It was not so long ago when being gay was considered a recognizable mental disorder, taught in classrooms at medical schools the world over. Thankfully, the days of the medical establishment viewing gay people as "sick" are now largely over, although unscrupulous operators continue to peddle misinformation and scientifically discredited theories about "curing" queer teens.
In Belgium, doctors are considering whether or not to accept the euthanasia request of a 39-year-old man. His reason for asking for physician-assisted suicide? Because he can't accept the fact he's gay.
The BBC reports that Sébastien—his last name is withheld—has asked for assisted suicide because of the psychological suffering caused throughout his lifeby his sexuality. Sébastien cited a difficult childhood, troubling feelings towards adolescent boys (although he claims not to have acted on these) and young men, and a strict Catholic mother as contributing to his distress.
"My whole life has led me to this, really. My mother had dementia, so I wasn't right, mentally." Tragically, Sebastian's first experience of love was also a catalyst for his feelings of misery today. "Growing up, I met a boy and I fell crazy in love. We were both 15. And it was just unbearable for me, you know? I didn't want to be gay."
Euthanasia has been legal in Belgium since 2003, and the country has some of the most permissive laws in the world. In 2014, Belgium became the first country to legalize euthanasia for children. Broadly speaking, the Belgian public supports physician-assisted suicide, although debate continues around the issue of whether euthanasia on mental health grounds should be permissible.
In order to qualify for euthanasia on psychiatric grounds in Belgium, three doctors must agree to a patient's request (the burden for physical illnesses is for two doctors to agree). Doctors must agree that the patient is suffering from incurable and unbearable mental suffering. They must also determine that the patient is making the decision to die based on their own free will, rather than a symptom of their mental illness.
While it may seem shocking that doctors would consider euthanizing someone who is physically healthy, it's worth emphasizing that Sébastien claims to have undergone 17 years of counselling, therapy, and medication. It's also worth pointing out that doctors wouldn't be euthanizing Sébastien because of his sexuality, but because they deem that his sexuality has triggered a mental or psychological condition in him that does not appear to be treatable.
Isra Black, who specializes in euthanasia law at Stockholm University, explains how Belgian doctors could interpret the law in Sébastien's case. "It's possible to have euthanasia for recognized psychiatric disorders that cause you unbearable pain and hopeless suffering."
I ask how a mental illness resulting from an inability to accept being gay might fit within the law. "Events in your life—such as the death of a loved one—can cause you to develop depressive disorders. In the same way, the difficulty of coming to terms with your sexuality can cause someone to be depressed.
"That's potentially what fits within the context of mental disorder in this case."
Not all assisted dying groups advocate for euthanasia in the case of mental illness. "We campaign solely for assisted dying for terminally ill and mentally competent adults," Dignity in Dying spokesperson Sam Dick tells Broadly. "The law we seek is one which contains strong safeguards to ensure people seeking an assisted death are terminally ill; have less than six months to live; are mentally competent; are doing so voluntarily, and have been offered all relevant treatment options. The scenario reported today would categorically not be permitted under the law that we seek."
The case serves as a depressing reminder that the discrimination experienced by some LGBQT people in their formative years can have a hugely scarring and lifelong effect. "Unfortunately we still live in a world where hate and discrimination directed toward lesbian, gay, bi and trans people can lead to many of them feeling distressed, alone and even suicidal," says a spokesperson for Stonewall, an LGBT charity. "We still have so much left to do until all LGBT people are accepted without exception."
Meanwhile, doctors will decide Sébastien's fate. "We tend to think of physician-assisted death as a matter of last resort," Black argues. "So there's always the issue of whether this is the last thing we can do for this person. Have substantial attempts have been made to help Sébastien accept his sexuality? In this case, it does seem they have been made."