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Indian Medical Education needs to stop promoting Queerphobia

By: Shivani Raheja

October 18, 2021

“Equality means more than passing laws. The struggle is really won in the hearts and minds of the community, where it really counts.” – Barbara Gittings

Being queer in India comes with many challenges. It was very recently, in 2018, that the LGBTQIA+ community was allowed to breathe a sigh of relief as Section 377 of the Indian Penal Code was read down by the Apex Court of the country in the Navtej Singh Johar vs Union of India judgement. The reading down of the section officially announced to India that engaging in sexual acts with adults of the same sex, with their consent, was no longer criminalised in India. 

While, the judgement was heartily welcomed by all members of the community, non-cisgender and non-heterosexual people knew that this would only be the first step in a long climb ahead of the community. Since 2018, activists, academicians and people from various backgrounds throughout India have become vocal and started to voice the rights of the LGBTQIA+ community and we are far from achieving our goal.

Indian Policies need to evolve to accommodate the LGBTQIA+ community

Reading down Section 377 was step one. However, the queer community still does not have civil rights in India- right to legally marry one’s partner or adopt children. Some organisations are making additional efforts to include the community and their needs- like Axis bank, in 2021, announced a charter of policies among which the option having a Joint Savings account with same sex partners is now open to the public. 

The efforts of private organisations to include the LGBTQIA+ community are appreciated. However, it would be ideal for all stakeholders involved, that the State lead by example. While the 2018 judgement created an option of public discourse about queer rights, civil society remains handicapped unless the government take initiatives to engage, educate and guarantee rights. 

The 2019 Transgender Persons (Protection of Rights) Act which was passed by the Parliament was problematic and insulting, to say the least. Some aspects of this Act were later flouted by the Transgender Persons (Protection of Rights) Rules, 2020 which were notified in September 2020. These rules scrapped the compulsory medical examination that transgender individuals had to go through as stated in the July 2020 Rules. 

The medical examination of trans individuals, as argued by stakeholders, was an infringement on their bodily autonomy and right to privacy. The medical examination allowed an official like a District Magistrate to verify a trans person’s gender identity. 

Since civil society argued that such a medical examination was unconstitutional and demeaning, the rules notified in September 2020, instructed the District Magistrate to process the applications of trans individuals on the basis of an affidavit provided by them declaring their gender, without any physical or medical examination.

The effect of the pandemic on the Indian queer youth

Life as a queer youth in an Indian family is not often a pleasant experience. Many youths do not come out to their family because of the fear of repercussions. However, the privileged youth who can escape their family home, do so at any chance they get. This allows them to freely explore their gender, their sexuality and the way in which they wish to express their identity. 

The queer community in certain metropolitan hubs of India is very vocal and expressive. LGBTQIA+ youth often flock to bigger cities to seek this sense of community, unshackled by familial expectations back home in the smaller cities. 

While cities like Delhi, Kolkata, Mumbai, etc. openly host pride parades and have public spaces especially organising events for youth on the queer spectrum, it is still taboo in most of the other parts of India to be anything but cis-het.

The COVID-19 pandemic is a global phenomenon that overwhelmed even developed nations. India tackled it with a strict six-week lockdown between March and May. This lockdown meant access to limited amenities. It was a psychologically tough time for many. However, it was an extremely scary reality for many queer youths. 

In light of all the restrictions, they had to shift back home. For some it meant going back into the closet, while others had to go back to houses where their personality was not fully welcome. These youth, however, were the comparatively luckier ones. There were many youths who had been ostracised from their families for their queer identities and they had no family to go to, even in a pandemic. Domestic violence cases went up in the lockdown and many queer youths were afraid of being subject to their family’s unpleasant behaviours.

It was particularly nerve-wracking for trans youth who were undergoing transitioning. Since transitioning didn’t qualify as an emergency health procedure- many people could not get access to assistance or necessary medicines/ injections. The supply chains were delayed and the pharmacies were crowded and understaffed.

Privacy is also a major challenge in Indian houses. Families do not understand the need for privacy and boundaries. Therefore, many queer youths who can afford therapy and have access to a therapist were unable to speak to their therapists and get necessary help because of lack of privacy. This raised their levels of anxiety. 

