The article is a rebuttal from a Mumbai-based counselling psychologist, Deepak Kashyap, to the earlier story published by TOI called 'Homosexuality can be cured: Psychiatrists'. He responds to the burning question of the day, is homosexuality a disease that can be cured, with a resounding no. There are areas of difference between humans over which we have little control like the colour of our eyes and skin. Our ethnicity and race. The sex we are born into. Our sexual experience and expression. Perhaps more than any of the others, it's the last that leaves us feeling most ashamed and apologetic about. As a sex columnist too, I can safely say that humans are the funniest sexual creatures. We are one of the few species that has no specific mating season, and perhaps the only ones that do not mate to reproduce. We have sex for emotional fulfillment, bonding and recreation. We are also the only species that gives so much thought to the question of sexuality. But, if every act - sexual or otherwise - is left to individual difference, how does one account for medical disorder? There are right and wrong sexual choices and behaviours laid down in medicine, but you may wonder what's the standard of judgment used. And, more importantly, why should you listen to me and not your religious book or a leader who is offering another interpretation? One standard medicine uses is human health. Sexual variations and expressions are classified as positive and negative, as disorders or mere difference. The common assumption behind medical science, including psychiatry and psychology, is that human health and life is valued, and we should seek to improve it. The fine line that psychiatrist and psychologists tread is between identifying and treating dysfunction and crushing the individuality of their clients by instilling social and personal shame for being different. So, is homosexuality a form of paraphilia? According to the latest edition of DSM-IV- Diagnostic and Statistical Manuals of the American Psychiatric Association, the authoritative book for mental health professionals world over - paraphilia ('para' means other than or unsual, philia means love) is characterised by recurrent, sexually arousing fantasies, urges or behaviours that generally involves non-human objects, the suffering or humiliation of oneself or one's partner, or children or other non-consenting persons, over a period of at least six months. The diagnosis is also made if the sexual urges cause impairment in social, occupational, or other important areas of functioning. Paraphilia is not tied to a specific sexual orientation. This means, hetrosexual people can be diagnosed with paraphilia, as well. The principle which should guide a mental health professional is if a sexual variation makes an individual harm oneself or another, and decreases the span and quality of the individual's life, then that is a negative variation of human sexuality. To put it simply, paraphilia refers to 'weird' sexual practices that are compulsively followed regardless of the individual harming his or her body and mental health, disregarding the consent of the other individual, as well. Biastophilia, a sexual fantasy to rape, is a form of paraphilia. Paraphilia - a term that was coined back in 1920, and no doubt defined by the cultural prejudices and assumptions of that era - does not include homosexuality. It did though, till 1973, but it was removed from the list of mental disorder by the American Psychological Association, because homosexuality does not threaten or devalue life. The International Classification of Diseases, a health unit of the World Health Organisation, followed suit removing homosexuality as a mental disorder in 1990. This is as much an indication that homosexuality was seen as a mental disorder till very recently - a view still held by many medical 'professionals' - as much as it is about prejudices that dominate the medical profession. Prejudices are tough to shake off, but ask yourself this - would you go for a bypass surgery as prescribed in a medical text from the '60s? No? Then why go with a medical viewpoint of homosexuality that held sway in the '60s, but doesn't any longer? Are homosexuals ego-dystonic? It feels natural to a gay man to lust for and love another man. In fact, a gay, lesbian, bisexual or transgendered person, who doesn't act according to their nature will experience stress and stress-related problems, both, physically, and mentally. A lot of lesbian, gay, bisexual and transgenders suffer from ego-dystonic sexuality, which is to say that their behavior, values, and feelings are not in harmony with the needs and goals of the ego, consistent with their ideal self-image. The reason for that is they don't fit with the ideals dished out by society - 'real men don't cry'; 'women must be subservient to men'; 'only men and women should be together'. The problems starts when they internalise the feeling that they are inadequate, because they are not what the society wants them to be. Is homosexuality unnatural? Homosexuality isn't unnatural, it's simply not what society expects or allows men and women to be. Most research suggests that anywhere between five to 10 per cent of most cultures and species have homosexuals (homosexuality is seen in over 15,000 species). And since we do not and cannot make a conscious choice of becoming homosexual, it's time to put our figurative axes and sickles down and rest assured that there are enough people to ensure the survival of human race. Can homosexuality be treated? Only a disease needs treatment. Homosexuality is not a disease, or mental disorder, but a natural variation of human sexuality. Culturally it may be considered unacceptable, but then so is being dark, or fat. What is more of a disorder - the colour of the skin or the attitude we have toward it? There are several who claim that they can 'cure' homosexuality. There is no cure, but trying to do so will only cause irreparable harm to the "patient." Changing the behaviour of a person does not change their orientation. The terms gay, lesbian, bisexual and straight are identities used to describe orientation, which defines what one wants. Behavior is what one does with that want. Sometimes, family and social pressure, internalised homophobia, fear of social reaction leads a person to have heterosexual sex, but desire a homosexual relation. Note that the doctors claiming to "change their homosexual clients" are not making any distinction between behavior and orientation; leave alone between homosexuality and bisexuality. Let's also remember what the American Psychological Association has to say about this: "Efforts to change sexual orientation are unlikely to be successful and involve some risk of harm, contrary to the claims of SOCE ((Sexual Orientation Change Efforts) practitioners and advocates." (http://www.apa.org/pi/lgbt/resources/therapeutic-response.pdf) There is an urgent need for many if not most Indian psychiatrists and psychologists to "culture-ise" and moralise the field of mental health.