LGBTQIA SENSITIVITY AND HEALTHCARE AWARENESS

A ROUGH DRAFT SUBMITTED IN THE COURSE OF LAW RELATING TO

WOMEN AND CHILD

SEMESTER X DURING THE ACADEMIC YEAR 2022-23.

SUBMITTED BY-

NAME :- ADITI CHANDRA

ROLL NO. - 1806

B.B.A., LL. B. (HONS)

SUBMITTED TO-

MS. SUGANDHA & MR. VIJAYANT SINHA

FEBRUARY, 2022

CHANAKYA NATIONAL LAW UNIVERSITY, MITHAPUR, PATNA, 800001

INTRODUCTION

Inequality is one of the most defining characteristics of Indian society and economy.
An area that demonstrates this is healthcare—health outcomes in India continue to
be closely tied to socioeconomic status, identity, and community. A key social group
that faces systemic exclusion from healthcare in India is the LGBTQ+ community.

There are various layers of discrimination in healthcare access in this country. The
healthcare providers often questions and ridicule about the sexual orientation or
gender identity of the patient in the process. The level of homophobia and insensitive
behaviour that starts from the guard to the receptionist to the doctors to lab
technicians often discourages people of the community to go the hospitals. It was this
particular problem that drove Prasad Raj Dandekar, a radiation oncologist at a top
Mumbai hospital to form the Health Professionals for Queer Indians (HPQI), an
organization that trains doctors, especially mental health professionals, to understand
the health needs of the lesbian, gay, bisexual and transgender community.
Healthcare needs of the various members of the community should be considered to
provide the best care and avoid inequalities of care.
Culturally competent care of a member of this community includes:

 Care that targets a specific population

 Social and structural equality of care

 Avoidance of discrimination and stigmatization

Members of the LGBTQ community have unfortunately experienced a challenging

history, but health professionals can learn to provide compassionate, comprehensive,
and high-quality care with proper sensitization, training and education.

Objective of the study

1. Describe acceptable terms for gender and sexual identity in the lesbian, gay,
bisexual, transgender, or queer community to help gain a better understanding of
the challenges and issues faced by them.

2. Summarize common health issues and challenges therefrom in the care of the
lesbian, gay, bisexual, transgender, or queer community.
3. Discuss laws related to physical and mental healthcare of the lesbian, gay,
bisexual, transgender, or queer community.

4. Suggest strategies to provide culturally correct evaluation, better and more

considerate treatment of the lesbian, gay, bisexual, transgender, or queer
community.

Hypothesis

The researcher would like to undertake the following hypothesis:

1) That there exists an enormous gap between the judicial and legislative
developments with respect to LGBTQ laws in India.
CHAPTER 1) NEED FOR FAVOURABLE AND INCLUSIVE HEALTHCARE FOR
LGBTQIA COMMUNITY

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. There was even a case of a
transgender, a victim of a train accident, dying unattended, because for 3-4 hours,
doctors could not decide whether to admit her to a male or female ward. 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 traumatized, the fight for
something as basic as access to healthcare became a priority for the young adult

These incidents indicate how deep-rooted this problem is and how it affects the basic
right to life and equality of the LGBTQIA individuals.Right to Health is a part and
parcel of Right to Life and therefore right to health is a fundamental right guaranteed
to every citizen of India under Article 21 of the Constitution of India. We owe the
recognition of this right to the fact that the Supreme Court of India, through a series of
judicial precedents, logically extended its interpretation of the right to life to include
right to health

CHAPTER 2) CONCEPTS AND ACCEPTABLE TERMS

Many people refrain from talking about sexual orientation and gender identity or
expression because it feels taboo, or because they’re afraid of saying the wrong thing.
Words help people give the words meanings to help make conversations easier and
more comfortable. LGBTQ+ people use a variety of terms to identify themselves, not
all of which are included in this glossary. This freedom of expression is important,
particularly when communicating with people from cultures that do not accept gay,
lesbian, or bisexual identities and may want to use other terms which might be
extremely derogatory to the community.
We begin with two concepts: sexual orientation and gender identity. All people have a
sexual orientation and a gender identity. Sexual orientation and gender identity are not
the same thing.

