When Can Everyone Pluck the Grapes?

This article was exclusively written for The European Sting by Ms. Natasha Sharma, a 4^th Year medical student from Gauhati Medical College, Assam, India. She is affiliated with the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writer and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.

India has had a troubled past with gender and sexual identities in the last 150 years, with the archaic British colonial laws criminalizing homosexuality. There were 3 major Supreme Court judgements within the last 2 decades, de-criminalizing, re-criminalizing and the 2018 historic judgement legalizing homosexuality, trans-genders and gender queer individuals. It has been a socially upward climb for the queer community in India, with legal same-sex marriages, recourses and vacations accepting gay couples, as well as having trans-gender elected members of state.

But what is wrong, if everything is so shiny, one may ask?

In the past, India has had a culture of respecting and tolerating all people, irrespective of how they dress, feel or do behind closed doors. In fact, many cultures revered trans-genders, and the Mughal empire kept eunuchs as personal guards of the noblewomen. Above all, no one was denied justice or resources. But over the last two centuries, a significant part of the population was broadly discriminated against. Where earlier there was no sex separation of public utilities and government resources, regulations made it clear that gender non-binary individuals were unnatural, and not welcome.

Today, society maybe slowly learning to accept the people who fly the rainbow flag, but administrative solutions, public institutions and facilities are still lacking sensitivity and acceptance towards gender diversity. Several organizational defects remain in addressing the integration of all people, and their rights to access basic resources.

Healthcare is no exception. Apart from a few clinics numbering less than hundred in all, catering to a population of more than a million trans-genders, or gender non-conforming individuals, the Indian healthcare structure is flawed. Public as well as private establishments turn trans-genders away, because, which side of the wall do they belong to? Male or female? What will they choose on the intake forms, where there is no option of a third gender? And which gendered utilities shall they avail?

We are taught in our textbooks that following diseases are more prevalent in males or females. But what about patients who are neither? What about those who have undergone sex reassignment surgery? On which side of the risk line do we count them? Their DNA carries a different identity whereas their psychological-physical identity is different. Don’t we need chapters dedicated to their unique circumstance?

It starts with the basics. Healthcare education needs to include gender studies, lessons on effective and sensitive communication with a population, who have been vulnerable for a long time. Making medical literature and standard research and training more accepting and inclusive of the gender spectrum is of utmost importance. Instilling values of respect, professionalism and sensitivity to attend to the needs of our patients, with no prior stereotypes, or administrative crutches deterring us from providing the best possible healthcare to our patients.

Medical school has made me aware of my privileged position in society and advocate for infrastructure development for creating a healthcare system which accommodates for a gender inclusive future, which I hope I can witness.

About the author

Natasha Sharma is a 4^th Year medical student from Gauhati Medical College, Assam, India. She was a member of UNESCO-MSAI Bioethics Unit for last term, and she is currently the Chairperson of the Bioethics Unit at Rotaract Club of the Caduceus, youth wing of the Rotary Club of Bombay Central. She is passionate about Bioethics, and advocate for sexual and reproductive rights. She is involved in research, and hopes to pursue a future in public health. She loves penning her thoughts down but seldom publishes formal writing. She is an avid reader and reads fiction whenever she can.