Advancing LGBTQI+ Health in India: evidence,and research and policy/program priorities from the 'Second National Symposium on LGBTQI+ Health'

Title

Advancing LGBTQI+ Health in India: evidence,and research and policy/program priorities from the 'Second National Symposium on LGBTQI+ Health'

Presenter

Chiranjeev Bhattacharjya

Authors

V. Chakrapani (1), S. Rawat (2), C. Bhattacharjya * (3), S. Kaur (4), A. Singh (5), S. Bharucha (5), L. Ramakrishnan (6), K. Ranade (7)

Institutions

(1) Centre for Sexuality and Health Research and Policy (C-SHaRP), Chennai, India, (2) Humsafar Trust, Mumbai, India, (3) United Nations Development Programme (UNDP), New Delhi, India, (4) USAID India, New Delhi, India, (5) John Hopkins University (JHU) ACCELERATE, Hyderabad, India, (6) Solidarity and Action Against the HIV Infection in India (SAATHII), Chennai, India, (7) Tata Institute of Social Sciences (TISS), Mumbai, India

BACKGROUND: With Supreme Court verdicts decriminalizing adult consensual same-sex relationships (2018) and recognizing the rights of transgender persons to self-affirm their gender identities (2014), India's legal climate looks promising for promoting the rights and health of Lesbian, Gay, Bisexual, Transgender, Queer and Intersex (LGBTQI+) people. To leverage this enabling environment to advance research and actions, and share best practices in LGBTQI+ affirming healthcare, a 'Second National Symposium on LGBTQI+ Health' was held in December (9-11) 2021, in New Delhi, India. Key findings are presented below.
DESCRIPTION: In this hybrid mode-symposium with 14 sessions, 130+ persons attended in person and 1000+ people watched the live-streamed proceedings. Speakers/panelists identified several gaps in LGBTQI+ health research, policies and programs. In relation to men who have sex with men (MSM) and transfeminine people, the government's focus has been on HIV prevention and care, with inadequate attention on mental health, alcohol/substance use, online HIV prevention interventions. Only a few state governments reimburse costs of or provide free gender-affirmative hormones/surgeries for transgender persons. Limited understanding of the health needs of LGBTQI+ people, secondary to misinformation in medical curricula, lack of institutional policies on gender categories in outpatient/inpatient intake forms and access to restrooms were discussed. Intersex activists reported ongoing practice of medically unnecessary surgeries on children with intersex variations and conflation of intersex people with transgender people. The lack of reliable estimates of LGBTQI+ populations poses a challenge for planning and budget allocation.
LESSONS LEARNED: Current evidence and national programs focus on HIV-related issues of MSM and transfeminine people, with little work in relation to mental health, stigma reduction, and health of lesbian/bisexual women, transmasculine people and people with intersex variations. There is a need to support research programs and build the capacities of young researchers in health research, especially researchers from the LGBTQI+ communities.
CONCLUSIONS: This national symposium helped bringing together diverse key stakeholders and provided a snapshot of the progress and gaps in LGBTQI+ health. An action plan for various stakeholders is being finalized to improve LGBTQI+ health, especially in relation to creating LGBTQI-specific policies, programs and research agenda.

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