2.1 Sexual Orientation

Sexual orientation tells you how a person characterizes their sexual and emotional
attraction to others. Some people are attracted to people of a particular gender; others
are attracted to people of more than one gender. Some are not attracted to anyone..
Common words to describe sexual orientation are: Asexual, gay, lesbian, bisexual,
pansexual, questioning, heterosexual etc.

2.2 Gender Identity or Expression

The ways in which a person identifies and/or expresses their gender, including self-
image, appearance, and embodiment of gender roles. One’s sex (e.g. male, female,
intersex, etc.) is usually assigned at birth based on one’s physical biology. One’s
gender (e.g. male, female, genderqueer, etc.) is one’s internal sense of self and
identity. One’s gender expression (e.g. masculine, feminine, androgynous, etc.) is
how one embodies gender attributes, presentations, roles, and more.

CHAPTER 3) COMMON HEALTH ISSUES FACED BY THE LGBTQIA PEOPLE

There are no LGBT-specific diseases or illnesses. However, LGBT people are more
likely to experience certain health issues compared to people who are not LGBT.
These health issues are mostly related to the stigma and discrimination experienced by
LGBT people in their daily lives—including at school or work, in public places, or at
health care settings. Being a member of a group that experiences discrimination can
cause high levels of stress (sometimes called minority stress), which can lead to
unhealthy coping behaviors and a broad range of health problems. For example, an
LGBT youth who is bullied by schoolmates may become socially isolated and turn to
drug use. Other experiences of discrimination can be the direct cause of health issues
requiring medical intervention. For example, a transgender person who is physically
attacked.

3.1 Physical Health

Gay and bisexual men are also at a higher risk for other sexually transmitted
infections (STIs), such as chlamydia, syphilis, and gonorrhea, which can all greatly
increase the chance of getting or transmitting HIV. Research published in LGBT
Health in 2019 highlights high rates of substance abuse disorders in the LGBTQ+
community. In comparison to their straight peers, LGBTQ+ individuals experience
unique stressors such as bullying, harassment, fear of rejection, internalized
homophobia, body image distress, barriers to accessing medical and mental health
treatment, and violence. These stressors place them in a higher risk category for the
development of eating disorders and other mental health issues.

3.2 Mental Health

Individuals belonging to sexual and gender minorities typically have higher

prevalence rates of mental ill health compared to the rest of the population. For
example, a qualitative study with queer women found that anxiety, high substance use,
and suicidal thoughts were a common part of their experiences. Another study found
that 70 percent of men who have sex with men (MSM) and 91 percent of transgender
persons faced depression, frequent alcohol use, and victimization due to violence.
CHAPTER 4: CHALLENGES IN CARE OF LGBTQIA PEOPLE

There are many reasons why LGBT people have difficulty accessing health care.
Most of these problems can be summarized in three categories.

4.1 Limited Access

First, they may have trouble with basic access to care. LGBT people are less likely to
have health insurance, either because they have been rejected by their families when
they are young, or because they are unemployed or homeless, or because they require
services that are not available to them even when they have health insurance.

4.2 Negative Experiences

Second, they may experience discrimination or prejudice from health care staff when
seeking care. Bad experiences with inadequately-trained professionals are a big
reason why LGBT people do not seek medical care; many also report that they look
for clues when arriving at a health care facility, such as the way they are greeted by
staff, whether non-discrimination policies are posted in public areas, or if there are
single occupancy or gender-neutral bathrooms.

4.3 Lack of Knowledge

Third, LGBT people sometimes discover that providers do not have knowledge or
experience in caring for them. These barriers present a challenge for LGBT
individuals and health care staff throughout the nation. The good news is that
overcoming them does not require extensive training or highly technical expertise.

