Medical textbooks in India have been found to contain outdated principles citing homosexuality as a pathological disorder. Such information could be enshrining this way of thinking into a new generation of doctors, leading to poor health outcomes in the LGBTIQ community as a result of discrimination.
Dr Sameera Mahamud Jahagirdar, Assistant Professor at the Department of Critical Care Medicine, Mahatma Gandhi Medical College & Research Institute who headed this study, – spoke to Health Issues India on the matter, as well as her own personal experiences as a member of the LGBTIQ community within the healthcare field.
“In India, most of the undergraduate medical textbooks are not as per evidenced based Medicine (EBM). EBM here stands for Experience Based Medicine where the experience is gained by wrong doings. These are mostly written by ‘experts’ or so called ‘doyens’ of the respective medical subjects. Such textbooks infuse medical knowledge which is intended to pathologize the LGBTIQ related content in the curriculum. On the contrary, any subject related to sexuality, gender variations are never being taught by these teachers to their students. They are selectively omitted.”
Dr Jahagirdar, along with her colleagues have performed extensive analysis of currently used textbooks, with the intention of raising awareness, as well as eventually bringing these textbooks in line with modern-day thinking.
“As a part of Vistaara project through SAATHII [Solidarity and Action Against the HIV Infection in India], myself and my colleagues, Dr L Ramakrishnan and Mr. Biswabhushan Patnayak, researched all the LGBTIQ pathologizing medical content as a phase one of the project. The next step involves eliminating these errors and building a more LGBTIQ inclusive medical curriculum.”
Dr Jahagirdar, as a transgender individual herself, has witnessed first-hand the prejudices held both in Indian society as a whole and within the medical community.
“My journey of transition to my desired gender identity started from 2011 onwards. Being a Doctor from a middle-class Indian Muslim family, I had to struggle to [manage] two different but equally demanding choices: my medical profession and gender Identity conflicts. I had my gender reassignment surgery (male to female) organised by myself through my workplace hospital’s “Gender Care Team”, which was the biggest challenge of my life.”
However, for many individuals who identify as transgender, these services are beyond reach. Gender-based services are lacking across much of India, with most services being located within cities. For those who can access the services, high costs present another barrier.
“Medical care is negligibly offered to the trans community in India. The surgical gender affirmation is at [a] meagre status to be affordable to poor and middle class working Indian transgender people. Moreover, there is [a] nonexistence of gender affirmative procedure related protocols, their awareness, and safety.”
The lack of care provided for those seeking both surgical gender affirmation, and counselling services is a severe hindrance to the LGBTIQ community within India. The absence of these services can result in anxiety and depression among those who identify as transgender, particularly in situations in which they deal with societal stigma.
Stigma being prevalent even among the medical community only exacerbates this issue. Dr Jahagirdar thus took the brave steps of leading the way into changing this situation.
“Being medical personnel, this made me look into the creation of channels to take part in [the] organisation at my own workplace by creating policies, protocols and acting on them. I became a walking example of ‘Transitioning Transgender Employee’ of the medical institution.
“Currently I am taking the initiative to organise and participate in activities related to Transgender community services apart from my passionate carrier in Critical Care Medicine.”
Dr Jahagirdar is part of a number of organisations and fulfills a number of roles in furthering the rights of the LGBTIQ community. She is the “Gender Care Team” secretary, overseeing the organisation of protocol for the Gender Care Team to help surgical transitioning of transgender clients. She is a resource person for SAATHII and is involved in efforts to help in the sensitisation of local Transgender community of the effects and side effects of cross-hormone therapy.
Dr Jahagirdar’s current work with “Project Vistaara: Medical & Health Domain” is entitled “Ending Discrimination and Expanding Access to Inclusive and Stigma-free Services for LGBTI Communities in India: A Four-state Initiative”. As part of this initiative the project aims to set up an Integrated Transgender Health Nursing Curriculum, with the direct aim of addressing the issue of stigmatisation within the medical curriculum and the medical community. The results of the project will be unveiled in the coming months.