Healthcare systems and Queerness in India

One of the many government systems where LGBTQ people do experience discrimination against them is the healthcare system in the country. Until the petitions in the Madras Court and the Kerala High Court in 2021, there had not been enough mainstream conversations in India about the “healthcare system and queerness.” The petitions spoke about the queerphobic literature in the medical curriculum.

A few areas where the discrimination and exclusion of LGBTQ individuals are way too obvious: mental health, sexual health, and COVID-19 vaccines.

The Trevor Project National Survey talks about the alarming numbers surrounding mental health issues. Members of the LGBTQ community are far more prone to suicidal thoughts and other mental health issues than the non-LGBTQ population in general. Another study reports that around 70% of men who have sex with men (MSM) and around 91% of transgender individuals face depression, and also resort to the use of alcohol due to violence. Apart from the higher prevalence rates of mental health issues, the pathologizing of the identities that prevent access to mental healthcare adds to the discrimination these individuals face.

Reports throughout the pandemic have mentioned how a large section of the LGBTQ community has faced barriers while trying to access COVID-19 vaccines. The lack of an acceptable photo ID, especially for transgender people, made it hard. For transgender people, their older documentation probably doesn’t take into account their gender and has the gender assigned to them at birth. Apart from the ID card-related issues, there were fears in the LGBTQ community regarding the side effects of the vaccine. There were apprehensions about the potential side effects for those undergoing hormone replacement therapy (HRT).

While for the general population, the HIV prevalence is 0.3%, for the MSM population it stands at 4.3%. Even with such a high number, there are barriers to accessing testing and medication. A study says that in the transgender community, almost two-thirds have no access to treatment for sexually transmitted diseases. This discrimination faced by the LGBTQ community is further aggravated by the intersection with other castes and religious identities in India.

While all these issues of discrimination in health access are systemic, they require intentional interventions by governments to solve them. But apart from these systemic issues, there is much that civil society can do.

Organizations that work in the healthcare space should ensure that their staff, documentation, and practices are inclusive. Inclusivity should be a part of all businesses and government systems, but there is a pressing need for it, especially in the healthcare sector. For example, reports or intake forms at the hospital or clinic should have more than gender binaries and include transgender and non-binary identities.

Non-normative families, or chosen families, are another important factor in the LGBTQ population. In their practices, the healthcare system should be careful not to make normative assumptions about families and relationships. LGBTQ people often leave or are abandoned by their natal families and have a ‘chosen’ family instead.

The Indian healthcare system must fully include everyone, and the path to that goal necessitates discussions about healthcare that go beyond simply discussing availability and affordability.