CHAPTER 5: INDIAN LEGAL AND JUSTICE SYSTEM ON LGBTQIA RIGHTS

Despite homosexuality been decriminalized, the laws in India still remain hostile and
prejudicial towards the LGBT community in several ways.The reason behind this is
that there exists an enormous gap between the legislative and the judicial development
of LGBT laws in India. So, though the Supreme Court of India through the landmark
judgments of National Legal Services Authority v. Union of India, Navtej Singh
johar v. UOI, and Justice K.S.Puttaswamy v. Union of India (Puttaswamy) has laid
the groundwork to confer upon the queer and non-binary community a bundle of
fundamental rights, but the legislature has failed to keep up with the recent
developments. So essentially speaking, the same-sex couples now have the legal right
to cohabit and conduct their personal affairs without any fear of persecution but are
still denied equality of treatment in various aspects. Thus, it is imperative to take the
conversation forward and talk about the various laws that continue to discriminate
against the LGBT+ persons. It includes anti-discriminatory laws such as no
recognition of same-sex marriages, no rights for adoption, surrogacy etc. A detailed
analysis of few landmark judgments and legislations like Transgender
Persons(Protection of Rights) Bill, 2019, or legislations surrounding areas like
marriage, adoption, surrogacy, guardianship, inheritance, protection at workplace
etc show how the community and its needs have blatantly been disregarded. Several
of their fundamental rights like Right to Equality (Art 14), Right to Life which
includes several other basic human rights like right to healthcare and medical aid,
right to dignified life, right to privacy etc, are still being violated.

CHAPTER 6: SUGGESTED STRATEGIES FOR PROVIDING BETTER HEALTHCARE

ACCESS

Better patient outcomes will be achieved in the care of the LGBTQ community if
providers learn the terms, healthcare risks, and maintain a good fund of knowledge in
the care of these patients. It is most important to be respectful of the LGBTQ patient
and remember that the challenges they face from society are substantial.
6.1.Sensitization to overcome behavioral and communication challenges
Simple changes in forms, signage, and office practices can go far in making LGBT
individuals feel more welcome. For instance, intake forms can be revised to be
inclusive of a range of sexual orientations and gender identities. All staff, including
receptionists, medical assistants, nurses, and physicians, can be trained to deal
respectfully with LGBT patients, including using patients’ preferred names and
pronouns. Educational brochures on LGBT health topics can be made available where
other patient information materials are displayed.

6.2. Promoting privacy and confidentiality

Some members of the LGBTQ community may not make their gender or sexual
orientation public. Further, they may not be used to discussing their relationships with
others. The health provider needs to assure the patient that their communication and
medical records, including tests and results, are confidential.

6.3. Changes in the legal and public health system

Local and state laws and regulations can serve a greater good and improve LGBTQ
health access — or they can perpetuate discriminatory practices and put people at risk.
Public health professionals fill a critical role in advocating for policy change that
creates a more equitable healthcare system for all.

CHAPTER 7: CONCLUSION

The success of health-care organizations of all types—from academic medical centers,

community hospitals, and community health centers to the many community-based
services with which they work to ensure continuity of care—depends on providing
high value care to patients that optimizes quality and clinical effectiveness while
keeping costs in check. Providing culturally competent care to LGBT patients does
not differ from providing patient-centered care to any other group. As with all patient
populations, effectively serving LGBT patients requires clinicians to understand the
cultural context of their patients’ lives, modify practice policies and environments to
be inclusive, take detailed and non-judgmental histories, educate themselves about the
health issues of importance to their patients, and reflect upon personal attitudes that
might prevent them from providing the kind of affirmative care that LGBT people
need. By taking these steps, clinicians will ensure that their LGBT patients, and
indeed all their patients, attain the highest possible level of health.