New Delhi: On September 6, 2018, the Supreme Court pulled down the draconian Article 377 from the Indian Penal Code (IPC), decriminalising homosexuality in the country. In a 493-page groundbreaking verdict, the five-judge bench said that history owes an apology to the community. The bench further said, “We have to bid adieu to prejudices and empower all citizens. Respect for individual choice is the essence of liberty. The community possesses equal rights under the Constitution.”
Social Biases Faced By The LGBTQIA+ Community
Ashok Row Kavi, India’s first gay rights activist, said that scrapping of the article gave members the right to live and cohabit together, but the community is devoid of some of the basic rights and benefits, which are available to the heterosexual couples, like nominating their partners for insurance policies, opening a joint account or adopting a child. Amonf all the community members, the transgender person face experience discrimination more frequently, be it social or gender biases or in accessing healthcare services.
Gender Biases Faced By The LGBTQIA+ Community
Dr Sakshi Mamgain, Founder, UTH-United for Transgender Health, said that the LGBTQIA+ identities are more acceptable to the Indian society than earlier, but acceptance of their sexuality and the ability to freely express their gender and sexual preferences still remains a daily struggle, within the constraints of family, home, and school. Dr Mamgain added,
The stigma, prejudice and discrimination they face for being different further drives them to several mental health issues.
Rudrani Chhetri, a transwoman and a Delhi-based social activist, who has been working a lot for LBTQIA+ rights in India, listed down two major problems faced by the community – gender biases and inaccessibility to healthcare services available to the general public.
Talking about the gender biases, Ms Chettri said,
Even when a child is born, people want to know whether it is a boy or a girl. No one wants to ask how the child is or about their health.
Discrimination In The Healthcare System
Talking about the lapses in the healthcare system, Dr Mamgain, said,
The first red flag is how the transgender health is completely ignored. It is also missing from the medical curriculum in India. There is obviously lack of awareness and the stigma is so deeply rooted that there is discrimination across and somehow all of this finds its way into clinics and hospitals.
Abhina Aher, a transgender rights activist, said that misgendering and denial of access to medical care are also examples of discriminatory behaviours in the public health system. This is because of the lack of sensitisation and awareness about the health needs of the community.
There is no sensitisation in the hospitals about this community. From mistreatment to receiving no treatment at all, we have seen it all.
Accessing healthcare services, even for common ailments, is traumatic for transgender people because they do not fit traditional gender roles, Ms Aher added. She also highlighted the infrastructural gaps in the healthcare system, for example, lack of separate wards for the transgender persons in the hospitals and clinics.
Adding to this, Dr Sakshi Mamgain said the scarcity of doctors specialising in the transgender-related healthcare services is also a major problem in India. She said,
There is a lack of standardised guidelines, protocols for treatment of transgenders. Not many doctors are equipped to conduct Sex Reassignment or Gender Reassignment Surgeries, and provide therapies. All these gaps lead to inconsistencies in care and hinder provision for adequate support for the community.
Talking about the unavailability of an adequate healthcare system in place for surgeries for transgender persons, Uma, a transgender from Bengaluru and founder of non-profit organisation Jeeva, a platform for LGBTQ community, said that the information about the surgeries and therapies is very limited in India. She further added,
Many of us want to go for a proper surgery, but accessibility is not there. Even today, our surgeries are not done in all hospitals, it is only available in a few small places. And the hospitals that conduct such surgeries, the doctors and healthcare staff ratio for such surgeries is less.
The ordeal does not end here. The therapies and surgeries come with a heavy cost. Narrating her story, Uma said,
I got my bottom surgery done at the age of 42, which cost me 2.5 lakh. This was just for the surgery alone, the regular counselling, medical check-ups are not included.
Talking about the unavailability of affordable healthcare, Mohul Sharma, Senior Diversity, Equity, and Inclusion (DE&I) Associate at The Lalit, Delhi, said,
It is very difficult for a transgender person to get a surgery done, because it is expensive and not everybody can afford it. We can either look at routine expenditure or put it all on undergoing a surgery. Plus, if we go for other health checkups, we are faced with all levels of discrimination.
Narrating his experience of the hospital visit, Ms Sharma said,
When I went for my migraine check-up, the doctor set treating my disease aside and started asking me questions regarding my gender. The worst part was when I opened up to them, I was shocked to know that not even one doctor was aware about the issue of gender dysphoria. The doctors could not comprehend how to examine or treat me even after a two-hour conversation. In most cases, doctors avoid trans people.
Ms Sharma said that healthcare is a basic right for every person, regardless of their gender and sexuality.
Interventions Required To Build An Inclusive Society
The activists highlight some of the interventions India needs to become more inclusive and improve the healthcare services for the community:
- Iron out the stigma associated with the community
- Foster a gender-inclusive school environment, wherein the students learn about gender and sexuality. Usage of inclusive language can be an add-on to education.
- Sensitise the young generation and make them aware about the specific needs and care that the community needs
- Increase awareness about the community among the medical and healthcare facilities.
- Conduct sensitisation programmes for the medical and paramedical staff about the diversity of the community and their health problems
- Like Ayushman Bharat TG Plus, the government should introduce more government policies and programmes for the LGBTQIA+ community members
NDTV – Dettol have been working towards a clean and healthy India since 2014 via the Banega Swachh India initiative, which is helmed by Campaign Ambassador Amitabh Bachchan. The campaign aims to highlight the inter-dependency of humans and the environment, and of humans on one another with the focus on One Health, One Planet, One Future – Leaving No One Behind. It stresses on the need to take care of, and consider, everyone’s health in India – especially vulnerable communities – theLGBTQ population,indigenous people, India’s different tribes, ethnic and linguistic minorities, people with disabilities, migrants, geographically remote populations, gender and sexual minorities. In wake of the currentCOVID-19 pandemic, the need for WASH (Water,SanitationandHygiene) is reaffirmed as handwashing is one of the ways to prevent Coronavirus infection and other diseases. The campaign will continue to raise awareness on the same along with focussing on the importance of nutrition and healthcare for women and children, fightmalnutrition, mental wellbeing, self care, science and health,adolescent health & gender awareness. Along with the health of people, the campaign has realised the need to also take care of the health of the eco-system. Our environment is fragile due to human activity, which is not only over-exploiting available resources, but also generating immense pollution as a result of using and extracting those resources. The imbalance has also led to immense biodiversity loss that has caused one of the biggest threats to human survival – climate change. It has now been described as a “code red for humanity.” The campaign will continue to cover issues likeair pollution,waste management,plastic ban,manual scavengingand sanitation workers andmenstrual hygiene. Banega Swasth India will also be taking forward the dream of Swasth Bharat, the campaign feels that only a Swachh or clean India wheretoiletsare used andopen defecation free (ODF)status achieved as part of the Swachh Bharat Abhiyan launched byPrime Minister Narendra Modiin 2014, can eradicate diseases like diahorrea and the country can become a Swasth or healthy India.