In India, the healthcare experiences of LGBTQIA+ individuals are marred by disparities and inequities; stigma, discrimination and a lack of awareness create a hostile environment
The challenge of unlocking inclusive healthcare primarily lies in the lack of training and sensitivity among healthcare providers. Photo: iStock. In a world that has historically silenced and marginalised the LGBTQIA+ community, pride month stands as a powerful symbol of resilience, empowerment and progress.
As rainbow flags unfurl and vibrant parades take centre stage, it is essential to remember that the fight for LGBTQIA+ rights goes beyond the festivities. It aims to inspire waves of change and action.
In India, the healthcare experiences of LGBTQIA+ individuals are marred by disparities and inequities. Limited access to inclusive services leaves this community grappling with missed opportunities for testing, treatment, and prevention campaigns against sexually transmitted infections and HIV/AIDS.
Mental health challenges, substance abuse issues and alarmingly high rates of suicide further compound the urgent need for targeted intervention and support.
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Data reveals significant disparities and challenges faced by the community in healthcare. A survey conducted by the National Legal Services Authority found that 27 per cent of transgender individuals reported being denied healthcare services due to their gender identity.
A mental health survey conducted by the National Institute of Mental Health and Neurosciences showed that LGBTQIA+ individuals are at a higher risk of mental health issues, with 36.7 per cent reporting symptoms of depression and 21.4 per cent reporting symptoms of anxiety.
Additionally, the National AIDS Control Organization reported that the prevalence of HIV/AIDS among transgender women is nearly 30 times higher compared to the general population. These statistics underscore the urgent need to prioritise LGBTQIA+ healthcare in India, address disparities and ensure equitable access to quality services.
Discriminatory laws and societal barriers exacerbate these health disparities, stifling progress. Despite the Supreme Court of India decriminalising consensual relationships among individuals of any gender in 2018 (Section 377 of the Indian Penal Code), the legacy of Section 377 persists, causing discrimination and hindering healthcare access and socio-economic inclusion.
Stigma, discrimination and a lack of awareness create an environment where seeking appropriate healthcare becomes daunting.
The challenge of unlocking inclusive healthcare primarily lies in the lack of training and sensitivity among healthcare providers to cater to the specific needs of the LGBTQIA+ community.
Lengthy waiting times and limited availability of gender-affirming healthcare services leave many uncertain.
A survey conducted in the United States by the National LGBTQ Task Force and the National Center for Transgender Equality revealed that 19 per cent of transgender individuals reported being refused healthcare due to their gender identity.
It is crucial to establish safe and inclusive spaces that prioritise their unique healthcare needs to promote inclusive healthcare for LGBTQIA+ individuals.
This can be achieved by providing healthcare professionals with culturally competent care training, bridging the empathy gap, fostering a supportive environment and promoting holistic well-being for LGBTQIA+ individuals.
In India, the Transgender Persons (Protection of Rights) Act of 2019 and subsequent rules emphasise non-discrimination and inclusion in healthcare for transgender individuals.
The government has directed states to establish gender-affirming medical facilities in tertiary government hospitals and include gender-affirming procedures in the national health insurance scheme.
Although these directives are yet to be fully implemented, they demonstrate government support for transgender healthcare.
Additionally, the National Medical Commission (NMC) issued a directive in 2022 declaring ‘conversion therapy’ by allopathic doctors as professional misconduct.
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The NMC also responded to the court’s order regarding the lack of LGBTQIA+-affirming content in medical textbooks by mandating corrections in psychiatry and forensic medicine.
Regarding intersex healthcare, the global consensus in paediatrics has moved towards avoiding genital surgeries on infants born with ambiguous genitalia unless they have life-threatening conditions that necessitate such surgery.
Following the Madras High Court verdict in Arunkumar and Anr vs The Inspector General of Registration and ors case in 2019, the Department of Health and Family Welfare in Tamil Nadu has also constituted an expert committee and enacted such a ban in the state.
LGBTQIA+ communities and allied healthcare providers are advocating for a similar ban to be enacted in other states.
The UNESCO International Technical Guidance on Sexuality Education emphasises informed decision-making and empowered choices for all young people, including those in the LGBTQIA+ community. LGBTQIA+ inclusive content in educational curricula fosters respect, understanding and diversity acceptance.
Pride month is a clarion call to raise awareness for inclusive healthcare rights, addressing challenges and promoting inclusive care, mandating collaboration between healthcare professionals, LGBTQIA+ organisations, and policymakers.
To ensure the same, it is essential to incorporate LGBTQIA+ inclusive content in pre-service and in-service training for doctors, nurses, counsellors and other health professionals.
Additionally, institutionalising a ‘non-binary’ or transgender option in healthcare facility intake forms, wards and restrooms is crucial.
Non-discrimination and anti-harassment policies should be implemented to protect LGBTQIA+ staff and students in health facilities and colleges.
Sensitising frontline health workers to issues concerning LGBTQIA+ and gender-nonconforming children is important for providing adequate support to families.
Collaboration between community-based organisations, non-profits like SAATHII and individual activists is also necessary to bring these inclusive changes to public and private healthcare sectors. By implementing these measures, India can strive towards creating an inclusive healthcare system that respects and addresses the diverse needs of all individuals.
Views expressed are the author’s own and don’t necessarily reflect those of Down To Earth
Randhoni is a social work professional working with the non-governmental organisation SAATHII in Manipur, for the past 12 years. Zainab works as a diversity & inclusion consultant, coach, facilitator and supports companies in changing towards more diversity in leadership.
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