Express news service
CHENNAI: Five years ago, Ramachandran Srinivasan set out to donate blood for the first time with the aim of doing a good deed on his birthday. He didn’t know the hospital needed more than just a sample from a healthy donor. When the gay person started submitting forms, excited to donate blood, he was faced with an unexpected flurry of questions.
“I was asked if I had had sex with men and other intrusive questions: was it penetrating? What was your role? When I refused to answer some of these questions, I was denied the opportunity to donate blood, ”he begins, sharing that despite having recently been tested for STDs, the stigma that homosexuals are likely to be HIV-positive or AIDS-positive influenced the physician’s judgment. staff. This unfortunate incident now marks the memories of his birthday.
“I was looking forward to this, so you can imagine I was very upset by this. I was disappointed, “he recalls gloomily. The next time Ram came back for a blood donation for someone in need, he was forced to hide his sexuality.” I’m a metrosexual person. tend to notice if someone has feminine features and ask them these questions. The last time I gave blood was in 2019, and then they just rephrased the same questions. The situation is slightly better now, but there’s still a lot of stigma and discrimination, ”says Ram, the founder of LGBTQIA + support group Pink People.
This story reveals one of the many battles fought by the queer community in their quest for impartial health care. While the right to health is a fundamental right of every citizen, the reality of it is much less ideal. In a country that has taken 71 years of freedom to recognize the legal existence of LGBTQIA +, a non-discriminatory health care system is a distant dream.
Change on foot?
However, that dream became a little less ambitious on October 13, when the National Medical Commission (NMC) of India issued a notice urging institutions and universities to revise their textbooks, as many medical books contained information. unscientific and derogatory remarks against LGBTQIA + – featuring cross-dressing as “sexual perversion,” the archaic term “sodomy” without distinguishing between consensual and non-consensual sex, for example.
“The information currently in our textbooks runs counter to all advancements in science and medicine, and results in printing with virtually no updates (so far). This information results in bias on the ground, ”says L Ramakrishnan, vice-president of the NGO SAATHII and LGBTQIA + activist. “There are three things to consider. One, pejorative terms. Second, outdated information (for example, referring to homosexuality as a “psycho-sexual disorder” and trans people as “gender identity disorder”).
And third, the lack of essential information about LGBTQIA + people. Of these, the first two were mentioned in the opinion. The third, however, has yet to be processed. This refers to the lack of representation of same-sex attraction or transgender identity in a non-pathological way in pediatrics, for example, ”Ramakrishnan shares.
While the announcement was based on a Madras High Court judgment in September, we also saw clues in the S Sushma case against the Police Commissioner. For the latter, Judge Anand Venkatesh interacted with several members of the queer community, including Ramakrishnan and Dr Trinetra Haldar Gummaraju (Karnataka’s first female trans doctor). The report, written by Dr Trinetra, deals with social rejection, harassment, conversion practices, healthcare and much more, “… He also acknowledged … that institutions in this country do not have absolutely no right to interfere with aspects of identity which are only natural and integral to their overall existence. Perhaps it is time that the pillars of democracy, law enforcement, the medical fraternity admit all their mistakes and make amends. ”Subsequently, it was suggested to the NMC, the Ministry of Education, the Department of School Education and the Department of Higher Education to modify the school curricula and conduct awareness programs.
Stigma and the scourge of fear
Medical fraternity awareness and awareness camps were also mentioned, which are necessary to erase unsavory practices and establish healthy communication with the queer community. This is very necessary, according to Dr Sneha Rooh, a palliative care professional who identifies as a bisexual cis-gendered woman, “We need to train our ground staff on how to deal with LGBTQIA +. A guard once said to my friend, a trans woman and an intensive care doctor, “tu kya hain, main jaanta hu” (I know what you are). ”
However, it also extends to doctors and nurses whose treatment has left many with a bitter taste. “Most of us refrain from visiting hospitals for fear of being judged and embarrassing questions,” says Sharan Karthick Raj, co-founder of Tamil Nadu LGBTIQ and gay. In 2006, Sharan took up residence in a boys’ home in Chennai. With residents not washing bathrooms or cleaning, bacterial and fungal infections have become common. “When I first saw the signs of an infection, I was afraid it was a sexually transmitted disease and was reluctant to see a doctor. I went to a nearby hospital where they treated me for two months but I did not recover. I then hid my sexuality because I had no support and was afraid that they would inform my family (although I am an adult).
