Healthcare Rights of the LGBTQIA+ Community
The LGBTQIA+ community is open to risks, disadvantages, and hardships of varied nature in the context of availing medical care. Are the prevalent laws adequate?
7 hours ago
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India’s healthcare systems persistently exclude LGBTQI+ people. While the issue of discrimination in health access is systemic and widespread, a key social group that is on the harshest receiving end of this discrimination is the LGBTQIA+ individuals. In 2018 it was estimated that 104 million Indians (or 8% of the total population) belong to the LGBTQIA+ community in India. Despite this sizable number, the difference in health outcomes for LGBTQIA+ citizens indicates the prevalence of exclusion.
While there is, reportedly, rampant discrimination in treatment and access, the medical rights and laws of the LGBTQIA+ community are the same as it is for the rest of society. However, there are no specific laws to govern, prohibit, regulate actions of discrimination in medical services.
In India, MSM has a human immunodeficiency virus (HIV) prevalence of 4.3% while for the general population this number is 0.3%. Yet, there are many barriers that prevent MSM from getting tested, including stigma and high costs of testing. When it comes to transgender people, almost two-thirds have no access to treatment for sexually transmitted diseases (STDs). While 7.2% of transgender people are living with HIV, only 59% of them have been referred for testing, and 33% have been given counseling about treatment options. In fact, for anybody living with HIV, accessing general healthcare comes with additional roadblocks such as stigma during dental care, excessive personal protective equipment and unnecessary referral to specialist services.
The exclusion from healthcare faced by sexual and gender minorities is exacerbated by the intersection with other identities. If we consider caste, Dalit transgender and intersex persons face a higher degree of exclusion and discrimination in healthcare than their upper-caste counterparts. In a survey conducted among a representative sample of Dalit persons from southern Indian states, 24% said they were denied treatment; 16% said the doctor did not know how to treat their medical condition and 4% experienced physical and sexual assault from their healthcare professionals.
In 2013, a 22-year-old was gang-raped by three men in West Bengal. She was taken to the nearest hospital. The doctors, on examining her, taunted her, “How could you even get raped?” They denied her first aid and did not even prescribe emergency medication for HIV prevention, which is usually recommended to a victim of sexual violence. She left the hospital, called a few friends and looked for a clinic nearby that would treat her without judging her sexual orientation. Still traumatised, the fight for something as basic as access to healthcare became a priority for the young adult.
The vilification of LGBTQ members has in fact become a norm, with doctors, instead of treating the ailment, often sexually harass or abuse a transgender, or worse, condemn the “unnatural sexual preferences" of the person. Justice Indu Malhotra, who was part of the five-judge bench hearing the petitions for decriminalizing Section 377 of the Indian Penal Code, highlighted how the LGBTQ community has been discriminated against even in availing healthcare in semi-urban and rural areas.
A 2016 Lancet paper on transgender health in India and Pakistan says that while the transgender community may have received legal recognition, its access to quality healthcare remains alarmingly scarce. And, there are hardly any anti-discrimination laws in place to safeguard equality in healthcare access. “There are various layers of discrimination in healthcare access in this country. The doctors are curious about the transgender identity, and so exploit them in the process," says Shuvojit Moulik, founder of Civilian Welfare Foundation, an NGO based in Kolkata. “A lot of trans people don’t even go to the hospitals for years, unless there is an emergency, say, an accident."
Early this year, Dandekar formed the Health Professionals for Queer Indians (HPQI), an organization that trains doctors, especially mental health professionals, to understand the health needs of the LGBT community. As the community is closely watching the events unfold on the legal stage, there are so many hopes pinned around it.