How Section 377 is Impairing Indian Healthcare
Section 377 is an outdated, homophobic law that is against the Hippocratic oath, and leading to increased disease burden and healthcare cost.

In 2001, Naz foundation filed a case of psychiatric abuse, regarding, a patient at the All India Institute for Medical Sciences, who had been undergoing treatment by a doctor in the psychiatry department for four years to cure him of homosexuality. However, NHRC finally chose to reject it, as homosexuality was an offence under Section 377 of IPC.
Interestingly, Section 377 was introduced by Lord Macaulay in 1860 as part of Indian Penal Code. It makes it clear that it punishes “carnal intercourse against the order of nature” with either imprisonment of 10 years or life and fine.”
This homophobic law is certainly outdated and is contributing to rising healthcare expenditure, according to a study by the World Bank. It could be costing the Indian economy as much as $30.8 billion every year. Increased incidence and prevalence of depression, suicide and HIV/AIDS in the queer community is well-documented, which means higher government healthcare costs and decreased participation in the workforce.
Impact of Section 377 on Healthcare
Dr L Ramakrishnan, Vice President of SAATHII, points out that some doctors misinterpret Section 377 and fail to comply with their responsibilities. “Doctors are not expected to share i . Further, information on same sex acts that were likely to have occurred is not grounds for prosecution. Only being “caught in the act” is grounds for prosecution. However some doctors, with a misunderstanding of the law, fail to comply with their Hippocratic Oath, and act in ways that are prejudiced towards the LGBT people. Section 377 fuels this pre-existing prejudice.”

“Further, the tag of ‘criminal’ makes many from the LGBT community hesitant to seek care for fear of being stigmatized, or have their orientations/gender-identities disclosed without consent to their family members,” he adds.
In fact, social intolerance often leads to situations where lesbian couples feel they have no other option than to commit suicide in India.
Ignorance on Part of Indian Doctors
When behavior therapy was applied to the treatment of gender identity, it involved exposing the patient to nude imagery of the same sex and giving the patient a mild electronic shock, so that the patient could link the imagery to feelings of pain.
Dr R Srinivasa Murthy, retired professor of Psychiatry, NIMHANS, says that LGBT health was never a subject of serious debates as a medical category in India . “Mental health interventions are based on the classification of diseases and disorders. The Indian Medical establishment has adopted the WHO system of classification of mental and behavioral disorders known as ICD-10. ICD-10 did away with homosexuality as a disorder and introduced a category called “ego-dystonic” sexual orientation.”

So what do doctors mean by ego-dystonic sexual orientation? “Egodystonic (or ego alien) is the opposite of ego-syntonic and refers to thoughts and behaviors (e.g., dreams, impulses, compulsions, desires, etc.) that are in conflict, or dissonant, with the needs and goals of the ego, or, further, in conflict with a person’s ideal self-image,” says Dr Murthy.
“It is true that many mental health experts don’t have the knowledge or training to provide care to the LGBTQ community. However, one should also remember that even in the west, gay marriages are still not legal. One cannot expect society or medical community to change overnight. It will take some time.”
A shift in attitude has happened over the last fifteen years, he says, particularly, since many activists have pointed out how society tries to cure their gender identity.
Dr Mukut Bhowmik, a HIV Physician who works in Telengana, says that there are several harrowing stories of medical neglect and abuse among LGBT community, yet authorities like National Human Rights Commission are unable to take any action due to legal hurdles.
“Our society, including medicine, really tends to operate on a gender binary. Historically, many of our treatments were aimed at making someone appear male or making someone appear female. So as a result of that, many LGBT individuals have actually faced ‘over-medicalisation ’, and have had to undergo unnecessary and traumatic genital exams and surgeries.”

Curing Alternate Sexualities
Since the beginning of this century, there were several efforts to treat homosexuality using surgical techniques. In 1917, Dr Stienach was the first to use surgical technique to cure homosexuality. He performed castration on a homosexual man and then transplanted testicular tissue from a heterosexual man in to the castrated patient, as he thought homosexuality was another form of hermaphrodites. In 1962, Roeder introduced a new surgical technique involving the hypothalamus region of the brain.
Even today, many doctors attempt to treat using hormones. In fact, international organizations like Exodus International had travelled to India to offer their expertise on treating homosexuality. They claimed that they had members who had successfully converted from homosexuality to heterosexuality using their treatments. However, they later admitted that not even one person was healed by their programmes.
In his famous “Letter to an American Mother,” Sigmund Freud’s confusion towards LGBT community was clearly evident. He pointed out that homosexuality was assuredly no advantage, but it was nothing to be ashamed of, no vice, no degradation, it cannot be classified as an illness. “We consider it a variation of the sexual function produced by a certain arrest of the sexual development,” he adds.
Horizontal and Vertical Identities
TED Speaker, Dr Andrew Solomon, a writer, LGBT activist and Professor of Clinical Psychology at Columbia University, is an example of why those who belong to gender minorities can go on to become highly successful professionals. “There are really two kinds of identities. There are vertical identities which are passed down generationally from parent to child. Those are things like ethnicity …nationality, language and often religion. There are those other identities which you have to learn from a peer group. And those identities, those horizontal identities people have almost always tried to cure,” he told the TEDMED audience.
In his popular TED talk titled Love no matter what- he narrated the struggles he faced when he came out of the closet in United States. He also noted that it was important to rethink about how we feel about cures and children with vertical identities should be encouraged and developed by educators and families.
