Making healthcare queer-friendly
By Ikyatha Yerasala
In a country where conversion therapies are still performed for queer people, Dr Prasad Dandekar is sensitizing healthcare professionals about the LGBT community and their healthcare needs through an iniative called Healthcare Professionals for Queer Indians (HPQI).
Kiran (name changed), a 21-year-old male, is a bright medical student from a top college in Bengaluru. A rank-holder who is brilliant at academics, Kiran has one major issue that holds him back from performing well – the fact that he cannot express his homosexuality to people around him in fear of judgment and losing everything he’s strived for. Kiran is just one amongst the thousands of medical students from the LGBT community in India who face massive hurdles when it comes to openly discussing their sexual or gender identity. Despite the Supreme Court of India decriminalizing homosexuality by overturning Section 377, the lack of awareness about the LGBT community in the medical profession, is alarming. In June 2018, the Indian Psychiatric Society stated: "Certain people are not cut out to be heterosexual and we don't need to castigate them, we don't need to punish them, to ostracize them.” But despite this, conversion therapies are still performed in India, causing depression, suicidal tendencies and more for the individuals involved.
Fortunately, there are some medical professionals who are sensitive towards the plight of LGBT individuals, and Mumbai-based radiation oncologist Dr. Prasad Raj Dandekar is one of them. A proud openly gay man, Dr. Prasad started a transformative initiative called HPQI (Healthcare Professionals for Queer Indians), which is aimed at sensitizing healthcare professionals to the healthcare needs of the LGBT community. In a span of 3 years, HPQI has sensitized around 1800 people from the healthcare industry towards the needs of LGBT folks.
The beginning
As a medical student and an aspiring young doctor in India in the 90s, Dr. Prasad was baffled by two significant problems – the first one was his sexual identity and the second, the non-existence of gender and sexual identity lessons in the medical curriculum. Fast forward to 2021, he noticed that the scenario is no different than what it was more than 20 years ago - the Indian medical curriculum has no mention of homosexuality or the LGBT community.
Dr. Prasad Raj Dandekar MD, DNB, EPGDHA, PGDIC, CPC
These gnawing issues plus a deeply personal experience lead Dr. Prasad to start HPQI. “A few years ago, during my previous job, I had a senior colleague post something homophobic on social media, so I commented on that post and called him out. He then launched into a homophobic attack on me in public and that incident broke me to the point that it took me days to recover from. I was furious with him; but I heard lots of stories about him, and I realized that he was actually a very nice gentleman, but was just ill-informed. That’s when the idea of HPQI came to to my mind. I decided not to stay in victim mode and took charge of the situation,” he reveals.
How HPQI works
Despite there not being clear numbers on the number of homosexuals in India, the Government of India submitted figures to the Supreme Court in 2012 stating that there were about 2.5 million Indian gay people (those who self-declared to the Ministry of Health.) So, it’s only safe to say that the number of undeclared members would make the total number even higher.
Through HPQI, Dr. Prasad began conducting conferences at/for medical colleges. Every few weeks, through a web platform, the doctor is running pan-India initiatives to tie up with colleges and train young minds. “The younger generation is more open-minded and can be taught easily compared to someone in their 40s or 50s who may have set beliefs. It can be quite tricky, but most people I’ve met through HPQI are open-minded and receptive. It’s very important to train young students on inclusivity as they’re going to treat many patients in the future. There are many LGBT students in medical school, so I want them to become sensitive to their own peers. LGBT community members in colleges should be made to feel comfortable. When I pursued my MBBS, I wasn’t even aware of what was happening to me. In those days, in the pre-internet era, nobody knew what being gay was and I couldn’t come out to my friends either. However, today, students are mostly aware of their sexuality or gender identity, but are unable to come out to their friends, as they’re afraid of being judged.”
Citing a real life incident, Dr. Prasad reveals how during one of his seminars in Chennai, he encountered a young gay student who wasn’t able to handle the stress of being closeted. “He was unable to focus on his studies and was afraid that he might ruin his career. It’s a huge waste of talent when a rank holder in a top medical college is unable to perform because of his predicament. My training aims at making LGBT students feel included and encourages them to express themselves better, which will have a significant impact not only on their personal life, but also on their professional life,” says the doctor, who is also an International Federation Certified professional coach.
