It is evident from experiences shared at the State Consultation for MSM and Transgender in Science City, Kolkata that the quality of healthcare that MSM and transgender communities have access to is appalling. Dr Venkatesan Chakrapani, Policy and Research Adviser, Indian Network of People living with HIV (INP+) presented some challenges and what could be done to realize the right to health for MSM and transgender. Read more
“There are barriers at the individual level regarding health. The situation needs to change so that MSM and transgender people have better understanding about health issues and increased access to non-discriminatory healthcare services” said Dr Venkatesan Chakrapani.
“Then there are barriers at the healthcare system level with limited understanding and competency in providing quality healthcare to MSM and transgender people. Attending to health needs of MSM and transgender people is not part of medical curriculum and training so that needs to be done so that healthcare workers have a better understanding and competency in providing quality healthcare to MSM and transgender people” said Dr Venkatesan Chakrapani.
The needs of MSM and transgender communities are not addressed adequately in the present healthcare system. For instance, sex reassignment surgery, gender transition procedures etc are hardly provided in non-stigmatising and non-discriminatory healthcare settings. The competency of healthcare staff for such procedures is also an enormous challenge.
Then there are other challenges that make it difficult for transgender and MSM people to access healthcare from public health system. There is no separate queue for them in hospitals and transgender people aren’t allowed to stand in women’s queue. Transgender people have to put on the male dress when admitted in hospitals, and are forced to stay in male ward. These are clear deterrents that make it difficult for MSM and transgender people to avail of existing healthcare services in public health system, said Dr Chakrapani.
“Among the healthcare provider, in general there is a negative attitude towards both MSM and transgender people” said Dr Chakrapani.
“Homosexuality is not listed as a psychiatric disorder in both guidelines followed by psychiatrists. Even if the psychiatrists are sensitive to MSM and transgender people, still they may not be capable of providing quality care because the mental health issues of MSM and transgender people are not being taught in medical curriculum” said Dr Chakrapani.
“At policy level, focus is on bringing down the HIV prevalence but not on an individual. Currently HIV counselling is not dealing with broader sexual health issues” said Dr Chakrapani. “We need a robust comprehensive national health strategy for sexual minorities to address issues related to physical, sexual, and mental health” added Dr Chakrapani.
“Engaging MSM and transgender communities in the dialogue on what changes can be brought about in the healthcare system and then devising appropriate strategies is essential” said Dr Chakrapani.
“Advocating with the State Directorate of Medical Education and Medical University management to include the health issues of sexual minorities in the medical curriculum is another area where MSM and transgender people can play a lead role” said Dr Venkatesan Chakrapani.
“MSM and transgender people should advocate with local branches of professional organisations to conduct sensitisation and training programmes for healthcare providers in their constituencies” said Dr Chakrapani.
“Advocating for formulation of national strategies for sexual minorities needs to be done in consultation with community groups” said Dr Chakrapani.
The public health system in India has made some interventions to improve healthcare for MSM and transgender. For example, in Tamil Nadu state of India, sex reassignment surgeries (SRS) is being provided free of cost in select government hospitals – although it only covers operating and other hospitalisation related costs. The environment in such settings is also tainted with discrimination and stigma towards MSM and transgender people and much more needs to be done to make these model interventions.
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