50.50: Investigation

Top Ghanaian doctors use misinformation to train nurses in ‘conversion therapy’

Influential mental health figures call LGBTIQ identities ‘disease’ and ‘disorder’ – yet regulators remain silent

Khatondi Soita Wepukhulu
28 July 2022, 8.13am

Illustration: Inge Snip

Leading Ghanaian doctors provided anti-LGBTIQ health misinformation and promoted controversial ‘conversion therapy’ practices at a workshop for medical professionals, openDemocracy has discovered.

The two-day workshop in the capital, Accra, on providing “treatment, care and support” for LGBTIQ people was run by the Ghana Registered Nurses and Midwives Association and aimed at nurses, psychologists, counsellors and midwives. 

LGBTIQ people were described as “persons with sexual orientation and gender identity disorder”, and one speaker asked if homosexuality should be “rejected” as a vice or treated “as a disease”.

One attendee told openDemocracy the trainers relied on “cherry-picked” information that emphasised bad-health outcomes for same-sex relationships, such as STDs and injuries from anal sex.

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The event was organised by the National Coalition for Proper Human Sexual Rights and Family Values (aka ‘The Coalition’), an anti-LGBTIQ campaign group in Ghana that is behind a proposed anti-LGBTIQ bill so far-reaching that Human Rights Watch has said it “beggars belief”. 

If passed into law, it would require anyone who knows an LGBTIQ person to report them to the police, while anyone identifying as LGBTIQ could attract a prison sentence of three to five years. People may also be compelled to undergo ‘conversion therapy’. The bill is currently going through parliament.

The health worker who spoke to openDemocracy said they got the impression the Coalition was using these workshops to “recruit members to join their cause”.

“They want their community to grow, heighten awareness, and make themselves popular,” they said.

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Prominent doctors involved

The American Psychiatric Association removed homosexuality from its list of diseases 50 years ago, in 1973, ending its classification as a pathology of any sort. The World Health Organization (WHO) did the same in 1992.

However, several prominent Ghanaian doctors pushed outdated, discredited or entirely untrue theories about LGBTIQ people and their health during sessions at the workshop. openDemocracy has seen copies of all their presentations and obtained audio recordings of the sessions. 

Professor Afua A J Hesse, a lecturer in paediatric surgery at the University of Ghana’s medical school, gave a presentation on the “health impacts of LGBTQQA+ [sic] lifestyles” as “seen by paediatricians”. Homosexuality, Hesse said, “is a lifestyle that is at war against public health much like smoking, alcohol intake [and] environmental degradation” and “results in the destruction of their [LGBTIQ people’s] social lives”. 

openDemocracy has seen a copy of her presentation; it contains graphic pictures of anal prolapse and lists bestiality as one of the “effects of LGBTIQ lifestyles”.

Professor Akwasi Osei, chief exec of Ghana’s Mental Health Authority, claimed that homosexuality is “an abnormality and a mental disorder” and anal sex is “disobedience to what God has said”. He also claimed that “some homosexual tendencies can be corrected through socialisation” and that “hormonal recreational therapy” can be used to “alter the unnatural balance in homosexual people”. Hormone therapy is commonly promoted as a type of ‘conversion therapy’.

The Mental Health Authority was set up by parliament in 2012 to “provide culturally appropriate, humane and integrated mental health care throughout Ghana”.

Homosexuality is ‘an abnormality and a mental disorder’ and anal sex is ‘disobedience to what God has said’ 

Professor Akwasi Osei, CEO of Ghana’s Mental Health Authority

Clinical psychologist Isaac Newman Arthur said that “environmental issues seem to be the most important factor” for a person identifying as LGBTIQ. He provided several anecdotal stories of LGBTIQ patients who, he claimed, had faced sexual abuse and trauma in their childhood, which “affected” their sexuality. 

He also repeated an anti-gay narrative that links homosexuality to formal education: “In secondary school, people go there… straight, they come back lesbians and gays.” He also claimed that pro-LGBTIQ campaigns target children and advised attendees to ask “parents [to] examine their children's private parts” as part of an “assessment” of their sexuality.

