The Supreme Court of India (SC), the apex court of India, on September 6, 2018 scrapped Section 377 of Indian Penal Code, thus decriminalised consensus same sex relations. With this decision, SC granted right to equality, privacy, life and dignity to LGBTQ (Lesbian, gay, bisexual, transgender and queer). Right to life and personal liberty that is guaranteed by Constitution of India also includes protection of health.
Despite it has been over a year since the decision, LGBTQ members don’t see change in stigma and discrimination they face in day to day life and that include while accessing healthcare.
Shyam Konnur, 30 years old social entrepreneur who owns Queer Bazaar selling artefacts made by LGBTQ in Pune city of India, said whenever he visits hospitals, weird and humiliate questions by health professionals leave him uncomfortable. He said, “I had jaundice in November 2018 and that was two months after SC’s verdict. I visited a doctor at Budhrani Hospital in Pune and as part of check-up he asked me whether I was sexually active. I answered yes and told I am a gay. He instead of examining me or jaundice, started asking questions how do I sex with my partner. He gave me a lecture of morality telling men having sex with men is unnatural and my parents would feel ashamed of me. I felt so uncomfortable that I left the hospital without taking treatment. Can you see despite same sex relations are legal, health professionals yet to understand what that means?”
International Commission of Jurists’ report ‘Living with Dignity- Sexual Orientation and Gender Identity based Human Rights Violations in Housing, Work and Public Places in India’ (https://www.icj.org/wp-content/uploads/2019/06/India-Living-with-dignity-Publications-Reports-thematic-report-2019-ENG.pdf) published in June 2019 mentions that right to health and other rights are inter-dependable and mentions that LGBTQ face difficulty accessing healthcare due to their sexual orientation. The report has mentioned that LGBTQ suffers due to lack of proper housing and affecting their right to health. The report recommends that the state has obligation to ensure there is no discrimination in accessing healthcare due to sexual orientation.
Puppy Deshpande, 25 years old transgender from Pune, in tunics, jeans and stole covering bosom like girls do, told, “I got infection at private body parts in April this year so I visited Dr Kotnis Health Centre at Pune. Doctor did not see my private body parts, did not check heart beats and did not touch me. He prescribed medicines based on my description. When he had to give me injection, he asked me to wipe spot of injection with cotton that he threw at me. Later he injected syringe taking precaution that he would not touch me and again asked me gauze the spot.”
Puppy who stays with parents and begs alms for survival had done make up with red lipstick, bangles, nail polish and would talk in feminine way said, “I did not mention doctor did not talk to me and he was shouting at me. No matter how much fees I pay, I face hate and anger of doctors and nurses whenever I visit clinics or hospitals.”
Sanjana Jadhav, 45 years old transgender from Pune who also begs alms and do sex work, said doctors are not aware of anatomy of transgender and whenever they examine her, they get shocked seeing her private body parts. Sanjana, wearing bright make up with red lipstick, kohl in eyes, big circular vermillion on forehead (Hindu women wear it), big ear tops, and anklets, red nail polish, said, “I go to Command Hospital, a public hospital in Pune, for health issues and staff at the hospital does not know which queue of men or women I should stand in. If I have to be admitted they get confused in which ward I should be admitted. Most of the times, doctors get scared and shocked looking at me as I am a transgender. They have no idea how private body parts of a transwomen look like and they give look like what awful thing I am.”
She added, “Staff at the hospitals or clinic make me wait and later tell me that doctor is not available. I am a strong woman and I can fight for my rights. But many of young transgender who are HIV positive avoid going for Antiretroviral treatment as they don’t bear humiliation they face at hospitals. We seniors accompany them but that is not possible every time.”
As per Lancet report published in 2016, two third of transgender have no access to healthcare for treatment of STD and HIV. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)32222-X/fulltext. Sonali G, LGBTQ activist, from Pune, says nothing has changed even in 2019.
Medical Council of India (MCI) (https://www.mciindia.org/CMS/about-mci/introduction), the arm of Health and Family Welfare Department of government of India, that sets guidelines for medical colleges to design syllabus and also for hospitals to treat patients, has yet to include correct information about LGBTQI in curriculum.
In fact, first ever LGBTI Health-National Symposium, held in March 2019 in Chandigarh city of India, hosted by MCI, United Nations Development Programme- India among others, had underlined that MCI curriculum still describes sodomy and lesbianism as offences.
Dr Venkatesan Chakrapani, chairperson of Centre for Sexuality and Health Research and Policy, who has written several research papers on LGBTQ and mainly Transgender facing difficulty while accessing healthcare, who was also a key figure at this symposium told CNN that, “medical, nursing and paramedical professionals need to be trained for health needs of LGBTQ. Senior doctors who were trained as per old syllabus that would teach homosexuality as disorder, stigmatise and discriminate LGBTQ patient even now.”
Dr Chakrapani who has assisted Ministry of Social Justice and Empowerment to develop policies regarding transgender (http://socialjustice.nic.in/writereaddata/UploadFile/Binder2.pdf), said, “health related research of LGBTQ in India still revolves around HIV and STDs. Their health of physical, mental and social wellbeing need to be addressed. Unfortunately, hardly any study has been done of this.”
Transgender Persons (Protection of Rights) Bill 2019, recently passed bill in India, has no provision for developing different hospitals or wards for trasgender. There is a mention that there should be discrimination against transgender at healthcare facilities.
Dr Sameera Jahagirdar, Assistant Professor, Department of Critical Care Medicine
Mahatma Gandhi Medical College & Research Institute, Pondicherry, who along with health professionals and social activists have written a letter to MCI demanding LGBTQ inclusive curriculum of medical studies.
She said, “Being a doctor, I am aware that many doctors ask uncomfortable questions to LGBTQ patients like how do they sex with partners, or how they feel about it or how can they go on a date and so on. It happens as they are brought up in the same homophobic environment like other Indians do and they forget they are doctors and ask questions like layman. But that humiliates LGBTQ who avoid to go to doctors. I have encountered many LGBTQ who had been to quacks for treatment.
Apart from request to MCI, her college has been developing LGBTQ inclusive curriculum for nursing students.
Nobody from MCI and Ministry of Health and Family Welfare of India responded to calls by this reporter and nobody replied to an email asking what measures MCI is taking make curriculum inclusive of LGBTQ.
A lesbian girl on the condition of anonymity told that it is risky to reveal her identity to doctors as well so she prefers to take self-medication most of the time.