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ISTANBUL PROTOCOL VI. PSYCHOLOGICAL EVIDENCE OF TORTURE AND ILL-TREATMENT

and tortured or the children have witnessed severe (b) Understand how the persecution experiences
trauma or torture, they may develop dysfunctional of lesbian, gay, bisexual, transgender and intersex
beliefs, such as believing that they are responsible for children, youth and adults affect their mental and
the bad events or that they have to bear the burdens physical health; 514
of their parents. This type of belief can lead to long-
term problems with guilt, loyalty conflicts, personal (c) Be familiar with the specific social, cultural
development and maturing into an independent adult. and political factors that may have influenced the
physical and mental health of lesbian, gay, bisexual,
transgender and intersex persons; 515
D. Lesbian, gay, bisexual,
transgender and intersex persons (d) Ask about persecution and abuse that target sexual
and torture and ill-treatment orientation and gender identity during childhood and
adolescence; 516
599. Based on their sexual orientation, gender identity,
gender expression or sex characteristics, lesbian, (e) Create a supportive environment in which lesbian,
gay, bisexual, transgender and intersex persons are gay, bisexual, transgender and intersex individuals
frequently stigmatized and dehumanized, leaving them are able to explore, discuss and reveal their sexual
particularly vulnerable to human rights violations, orientation and gender identity as much as possible
including persecution, criminalization, imprisonment, at the time;
torture and ill-treatment. Research on lesbian, gay,
bisexual and transgender children and young persons (f) Recognize that lesbian, gay, bisexual and
shows that they are at risk of experiencing severe and transgender and intersex persons may not have
prolonged physical and psychological abuse, with a disclosed their sexual orientation, gender identity, sex
potentially severe impact on their mental health. 512 characteristics, chosen name or gender pronouns in
Lesbian, gay, bisexual and transgender adult asylum previous interactions with authorities out of fear based
seekers also have particular persecution experiences, on past experience and other factors;
with consequences for mental health. 513 Depending
on the different levels of stigma and pathologization, (g) Use whenever possible the proper names and gender
lesbian, gay, bisexual, transgender and intersex persons pronouns chosen by the individual, compatible with
have experienced in their lives, including health the individual’s self-identification;
care, they can develop great difficulty in revealing
their identity, including to the examining clinician. (h) Be aware of their own attitudes, perceptions and
prejudices and how they might affect the quality of
600. When examining an alleged torture victim from the interaction with lesbian, gay, bisexual, transgender and
lesbian, gay, bisexual and transgender community, intersex persons;
specific considerations should be taken into account
to avoid pathologizing or retraumatizing them. Some (i) Apply an intersectional, intercultural and
of the basic principles and keynotes that should be interreligious approach and strive to understand the
taken into account by clinicians in order to create a specific barriers that lesbian, gay, bisexual, transgender
sense of safety and respect and thus help individuals and intersex persons face when they have additional
reveal all the aspects of their torture history and help stigmatized and/or minority identities (e.g. HIV-
the clinician better understand their current needs positive person, refugee, sex worker or person with
(medically, psychosocially and legally) include: physical disabilities);

(a) Recognize that diversity in sexual orientation, (j) Do not attempt to change the interviewee’s sexual
gender identity, gender expression and sexual orientation or gender identity;
characteristics is normal and is not a mental illness;

512 Edward J. Alessi, Sarilee Kahn and Sangeeta Chatterji, “‘The darkest times of my life’: recollections of child abuse among forced migrants persecuted because of their sexual
orientation and gender identity”, Child Abuse & Neglect, vol. 51 (2016), pp. 93–105.
513 Rebecca A. Hopkinson and others, “Persecution experiences and mental health of LGBT asylum seekers”, Journal of Homosexuality, vol. 64, No. 12 (2017), pp. 1650–1666.
514 Alessi and others, “‘The darkest times of my life’”.
515 Ibid.
516 Ibid.

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