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Category 302 is a medical code used to classify personnel in the Singapore Armed Forces (SAF) who are "homosexuals, transvestites, paedophiles, etc.", as stated in a confidential directive. Gay soldiers who declare their sexual orientation to the army medical officers are shunted into this category, a practice which gives rise to much of the discrimination they face during National Service.

Origin[edit]

This medical code is derived from an outdated version of the ICD's (International Classification of Diseases) codes for mental disorders. The ICD is the World Health Organisation's (WHO) healthcare classification system which provides a system of diagnostic codes for categorising diseases for epidemiological, health management and clinical purposes. Singapore's civilian as well as military medical establishments have adopted the ICD system to classify all diseases here.

The SAF's Category 302 bears exactly the same number as the now-defunct ICD-8 (ICD-8th revision, published in 1965) and ICD-9's (ICD-9th revision, published in 1975) codes for psychosexual disorders. "Code 302" in the ICD-8 was the classification for "Sexual deviation"[1] and in the ICD-9 for "Sexual deviations and disorders"[2]. At the time of the ICD-9's publication in 1975, homosexuality, together with zoophilia, paedophilia and satyriasis, amongst others, was included under Code 302.

Cat302-001a.jpg


However, a landmark development was the removal of "homosexuality" from inclusion under Code 302 in the ICD-9 by the World Health Organisation in 1990. In its place was inserted "Ego-dystonic homosexuality"[3]. This change was long overdue as the world's most influential bible for psychiatric diagnosis, the Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association had removed homosexuality from its list of mental disorders in 1973 (see main article: Diagnostic and Statistical Manual of Mental Disorders).

Cat302-002.jpg


The ICD is currently in its 10th revision (ICD-10, published in 1992) and its Chapter V, which deals with mental and behavioural disorders, has overhauled its predecessor's codes entirely - the number 302 is nowhere to be found.

Determination of fitness for combat training and staying in[edit]

Prior to the mid-2000s, homosexual soldiers classified under Category 302 (popularly referred to as "Cat 302" or simply "302") were further subdivided into those "with effeminate behaviour" (in various degrees) and those "without effeminate behaviour" based on the arbitrary observations of psychologist performing the assessment. The higher the perceived level of effeminacy, the lower the PES (Physical Employment Status) grading. One drawback of this arbitrary assignment was that some gay NSmen may fake effeminate mannerisms to obtain a lower PES status, which would in turn lead to less demanding physical training and exemption from staying in camp.

Enlistees certified as transgender are assigned the lowest status of PES F (Medically unfit for any form of service). All personnel with the latter PES grade are not required to serve National Service.

However, the current practice is for the examining psychologist or psychiatrist to assess the suitability of 302 servicemen for combat training or staying in camp based on his medical condition and fitness level, rather than on his perceived effeminacy.

Rationale for use[edit]

It is not clear why the SAF persists in using such an outdated classification of homosexuality in its assessment of the medical fitness of recruits.

A clue is provided in an article entitled, 'Understanding Homosexual Servicemen' written by Mrs. Lily Wong-Ip in 'Council Link', a publication of the SAF Counseling Centre (now removed from this URL:[4]). In her article, Wong mentions the following perspectives of the SAF:

"...it is assumed that gays would threaten discipline and morale.

...it is assumed that the male bonding that takes place in combat would be jeopardised if its potential for erotic contact were condoned.

...it is believed that gays are subject to blackmail in the military context."

Impartial, long-term observations of openly gay men serving in the military in many countries has debunked the above fears. They are completely irrational.

This refusal to jettison an archaic medical concept of homosexuality and harbouring of irrational fears engenders discrimination because the military's grouping of homosexuality together with transvestism and paedophilia further reinforces the general public's misconception that it is abnormal.

It is therefore not surprising that "302" has become derogatory army slang for an effeminate soldier. One NSman recalls that when he approached a table of military personnel during mealtime, one of the officers remarked, "Here comes our 302!".

On the other hand, the SAF may also have the benevolent intention of protecting servicemen classified under Category 302 from emotional and physical abuse by their heterosexual counterparts and homophobic colleagues. Indeed, some gay servicemen think that it is beneficial for them to be thus classified. Another advantage was the former exemption of even masculine Category 302 personnel from staying in camp and from combat training.

Other reasons for the SAF's reluctance to abandon the outdated ICD-9 for the more comprehensive and contemporary ICD-10 may be the fear of how military medical practice will handle the drastic change with large-scale alterations required in order to ensure documentation is up to standard with full detail and specificity, the cost of implementation and increased administrative complexity. Not only is the coding organisation different, the sheer number of additional codes due to increased specificity is daunting. Using the new codes effectively and efficiently takes practice and time[5],[6],[7]. In fact, the Ministry of Health only migrated all Singapore hospitals and clinics from ICD-9 to ICD-10 in the early 2010s, and it was an extremely complicated, expensive and time-consuming process[8] which the SAF did not want to follow.

However, since the mid-2000s, military manpower authorities have gradually become more enlightened about homosexuality, i.e., it was part of the normal spectrum of human sexuality. SAF doctors have also accepted the fact that homosexuality had been removed from the ICD-9 coding system they use since 1990. This had led to the non-exemption of masculine, self-declared gay NSmen from combat training and from staying in camp. But with Category 302 still in place, homosexuals in the military are marked as being different and this subjects them to potential discrimination.

Category 302 in popular culture[edit]

"Glad to Be Gay", a 1978 song by British punk rock/new wave group Tom Robinson Band and considered to be the United Kingdom's national gay anthem was dedicated to the World Health Organisation because of its International Classification of Diseases' Code 302[9],[10].



See also[edit]

References[edit]

Acknowledgements[edit]

This article was written by Roy Tan.