“We had a course called Forensic Medicine back then and the book had a paragraph which said that homosexuality is a crime and is unnatural. The book continues to be used for current students too. The Chennai High Court has asked the government to change the medical curriculum to include LGBT awareness. So, the movement is heading in the right direction,” feels Dr. Prasad.
Future plans
Dr. Prasad’s hectic schedule doesn’t allow him the time to grow HPQI into a full-fledged organization, but he says, “Until recently, I was giving talks because I was invited to them, but now, HPQI will work in a structured manner where I plan to have 12 events, one each month, in 2021. If each event has 250 doctors (who will then be seeing lakhs of patients), we will be impacting a huge number of people indirectly and directly.” The professional bodies that HPQI wants to work with include The Gynecological Association, Endocrine Association and The Indian Psychiatric Society. Working with professional bodies is more feasible for the doctor who reveals that working with a hospital involves tremendous work. “I work on the webinars by myself, and often have friends in the fraternity who assist me, but I still require someone to take over the outreach work of HPQI,” he adds.
Sensitizing healthcare professionals
When it comes to treating patients from the LGBT community with respect, Dr. Prasad reveals that small changes in the way doctors treat patients can go a long way in promoting inclusivity. “A person visiting a doctor with a UTI or any other illness may be asked if his wife also has the same problem. This is a very simple question, but at that moment, you have made the patient feel uncomfortable by using the term ‘wife’. Instead, healthcare professionals should make an effort to ask the patient if his partner also has the same problem – simple rewording can make a huge difference in being sensitive. If an outspoken person like me feels stressed during doctor visits, I can’t even fathom what somebody who hasn’t come out of their closet would feel. At the end of each seminar I conduct, I remind those attending them that not every patient who walks into the clinic is heterosexual or a transgender. Many medical professionals state that they don’t have any LGBT patients, to which I enlighten them that 6-10 of patients they see every day are from the LGBT community, but they don’t open up to them as they’re afraid of being judged. If healthcare professionals keep an open mind, things would change greatly.”
Making healthcare accessible to the queer community is crucial. “Building a network of LGBT friendly doctors will help. Asking the right kind of questions, keeping a small item in the office (like a rainbow flag) to indicate that you’re queer-friendly can help provide access. Also, having the competence to treat them is important - training doctors to make them competent to understand the issues queer folks face and why they face it, is crucial. Financially, the lakhs of people who cannot afford private healthcare won’t be able to access the private sector. So government hospitals and medical schools need to have LGBT-friendly services. Things are changing and some hospitals in Mumbai have LGBT-friendly senior psychiatrists who are also training young psychiatrists on this subject.”
Influencing a landmark judgment
When the landmark judgment of overturning Section 377 was made by the Supreme Court of India, Dr. Prasad, with the help of the Indian Psychiatric Society played a huge role in it. “I persuaded IPS to issue a letter that homosexuality is not a psychiatric illness and should be decriminalized and that was an important tool in tilting the case – three of the five judges quoted that in the judgment. Dr. Ajit Bhide, Dr. Kesri Chavda, Dr. Avinash D’Souza and Dr. Amrit Pattajoshi worked towards this,” he shares.
Post that, things in the medical fraternity are changing. “Any doctor who states that homosexuality is unnatural or a crime can now be shut down easily. One big change I’ve seen is in the students in medical colleges who have begun to talk about it, have college festivals with LGBT events in it, which was unheard of previously. Earlier, the deans of colleges would call such events illegal, but that isn’t the case now. Recently, a medical college in Mumbai dedicated an entire week to the mental health of the LGBT community and invited me to talk. I hadn’t received a single invitation before this judgment,” shares the doctor.
While Dr. Prasad is doing his bit through HPQI to sensitize healthcare professionals, we need more LGBT crusaders and larger players like hospitals and institutions to step up to help build a robust support system for marginalized queer population in the country.