Context

The National Medical Commission (NMC), the body responsible for regulating medical education in India, released an advisory regarding the LGBTQIA+ community and the necessary changes in the competencies of its competency-based medical education (CBME) curriculum.

Exclusion of LGBTQIA+ community in medication

• Medical education in India has focussed only on the binary of male and female, heterosexuality and cis-gendered lives, while excluding homosexuality and gender non-binary and transgender issues.
• This results in the exclusion of the LGBTQIA+ community.
• Even with the release of the competency-based medical curriculum in August 2019, the curriculum continues to include a queerphobic syllabus.

About the NMC notification

• The Transgender Persons (Protection of Rights) Act, 2019 mandates governments to take measures for the “review of medical curriculum and research for doctors to address their [transgender] specific health issues,” but no action has been taken since then.
• In June 2021, in response to a case filed by a queer couple, the Madras High Court laid down a set of guidelines and directed the NMC to ban queerphobic practices such as conversion therapy which aims to forcibly change the sexual orientation of a person.
• In its notification, the NMC has advised medical colleges to teach gender in a way that is not derogatory to the queer community.
• The authors of medical textbooks have also been asked to amend the books to remove any harmful contents regarding virginity and the queer community.

Issues with the NMC notification

• While the NMC advisory title mentions necessary changes in the competencies of its CBME curriculum, there are no specifications on what these changes are.
•  At the same time, the CBME curriculum itself mentions queerphobic things that are to be taught to students.
• Certain acts are called as sexual offences even though the Supreme Court has read down Section 377. 
•  Also, the competencies which will make a future Indian doctor respectful and empathetic in treating a queer patient are missing.

Way forward

• The NMC must start by recognising the flaws in its own CBME curriculum and explicitly state the changes required.
• Specific guidelines on how to make healthcare queer-affirmative are needed.
• The directive also needs to specify changes across several subjects and not just forensic medicine and psychiatry.
•  For this, there needs to be a participatory stakeholder consultation towards the development of a queer-affirmative curriculum.
• Finally, there needs to be clarity on what the NMC plans to do for tackling queerphobia in the current set of health professionals.

Consider the question “The Transgender Persons (Protection of Rights) Act, 2019 mandates governments to take measures for the review of the medical curriculum. In light of this, discuss the changes needed in the medical curriculum regarding the LGBTQIA+ community.”

Conclusion

Without these changes, equitable access to healthcare for queer persons will remain a faraway dream.

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