includes Voyeurism, Exhibitionism, Sadism, Masochism, Fetishism, Autogynephilia (the sexual arousal of a man by his own perception of himself as a woman or dressed as a woman), Frotteurism (arousing fantasies, urges, or behaviors involving touching and rubbing against a nonconsenting person—something that former doyen of cognitive behavioral therapy Albert Ellis used to enjoy regularly on the New York City subways), and Telephone Scatalogia (sexual arousal associated with making or receiving obscene phone calls).
The same list includes Zoophilia and Pedophilia. Pakistan was misreading the DSM as classifying every paraphilia a “sexual orientation” in order to draw the conclusion that a new international human right to non-discrimination on grounds of sexual orientation and gender identity would give protection to rapists of children and animals. This was in the service of the OIC’s spurious insistence on the need for a consensus legal definition of “sexual orientation” before the UN can make any further advances in the protection of the human rights of sexual minorities.
In bed with conservative Christians?
There is some evidence to suggest that this devious argument originated with North American evangelical groups such as Concerned Women for America and the Traditional Values Coalition and that it has been circulated in UN circles by Thomas W. Jacobson, a United Nations representative for Focus on the Family—one of thousands of religious organizations that have received affiliation, while Homosexuelle Initiative Wien and other LGBTQ–rights applicants languish in bureaucratic purgatory thanks to OIC–led obstructionism.
When the Israeli representative on the Committee on NGOs intervened to point out that this Austrian organization would never be able to define sexual orientation to the satisfaction of the governments of Pakistan and Morocco, he turned the tables in a way that had to be admired.
I’m not really certain what the distinguished representative of Morocco means when he says that they try to justify homosexual behavior. What really is there to justify? And why is the reference specifically to behavior? How can a man or a woman justify who they are? I’m sorry I think these questions will remain open and I believe that we shouldn't present questions that have no answer to NGOs, questions that may be discriminatory. In this case, it seems they are.
That got Pakistan hot.
Let me start by saying that while I have full respect for the views expressed by my distinguished colleagues from United States, Belgium, and Israel, irrespective of the fact that how [sic] I may differ with them, I would never be calling them discriminatory because these are the views that they are entitled to and as sovereign states they have the right to express them in any forum, especially in the UN forum.
Throwing up his hands at Israel’s sensible observation that governments such as Pakistan’s that criminalize homosexuality must themselves be in possession of a working definition, Butt brought the curtain down:
I think this type of discussion should end. Let me just say that yes we know what we mean in our countries what is sexual orientation. But we are not granting the consultative status to these NGOs in our countries. We are granting consultative status to these NGOs in the United Nations. That is why we need a definition from the United Nations. So I think this discussion should stop here. We know that this is for the sake of political argument and if that be the case I thought that it’s appropriate that I should also put on record what we believe on the subject.
With that, he bolted to the back of the hall to make some calls, leaving his colleagues to respond to his performance. I got the distinct feeling that the discussion would not stop here.
1. Toonen v. Australia, Communication No. 488/1992, U.N. Doc CCPR/C/50/D/488/1992 (1994). ↩
2. John Cloud, “What Counts as Crazy?” Time magazine (March 19, 2012), 44. ↩
3. Diagnostic and Statistical Manual of Mental Disorders, Fourth edition, Text revision (Washington, DC: American Psychiatric Association, 2000), 535. ↩