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European Journal of Applied Sciences (EJAS) Vol. 10, Issue 2, April-2022
European Journal of Applied Sciences – Vol. 10, No. 2
Publication Date: April 25, 2022
DOI:10.14738/aivp.102.11654.
Chan, A. S. W. (2022). Social Inclusion and Human Right: The Impact of Mental Health Among LGBT Community in Mainland China.
European Journal of Applied Sciences, 10(2). 27-32.
Mental Health and Social Inclusion: The Human Rights
challenges Among LGBT Community in Mainland China
Alex Siu Wing Chan
Department of Applied Social Sciences
The Hong Kong Polytechnic University, Hong Kong
ABSTRACT
Mainland China has the world's largest population and is also home to the LGBT
community’s highest proportion. Despite the legalization of homosexuality in
mainland China in 1997, the LGBT community faces discrimination in their daily
activities. The recent studies carried out in 2019 and 2020 on the LGBT community's
prejudice in mainland China showed that these individuals still encountered
rejection despite its legalization two decades ago. Rejection starts from family,
continuing to school, workplaces, and religious centers. The Burki (2017) study
revealed that the majority of LGBT individuals live in their cocoons, fear of
discrimination, and the implications of those factors may negatively impact their
mental and physical health. In some LGBT communities, marriage is a form of social
conformity. Despite the fact that some heterosexual individuals are likely to interact
with homosexuals, many are highly opposed to allowing their children to associate
with the LGBT community. It is expected that everyone conforms to the norms that
are acceptable to the majority of the population. While the available research has
led to greater acceptance of the LGBT community, more work is needed, particularly
when it comes to recognizing homosexuals by the government. Therefore, the
purpose of this paper is to increase awareness of LGBT mental health and promote
social inclusion.
Keywords: LGBT, men who have sex with men (MSM), social inclusion and exclusion,
discrimination, mental health, Mainland China
INTRODUCTION
A world meter elaboration of United Nations data estimated mainland China's population at
1,440,828,045 people, equivalent to 18.47% of the global population (Tang & Yu, 2021). As the
country with the highest population globally, it is also the country with the largest gay, lesbian,
bisexual and transgender (LGBT) community (Hua, Yang & Goldsen, 2019). The LGBT
community in mainland China lives in their cocoons, the barriers they continue to face in their
everyday lives (Burki, 2017). Though these are turbulent times for the world population, the
situation has only become worse for the LGBT community in mainland China due to the COVID- 19 pandemic. Homosexuality in mainland China was illegal until 1997, when the first
version of the mainland China Classification of Mental Disorders recognized homosexuality as
a sexual disorder. In 2001, homosexuality was officially removed from sexual disorders (Wang
et al., 2020; Table 1). LGBT in different parts of mainland China continue to experience
discrimination, even in official and legal offices. Moreover, the population is uncertain whether
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European Journal of Applied Sciences (EJAS) Vol. 10, Issue 2, April-2022
they will be able to hold meetings, hold rallies, or provide social services. Nearly all government
offices in mainland China continue to discuss the legal status of the LGBT community. As it
appears, the government has decided to maintain a cautious and conservative stance on the
issue, often called "not encouraging, not discouraging, not promoting" (Mountford, 2017).
Sexual minorities might foresee exclusion and bad encounters and absorb homophobic sentiments
as a consequence of living in a heteronormative and discriminatory society. Such processes are
close to the ego and may thereby increase the likelihood of psychological suffering. In a longitudinal
study with MSM in Beijing, it was shown that anticipating MSM stigma had an effect on both
sadness and anxiety by increasing avoidance and decreasing social support-based coping methods
with sexual identity-based stigma (Sun et al., 2020). Thus, MSM who expect discrimination and
refusal from others might avoid tackling issues and retreat socially, which might exacerbate
alienation and suffering. This study lends credence to the mental mediation concept, which asserts
that stigma increases maladaptive coping behaviors such as social avoidance, hence mediating the
association between stigma and psychopathology (Liu & Kozinets , 2021). Internalized
homophobia is shown to have a significant impact on the mental health of MSM in western
countries (Li, 2021). Nevertheless, studies in mainland China have produced contradicting findings:
multiple studies, both cross-sectional and longitudinal, found no evidence of an association or
prediction of emotional problems with internalized homophobia (or internalized sexual identity
stigma) (Lee et al., 2022).
A questionnaire of a major state sample of MSM in mainland China discovered that while
interpersonal-oriented identity worries such as acceptance concerns and interpersonal
marginalization were not linked to emotional problems, minority stress processes proximal to the
self (i.e., internalized homonegativity, identity concealment) were (Yu & Peng ,2022) . Likewise, a
longitudinal study with MSM in Beijing found no notable immediate or subtle influences of
internalized gender identification stigma on depression or anxiety, but predicted such
psychological wellbeing problems (JI et al., 2021). A further study of Chinese LGB young adults
found no link between proximal minority stress (internalized homophobia, self-concealment, and
rejection sensitivity) and psychological maladjustment, but support networks, particularly
apparent parental support concerning one’s gender identity, were linked to favorable mental
consequences (Nichols et al., 2022). Meanwhile, two other studies discovered an association
between internalized homophobia and unsatisfactory mental wellbeing.
Discrimination against different groups of people based on their race, age, sex, or disability
(Modrakovic et al., 2021). While the Chinese government chooses to remain neutral on the issue,
the LGBT community continues to suffer in silence. LGBT individuals continue to face political,
legal, social, economic, and cultural discrimination, causing them to remain a hidden sub- population in the country (Ren & Yuan, 2018). Such discrimination has led to the LGBT
community's marginalization, with negative impacts on their mental and physical health and
their daily lives (Chan, 2021a; Chan, 2021b; Table 2). With over 47 million homosexuals in
mainland China, it is only right that their visibility is increased, rights advocated for, and
discrimination eliminated at all levels in the society (Parkin, 2017). Previous studies show that
with economic development and modernization, the community becomes more tolerant of
people with queer sexual tendencies (Xie & Peng, 2018). Mainland China has recently been
experiencing one of the most remarkable economic growths in the world and is currently ranked
with other superpowers like the United States and Russia. The distinctive Chinese Cultural
context appears, however, to have a significant impact on the people's attitude toward the sexual
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minority groups.
Year Event
1973 Declassification of homosexuality as a mental disorder in the U.S.
1990 The World Health Organization declassifies homosexuality as a mental
disorder in May 2017.
1997 As a result of the "abolition of hooliganism law" in mainland China,
homosexuality is no longer a crime.
2001 The Chinese government declassified homosexuality as a mental illness.
2004 International Day Against Homophobia, Transphobia, & Biphobia celebrated on May 17.
2014 Chinese court rules homosexuality cannot be fixed by therapy.
Table 1| A timeline of homophobia milestones (Lin & Wang, 2021; Wu & Nie, 2021)
One study with MSM in Jiangsu Province found that those with high rates of depression had
significantly greater rates of internalized homophobia than those with lower rates of depression
(Wang et al., 2021). Another experiment with homosexual and bisexual males in Southwest
mainland China classified subjects into two groups depending on their degree of internalized
homophobia, with the “high internalized homophobia” group experiencing greater mental
discomfort and sexual compulsions (Tan, 2022). Both investigations, however, dichotomized the
crucial factors such as depression or internalized homophobia (Fan et al., 2022), which may
diminish assessment accuracy and raise the probability of false positive and prejudiced results (Qu,
2022).