Lack of knowledge and awareness in the medical fraternity can often lead to invasive questions. “I was able to get access to doctors who are not too intrusive through friends, but if I had to go to a random gynecologist they would ask me why I am not married – I am 36 years old – and other uncomfortable questions. If a person has a different gender presentation, they are asked strange questions; stranger if you’re not a binary, ”says Deepthi K, a cis lesbian and core team member at the Chennai Queer Club. Marriage matters may seem trivial at first glance, but in such situations they are often used as euphemisms to delve into the sex life of a queer person, shares Ramakrishnan who has heard of troubling cases where doctors impose their lawsuits. concept of femininity and reproduction. “A surgeon, about a hysterectomy, once said to a trans man, ‘How do I remove the uterus from someone who hasn’t experienced the pleasure of childbirth,’ he says. .
Ignorance and information
LGBTQIA + social ostracism aside, unpleasant practices are often born out of ignorance, as many community members report. Curious medical students aren’t particularly sensitive, creating awkward moments for gay patients. “There is also a lot of curiosity because of the lack of exposure. For example, a checkup for an STD would include questions such as: Have you had sex with a man or a woman? How did you get this? Something a straight person wouldn’t hear. Or if not, do you have a uterus? Can you penetrate? And everyone is looking at them. It is understandable that they are trying to learn but they should also consider the point of view of the trans person ”, sighs the general manager of the NGO Sahodaran and the trans woman, Jaya.
Ramachandran agrees, but also observes that Tamil Nadu is more active than most other states. Several NGOs work with the medical fraternity for trainings and workshops. “There is still a long way to go and a need to make provision for minorities and alternative genders. Many NGOs here have links with local doctors for exams, so the community often depends on them. Some on their list are also quite expensive, but some are flexible to give a discount, ”he says, referring to LGBTQIA + friendly physician lists compiled by NGOs. These lists of vetted professionals or queer networks are necessary solutions for some members of the community, who fear seeing doctors otherwise, according to Deepthi.
Lack of skills and resources
Sneha, the founder of Orikalankini and a licensed medical practitioner, witnessed the adverse health system conditions from within. “In terms of infrastructure, very few hospitals have neutral services. Even on the forms, there is a box for the husband and the wife, but none for the spouses. It’s also a problem when it comes to making decisions, ”she says. The same can be said about the toilet, mention the two, Sneha and Ramakrishnan. “The SC has asked all hospitals to be gender neutral, but this is not yet a reality. All toilets are male and female, so transgender and non-binary people and more are often excluded, ”shares the latter, adding that there are challenges in medical education, combined with socio-cultural prejudices against anything heteronormative. and ultimately contributes to inferior quality. unethical service and practices.
With the Tamil Nadu Aravanigal (Transgender) Welfare Board, insurance, education, employment, gender reassignment surgery and transgender clinics are now more accessible, but this does not guarantee a satisfying experience, such as Heena, a trans woman, can attest to this. For her gender reassignment surgery, Heena opted for a public hospital for financial reasons, but encountered disappointing efforts from the medical fraternity. Despite the same implants, Heena said, treatment and care in public and private hospitals was not comparable. The first was inexperienced and had little follow-up after her operation.
“When I had my breast implant surgery (four weeks after the check-up), there was a problem after the operation. But when I returned to the hospital for follow-up, there was no response. They kept delaying the date and finally, after a week, I was there for 10 days before having the implant removed. Two months later I had to spend over a lakh to do it in a private hospital which successfully did it within a week. Wouldn’t I have saved up and went to a private hospital first?
The public hospital said that the 250g implant did not attach (to my body), but then how did the 300g implant attach to the private hospital ?, asks she does. Terms may be imperfect, but over time more and more people are becoming allies, embracing the queer specter – albeit at a snail’s pace – and working to restore LGBTQIA + rights. Today we started with medical manuals and medical lists. Hopefully there are more changes to come.
Medical resources adapted to LGBTQIA +
SAATHII-Varta Orinam secure access
In principle, the right to health is a fundamental right for all citizens, but it seems to be a distant dream for the LGBTQIA + community which frequently faces discrimination and disappointing treatment from the health system.