“Medication for psychosocial disabilities have effect on sexuality” – Ratnaboli Ray, Anjali


Our conversation with Ratnaboli Ray, Founder – Anjali Mental Health Rights Organisation began as a conversation around pleasure and politics present in the lives of persons with psychosocial disabilities. Understanding the intricacies of the politics around pleasure in these lives requires understanding psychosocial disabilities. What is a psychosocial disability? We thus find our into the web of pagalpan (madness)


Hidden Pockets: How would you define psychosocial disabilities or pagalpan?

Firstly, psychosocial disability is about the person who is experiencing mental health issues. Psychosocial disability is a language that has come into force through the United Nations Convention on Rights of Persons with Disabilities (UNCPRD). Secondly, psychosocial disability as a concept moves away from the clinical medical gaze. It lays emphasis on a person’s life trajectory or lived-in experiences.

Hidden Pockets: How different are people with psychosocial disabilities from people without these disabilities with respect to sexual pleasure?

You need to realize that psychosocial disability is an invisible disability. Unless and until I tell you that I have a psychosocial disability, you wouldn’t know. They’d pass off as ‘normal’ people. With disabled sexuality, you can look at a body and know what the body can or cannot do with respect to sexual engagement or sexuality. Therefore there are complicated conversations around how normal it should be as far as sex is concerned. The understanding of sexuality of a disabled body can be mainstreamed. Or the disabled body could construct a different kind of a story about sexuality. As far as psychosocial disability is concerned, the body doesn’t reveal anything unless and until you are wandering on the street or locked up in an institution. Our experience shows that mental health conditions or recovery at different stages can intertwine with sexuality in different ways. For example, there could be a person with a psychosocial disability having problems with moods for 15 days in a month. During those 15 days, the person’s sexual expression is dependent on different factors such as mood, where the individual is, the culture and the context enveloping him or her. There is no common script for sexual pleasure or sexual expression as far as people with psychosocial disabilities are concerned. It varies.

Hidden Pockets: With no single template for their sexual expression, what are some common challenges that people with psychosocial disabilities face?

There are many challenges. Finding a sexual partner for persons with psychosocial disabilities is one of the major problems. It is fine as long as you don’t disclose your identity as a person with psychosocial disabilities. When you are dating or like someone, you would like to disclose who you are. You want to tell the other person that you are a person with psychosocial disabilities. And the moment they disclose their identity is when they lose their sexual partners. They are abandoned because they are conceived and perceived the way they are portrayed in popular imagination. This is because of the stigma associated with psychosocial disabilities. I think it has also to do with perception that people with psychosocial disabilities are not potentially sexual. The biggest problem lies with people questioning the sexual potential of people with psychosocial disabilities.

There is also the huge problem of the effects of medication. We know for sure that medicines given to control symptoms have side effects on their sexuality. Men may have erectile problems. Women may have lack of lubrication and dryness of vagina though the people with psychosocial disabilities tend to internalize it and think of it as normal and often do not bring up these problems  even with their consultants.

There are many other issues like where one lives. The set of challenges faced by people living on the streets are different from those living in institutions. The challenges tend to be different if the person has recovered and is living with the family. The challenges vary as and when the subject moves from one location to another but they are similar in certain contexts: like the challenges faced in the institution, are more or less similar to the challenges faced within families, since families are also mini-institutions largely mimicking institutional values.

There are legal challenges emanating from perceptions of non-affirmative sexuality. Even the United Nation Convention on Rights of Person with Disabilities (UNCRPD) doesn’t talk about sexuality in an affirmative manner. It still talks about sexual abuse, sexual violence and marriage. Therefore the discourse of sexuality is primarily limited within the framework of marriage, violence, abuse, assault and prevention and doesn’t talk about affirmative sexuality or about access to sexual services.

Hidden Pockets: With all these challenges, what are some ways in which persons without disabilities can become more accepting of persons with psychosocial disabilities as sexual beings?

This is a difficult question to respond to because it is tied to so many things.

Firstly, they have to be recognised as human beings and only after that arises the issue of their sexuality. In fact ‘recognition as a human being’, automatically implies that they also need to be recognised as sexual beings. But how will people with psychosocial disabilities be recognised as sexual beings without the strengthening of the de-stigmatization movement?

Secondly, we also need to think about public sexual policy and sexual policy within public health. Policies have to be framed for promoting healthy, affirmative sexuality. For example, within the confines of institutions, if a person desires to have private time for self-pleasuring then the person should be given a room to engage in self-pleasuring in private. There has to be access to toiletries and grooming facilities so that their sexual identity becomes visible as opposed to being invisible and these have to be framed as part of a policy. Without these type of policy changes, I don’t see how acceptance of psychosocial persons is going to happen.

More and more people with psychosocial disabilities need to come into public spaces and talk about their desires, their needs and challenges and make it a political statement because with sexuality, there is a huge dilemma about how public can you make the private. Whether we like it or not, sex and sexuality is very private. You have to be ready to bring it out into the public domain to make it a political statement. We activists can go out and talk about it but we cannot drive the agenda because I always feel like a voyeur. I’m privileged to many narratives. And I really have to deal with a moral and activist dilemma of whether we can make this public or not.

Hidden Pockets: This being a complex issue with complex solutions, what are the ways you encourage the participants whom you work with to explore pleasure?

One is legitimizing and de-shamming the subject and the other is creating a safe place for them to trust us.

We have been having these conversations with our participants for the last three years. In the first meeting, they asked me about the shift. I usually ask them if they have taken their medication, if they are well and if they are working. For the first time, I was talking to them about: whether they were in love; and encouraging them to talk about their love stories. Though it was new to them, they admitted to feeling good about talking about these areas of their life. It gave them a certain sense of complete-ness and wholeness. And all this depends on our alliance with them and the amount of trust and stability that they have with us because without trusting they will never ever tell us their story.

We have created a space that they know is a safe space, where they can come and talk about their pleasure. Most of the women have seen porn. Their husbands have made them see porn. Many said that they enjoyed it. Many said that they didn’t enjoy it. But they agreed to watch it because their husbands wanted it and they want their husbands to be satisfied so they watched it together when their in-laws were away and the house was empty. They watch porn together and make out. The important aspect is that they have opened up.

We have also spoken to them about how masturbation is ok and how masturbation does not lead to weakness as is usually perceived but then they say that they don’t have the privacy even to masturbate. You need privacy to masturbate especially in institutional spaces wherein if they are caught masturbating, they are punished because institutions have this assumption that relationships are heterosexual and hetro-normative in nature. Institutions have separate wards for women and men because; intermingling will create babies and chaos. Same-sex relationships are not even in the ambit of their imagination. The inmates are punished if they are caught self-pleasuring or seen with their partners resulting in their medications going up; being condemned to seclusion cells and being kept naked. Sexuality can become very obscene so we have to balance it in a way that it does not become vulgar and obscene.

Disclosure: Hidden Pockets is Media Outreach Partner for Pleasure, Politics and Pagalpan

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