Scrubbed Out

When I was in my second year at Delhi’s Lok Nayak Jai Prakash Narayan Hospital, a lanky boy in a red shirt and fraying jeans came to the dermatology OPD for a consultation. He spoke openly about the globular swellings on his penis that had ruptured, leaving shallow craters. A busy resident asked him to strip and lie down on the examination table. She enquired about his history of contact: “Have you had sexual relations with a girl?” “Are you married?” “Have you visited any sex workers?” “No,” he responded to each question, quickly and confidently. Running out of time and patience, the resident referred him to me. It was only when I changed “girl” to “partner” that I understood the reason for his denial. He was in a sexual relationship with a male partner. With a medical curriculum that turns a blind eye to questions of gender, such incidents remain a common occurrence even in the country’s most reputed hospitals—leaving both doctors and patients struggling with their identities.

A doctor friend told me, on condition of anonymity, that their sexual awakening, during their second year at a women’s college in Sonipat, came at a hefty price. They identify as a trans man, but transitioning would have put their college seat in jeopardy. They decided to wait until graduation, but another exam and another degree awaited. Their doctor parents wanted them to choose gynaecology, which proved to be the final nail in the coffin. A male gynaecologist in Haryana was still a concept hard to digest.

In India’s medical colleges, where students are allotted cadavers to dissect in their very first week, nobody discusses gender and sexuality. What little discussion that does exist has historically been negative, with psychology textbooks describing homosexuality and gender dysphoria as psychosexual disorders, and forensic medicine textbooks describing “sodomy” and “lesbianism” as sexual offences. Chandan Kumar, a medical student at Gajra Raja Medical College, Gwalior, who came out to his friends last year, told me that he felt discriminated against when his forensics professor smirked while talking about homosexuality. “While he didn’t refer to it as unnatural for the sake of being correct, his expressions revealed his disgust.”

In October 2021, after the Madras High Court noted that medical education reinforced homophobia, the National Medical Commission directed colleges to remove “unscientific” and “derogatory” references to queer communities from textbooks. Even as publishers work to edit out the erring passages, there is little hope of the curriculum becoming gender-affirmative anytime soon. Attitudes, Ethics and Communication, a manual created by the Medical Council of India, in 2018, to bridge the glaring gap between competent physicians and educated doctors, totally shies away from the subject. None of the modules discuss gender, and there is no emphasis on educating professors who might themselves be ill-informed.