Aid-funded Ugandan health centres offering anti-gay ‘conversion therapy’

Khatondi Soita Wepukhulu is openDemocracy East Africa investigative reporting fellow.

At Mulago, Uganda’s biggest public hospital, a receptionist at an HIV clinic for “most at risk” populations, including LGBTQI+ people, told an undercover reporter that her 17-year-old gay brother could “quit” his same-sex attraction.

“Whoever wants to quit homosexuality, we connect them,” she said, including to the anti-gay evangelical pastor Solomon Male. She also gave the reporter the number of a man who “was once a patient here” and “was once a homosexual but isn’t any more”. 

The USAID aid agency – which says it supports LGBTQI+ inclusive development – gave the Most At Risk Populations Initiative that runs this clinic a $420,000 grant in 2019, ending this September. (It is unclear if any of this money went to this specific clinic.)

It is just one of several examples of health centres in Uganda where our undercover reporters witnessed staff providing, or providing referrals for, controversial anti-gay “therapies”.

Our investigation identified similar support for “anti-gay” counselling at three hospitals in the Uganda Catholic Medical Bureau (UCMB) network. This network received more than $1-million from USAID between 2019 and April 2021, though it is unclear whether the specific hospitals identified in this investigation received any of this money.

At one of these hospitals – Nsambya, Uganda’s biggest private health facility – staff referred our reporters to the private office of Cabrine Mukiibi, on the outskirts of Kampala, who mixed Freudian theories, biblical quotes and anti-gay messages in his diagnosis.

Without procreation, said Mukiibi, sex “becomes evil” – before recommending what he called “exposure therapy”, telling the boy’s supposed sister to “get a housemaid [...] he can get attracted [to]’’, one who is “between 18 and 20 years of age”. 

A US embassy spokesperson, Anthony Kujawa, said “conversion therapy” goes against “the policy of the United States to pursue an end to violence and discrimination on the basis of sexual orientation, gender identity or expression, or sex characteristics”.

In response to questions from openDemocracy, Kujawa explained that US funding for UCMB was supposed to support the capacity of Catholic health facilities involved in HIV and Aids care. He said: “USAID does not fund or promote anti-LGBTQI+ conversion therapy and will investigate any report that a USAID-funded partner is doing so.”

Rosco Kasujja, director of mental health at Makerere University’s school of psychology and head of the Uganda Clinical Psychologists Association, called openDemocracy’s findings “disturbing”. He highlighted the need for a national regulator for psychologists, which could ensure that all patients receive quality care.

“It’s really frustrating that we don’t have any power,’’ he said, in reference to his association’s voluntary and non-binding standards. “People are playing by their own rules and [we] can’t do anything about it.”

‘Extremely unethical’

Globally, more than 65 associations of doctors, psychologists or counsellors – including two in South Africa, but none in Uganda – have condemned “conversion therapy” practices, according to a 2020 report by the International Lesbian, Gay, Bisexual, Trans and Intersex Association rights group, which called them “ineffective and harmful”.

Brazil, Ecuador, Germany and Malta have banned these practices, which range from “talk therapy” to physical “treatments” including so-called aversion therapy. Several US states have done the same, while the UK recently pledged to ban “conversion therapy”.

Anal sex is illegal in Uganda, and homosexuality is heavily stigmatised. It is unclear how common “conversion therapy” is, but openDemocracy teamed up with local researchers to document the experiences of 20 LGBTQI Ugandan survivors of such “treatments”.

Interviewees said such “therapy” “felt like murder” and that they “suffered depression and anxiety”, drug dependence and suicidal thoughts. Mulago and a hospital in UCMB’s network were among the facilities they named as having provided the treatments.

Godiva Akullo, a feminist lawyer in Kampala, said, of those providing “conversion therapy”: “I think it’s extremely unethical behaviour.”

Unregulated therapy

In Kampala, openDemocracy undercover reporters visited three hospitals in the aid-funded UCMB network, looking for “treatment” for same-sex attraction, and were referred to providers of such therapy either within the health facilities or externally.

At Kisubi Hospital’s “youth-friendly” clinic, a counsellor offered a session for 50,000 Ugandan shillings ($14), saying a “17[-year-old] is still a small child we can modify”. 

At Lubaga Hospital, Matthias Ssetuba introduced himself as the facility’s “mental health focal person”. He claimed that homosexuality is caused by factors ranging from peer pressure to the internet, and also said that it can be “changed”. 

“It is a mental health issue,” he added, “because once you start having sex with the same sex, much as those whites are saying ‘it’s normal’, in our society it’s abnormal. And anything to do with abnormality has something to do with mental health.”

He stressed that a person “has to accept” that they need help “in converting”.

In an email to openDemocracy afterwards, Ssettuba said it was the first time he’d had “such a case at the hospital”, which “has never aided any anti-LGBT conversion therapy”.

“We would only wish to support those who might want to do so at their own will,” he said. He did not reply to further questions about his statements to our undercover reporters.

Homosexuality, said Cabrine Mukiibi (the counsellor referred by Nsambya Hospital) is often caused by “unresolved competition” between a child and a same-sex parent for the attention of an opposite-sex parent during their development’s “phallic stage”. 

He wore a label on his coat saying “clinical psychologist” when he met our reporters. He has also been quoted in local media as a “clinical psychologist”.

He said he had just finished (but not yet been awarded) a master’s degree in clinical psychology at Uganda Martyrs University, which is affiliated to the Catholic Church. However, this degree is not listed on the university’s website, and Uganda’s higher education regulator told openDemocracy it is not accredited to offer this programme.

Nsambya Hospital’s director, Peter Sekweyama, told openDemocracy that Mukiibi is “just offering counselling”, and that he is “trained in something like humanities”.

Kasujja, head of the psychologists’ association, said hospitals have a responsibility to ensure their staff are qualified – but warned that without national regulation of counsellors and psychologists, “there is going to be lots of abuse, […] lots of harm”.

No one from Nsambya and Kisubi hospitals responded to openDemocracy’s requests for comment; neither did UCMB nor the HIV clinic at Mulago Hospital.

The US embassy in Kampala did not say if USAID funding to UCMB has been renewed, but the network still seems to be a US government partner as its hospitals implement Pepfar (US President’s Emergency Plan for Aids Relief) activities. In total, about 30% of UCMB’s funding comes from aid donors.

Noah Mirembe, a human rights lawyer and trans man in Kampala, said that Ugandans who have been harmed by “conversion therapy” practices and are interested in legal redress should contact the Taala Foundation (an organisation he co-directs), for support. DM/MC

*Additional reporting by Nnanda Kizito Sseruwagi