What the LGBTQIA+ youth need

The Indian government spends only 1% of its GDP on health. Not even a fraction of this is spent on mental health. As per the global estimates based on “Kinsey reports,” India is estimated to have around 135 million people on the LGBTQI+ spectrum. The government cannot de-criminalise a gender and sexual minority and expect them to just survive.

 

Making use of its paternalistic powers, the government has to ensure that the needs of people belonging to this minority are met. LGBTQIA+ people need that the archaic institutions in the country be reformed in order to accommodate them. 

 

Queer youth need access to mental health professionals, to not only accept their own sexuality, but also to navigate through family and social life. Youth in India do not have access to affordable therapists or psychiatrists. One session with a mental health professional can cost more than a thousand Indian Rupees. This makes youth, especially those who live off their parent’s income, hesitant to approach the professional help they need.

Gender and sexuality are also a taboo in India. Our schools do not give us proper sex education and when they do, it is from a cis- and hetero-normative perspective. This leaves a lot of adolescents feeling like there is something wrong with them and that they aren’t “normal.”

The education boards of the country need to approach sex education from a more diverse point of view. Teachers who are open to discussions about gender and sexuality should be hired and schools need to have queer affirmative counsellors instead of just queer friendly ones.

It is imperative that LGBTQIA+ youth also see the Indian media portraying a more positive image of the community instead of the engrained stereotypical one. The government should essentially launch initiatives to educate adults in the country about gender and sexuality. The use of pronouns in government forms and official ids needs to be adopted. 

Unless the State launches initiatives to normalise conversations regarding gender and sexuality, it is highly unlikely that people will stop seeing queerness as taboo. We need to start dialogues about people being not cisgender and not heterosexual to erase the antiquated idea of the “normal” in society. 

Why Indian medical education needs to be revamped

The Madras Hight Court, in a recent judgement stated that they were abhorred by the language used in the country’s medical curriculum. The judge referred to a report filed by a transwoman, Dr. Trinetra Haldar Gummaraju, and directed that the medical curriculum in Chennai be rectified to remove queerphobic language. 

Dr. Gummaraju’s report gave instances of how the curriculum describes “‘sodomy’, ‘lesbianism’ and oral sex as sexual offences, and ‘transvestism’ (cross-dressing) as a ‘sexual perversion’.” In its judgement, the court noted that it was important for people in the medical profession to be “non-judgemental and free of moral or personal prejudices.” India guarantees a right to equality to all its citizens and no person should be discriminated against based on their gender or sexual identity. 

It was also noted by the court that the outdated curriculum was dangerous as it was reaffirming queerphobia and posed an inherent risk to queer people who might approach physicians or psychiatrists whose education legitimised this sort of discrimination. 

The court also observed in its judgement that conversion therapy disguised as “treatment” should be illegal and strict action should be taken against professionals who try to “cure or change” the sexuality of patients who approach them. 

In conclusion, the Indian medical curriculum needs to be revamped:

  • To educate medical professionals about the difference in gender orientation and sexual orientation,
  • To ensure that professionals know that conversion therapy cannot fix gender or sexuality,
  • To remove taboo surrounding the queer community and lastly,
  • To ensure that trans individuals do not face traumatic experiences in getting medical help. It is very necessary for India to recognise the need for specialised health professionals for trans people so they can seek advice, get general medical care and actively transition in the country without facing harrowing experiences at the hands of the medical community. 

The first step to acceptance is always awareness. Queerness is not a new concept in India and has existed since age immemorial. The fluidity of gender and sexuality in India can be observed through ancient texts and architecture. 

Uptil the 1700s, Indian society held no bias against people for their gender or sexuality. It was only due to the British Raj imposing S. 377 in India, that the perception of Indians changed regarding trans people and non-heterosexual people. 

India needs to make an effort to educate people about the way colonialism impacted their perception of the queer community. It will undoubtedly take a lot of time for the country to tackle queerphobia at grassroots level.

However, we can ensure that atleast the literate class of Indian society accepts the community. It is very necessary for our medical and legal institutions to accept queer people, embrace them and help guide them through the stages of acceptance and transformation as required. India needs to include the LGBTQIA+ community in its socio-cultural and economic decisions to truly embrace the spirit of the diversity that the country brags about in the preamble to its Constitution.