As a successor to a meeting on Continuing Medical Education (CME) in 2018, organized by the India Psychiatric Society, Gujarat State Branch, another such session was held on September 26th, 2020, entitled “Towards LGBTIQ+ Inclusive Healthcare In Gujarat”. Given the COVID-19 crisis, the same was held online through a virtual meeting in the form of a webinar. Along with Vikalp, the webinar was organized in partnership with Solidarity and Action Against The HIV Infection In India (SAATHII)1 and Lakshya Trust2.
Manoj Aggarwal, the Additional Chief Secretary to the government of Gujarat, Department of Social Justice and Welfare, opened dialogue by speaking about the Transgender Welfare Board and Fund. He emphasized on the need to ensure:
(1) appropriate use of funds to ensure opportunities for trans persons
(2) a necessary change in medical curriculum.
Dr. L Ramakrishnan from SAATHII provided a brief but important explanation on the term Sexual Orientation, Gender Identity and Expression, and Sex Characteristics, abbreviated as SOGIESC. Here, the torture practice of conversion therapy was also brought up, practitioners of which claim that such ‘therapy’ can make individuals ‘normal’ i.e. the socially accepted and recognized way of being – cisgender and heterosexual.
In this context, Zainab J. Patel carried forward this conversation and cited the Mental Health Act 2017 which provides a legal basis to declare conversion therapy as illegal and therefore liable for punishment. Section 18 (2) and 21 (a) outlaw discrimination on the basis of gender and sexual orientation in provision of mental health treatment, and Section 86 (5) states that a patient cannot be treated in any form without their consent.3 This effectively means that the practice of conversion therapy being illegal.
Dr. Sameera M Jahagirdar elaborated on the “Minority Stress Model” given by I.H. Meyer, explaining how on every level of existence – social, close-network, and individual – persons from the community are vulnerable to experience forms of discrimination, prejudice and stigma. These issues lead to higher chances of indulgence in substance abuse, dying by suicides, being rendered homeless, being vulnerable to violence and trafficking. When left unchecked, these may continue to affect old and senior LGBTQI+ persons. She spoke informatively about trans-specific issues in healthcare, and strongly advocates for positive changes in medical curriculum to make it more sensitive and intersectional.
Manvendra S. Gohil shared his thoughts about the stigma and taboo that exists around HIV testing. Combined with transphobia and homophobia, it translates into lack of access to health and medical services. He was of the opinion that there is an urgent need for change in the education system to help to cultivate and promote sensitivity and inclusivity.
Adhyasa, a trans woman, shared her personal experiences of transition, highlighting in the process the discrimination and stigma she had to face from doctors and psychologists, and how their prejudices affected her mental health and well-being. Kiran and Krish from Vikalp, too, shared their experiences as trans men, and the dilemmas they had to, and still have to, encounter in their daily lives.
For Dr. Rajesh, “inclusion is not an option; its a must”. In order to achieve this, there is a need for holistic involvement to remove misinformation and simultaneously fill those gaps with correct scientific and social information.
Dr. Bhavesh, senior psychologist, discussed the term ‘gender dysphoria’. This term replaced the earlier stigmatizing one i.e. “Gender Identity Disorder” in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5).
The webinar successfully covered medical, psychiatric, legal and police-based developments in the path to creating LGBTIQ+ inclusive spaces in healthcare. It is necessary that positive and intersectional changes are recognized in all of these areas, for they all overlap and play a crucial role in the field of healthcare.