Rev Dr Dinah Baah-Odoom, a board member of the Ghana Psychology Council, the regulatory body for mental health practitioners, gave a presentation called ‘LGBTQI+: Causes, Consequences & Cure’. A clinical psychologist and a Methodist minister, Baah-Odoom said health workers must be “accepting, but not condoning” of LGBTIQ people, and should “help those caught up in LGBTQI+ find a sanctuary for counselling”.

Official silence

“I think their views are mostly personal and do not represent the official position of mental health personnel in Ghana,” Sammy Ohene, a lecturer of psychiatry at the University of Ghana’s medical school, said of the health professionals who led sessions at the workshop. 

He added that their claims “echo the views of some who consider their anti-gay stand to be ‘Ghanaian’, in the absence of objective evidence, and who have elevated this to a political issue.” 

The workshop attendee who spoke to openDemocracy echoed Ohene’s sentiment. “What my fellow carers were saying is unethical. As a carer who took an oath to take care of my community, irrespective of age or creed, you are supposed to assess LGBTIQ people firstly as whole human beings with individual rights and choices – even if the oath doesn’t specifically mention sexual orientation,” he said. 

openDemocracy approached several regulators and health personnel authorities but none responded – to dispel or otherwise comment on the claims or conduct of their peers. openDemocracy contacted Ghana’s Nursing and Midwifery Council, the Medical and Dental Council and the Psychology Council, but received no response. 

However, a marketing brochure for the Accra workshop suggests it had official endorsement. It promises that participants will receive continuing professional development (CPD) certificates recognised by medical regulators. The Nursing and Midwifery Council renews its members’ licences annually and one of the requirements for renewal is CPD training. The council did not respond to openDemocracy’s question as to whether or not the organisers’ claim was accurate.

Other international bodies and aid organisations were equally silent. openDemocracy received no response from WHO Africa (which is working with Osei’s Mental Health Authority on a programme called ‘Quality Rights Ghana’) nor from the Australian High Commission and the United Nations Population Fund (UNFPA), which are working with clinical psychologist Arthur on a shelter for domestic violence survivors.

Anti-LGBT bill will ‘strengthen our hands’

Danny Bediako, a Ghanian LGBTIQ rights activist, said he fears the doctors and organisers of the Accra workshop are “preparing these health workers to offer so-called ‘conversion therapy’ services if the anti-LGBTQ bill is passed”. 

He suggested that some health workers will use the workshop training certificate to “claim expert status”, adding, “these ‘sexual orientation experts’ will soon open clinics and other facilities for conversion therapy, at a fee.” 

Osei, head of theMental Health Authority, seemed to affirm Bediako’s fears. A vociferous supporter of the anti-LGBTIQ bill, he specifically mentioned it in his speech, saying its passage would “strengthen our hand”. 

Paediatrics professor Hesse spoke extensively about intersex children. She said she prescibed “surgical reconstruction” and “removal of the organs that don’t fit the genotypic sex”, claiming that leaving them may cause cancer later in life. In fact, research has shown that medically unnecessary surgery on intersex children can “inflict permanent harm” and cause “both physical and psychological… devastation”.

The draft bill proposes mandating conversion therapy for people known to be gay and giving parents of intersex children the legal right to subject them to ‘corrective’ surgery. Conversion therapy for minors has been banned in several countries, and Greece plans to prohibit “unnecessary” ‘sex normalising’ surgeries” on intersex babies.

Conversion therapy practices in Africa are commonly pushed in religious settings, but are increasingly seen in healthcare settings too. A 2021 investigation by openDemocracy revealed that health centres in Uganda, Kenya and Tanzania – including some funded by foreign aid money – had either offered such anti-gay ‘therapy’ to undercover reporters or referred them to external providers of such treatments. 

The workshop speakers quoted above did not respond to openDemocracy’s requests for comment.

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