Opinion: Beyond Pride —LGBTQ+ people need equal access to healthcare

By Dr Kattamreddy Ananth Rupesh

Medicine is unique as a profession because it touches almost every aspect of human life and society. The health of individuals and communities is shaped not only by biology, but also by social, economic, and political conditions. This close connection between medicine and society inspired ideas such as Friedrich Engels’ concept of “social murder,” which views avoidable illness and death as consequences of unjust social structures.

The same spirit is reflected in the famous words of German physician Rudolf Virchow: Medicine is a social science, and politics is nothing but medicine on a grand scale. His insight remains relevant even today in India, reminding us that often requires changing society itself.

An andrologist recently shared a striking experience that shed light on the unseen struggles people face because of stigma and societal expectations. A young couple sought infertility counselling after several years of marriage, with the wife distressed over childlessness. During the evaluation, it emerged that the husband was a gay man who had entered into a heterosexual marriage under intense familial and societal pressure. Overwhelmed by guilt, shame, and the fear of social rejection, he had even attempted suicide by consuming pesticide.

For clinicians, this is not an isolated story but one of many that reflect the realities of a present-day Indian society, which extends far beyond rigid binaries. Medical practitioners are increasingly encountering individuals who, unable to express their sexual orientation openly, are compelled to enter heterosexual marriages for which neither they nor their partners are prepared. The consequences extend far beyond marital discord, often manifesting as anxiety, depression, sexual dysfunction, and, in extreme cases, self-harm.

The Pride March

Pride Month, observed in June, traces its origins to the Stonewall uprising of June 1969 in New York, when members of the resisted routine police harassment and discrimination. The uprising transformed a local protest into a global movement for dignity, equality, and rights. In India, the journey has followed a different but equally significant path, driven less by street rebellion and more by sustained legal and public health advocacy.

Landmark milestones such as the NALSA judgment (2014), which recognised the rights of transgender persons, and the Navtej Singh Johar verdict (2018), which decriminalised consensual same-sex relations, marked historic advances towards equality. Nevertheless, these legal victories have not fully translated into social acceptance or equitable access to healthcare.

The Supreme Court’s refusal to recognise followed by its dismissal of review petitions challenging that decision in 2025, further underscored the gap between constitutional ideals and lived realities. While India has moved from criminalisation towards greater legal recognition, many queer individuals continue to navigate stigma, family pressure, discrimination, and invisibility—making Pride not merely a celebration of identity, but an ongoing reminder of the unfinished struggle for health, dignity and equal citizenship.

Substance over Spectacle

While Pride Month is increasingly marked by parades, corporate campaigns, and public events in metropolitan cities, visibility alone does little to address the everyday realities faced by LGBTQ+ individuals across much of India. Beyond the symbolism of celebration lies a range of unmet health needs shaped by Physical health concerns, including limited access to gender-affirming healthcare for transgender persons, inadequate sexual and reproductive health services, and fear of discrimination within healthcare settings, remain significant challenges.

LGBTQ+ health research in India remains heavily focused on HIV and sexually transmitted infections, while mental health, chronic diseases, reproductive health and ageing remain understudied

Recent attempts to further medicalise gender identity through amendments linked to the implementation of the have also raised concerns among activists and health professionals. They argue that policies affecting the community should be grounded in evidence, lived experiences, and contemporary medical understanding rather than bureaucratic or paternalistic frameworks.

In India, marriage remains a foundational social institution, shaping not only personal relationships but also access to housing, inheritance, insurance, taxation, caregiving, and healthcare decision-making.

Without legal recognition, same-sex couples frequently encounter barriers during medical emergencies, end-of-life care, and routine interactions with healthcare institutions. The judicial position that the matter falls within the domain of the legislature leaves many of these issues unresolved. In a society where family is often the anchor for health and wellbeing throughout life, from adolescence to old age, this legal vacuum translates into tangible health inequities.

Walk the Talk

Existing evidence suggests that LGBTQ+ health research in India remains disproportionately focused on , while issues such as mental health, chronic disease, ageing, reproductive health, access to gender-affirming care, and the experiences of lesbian, bisexual, queer, and intersex individuals remain understudied. There is also a paucity of high-quality population data, limiting evidence-based policymaking.

Future research must adopt a life-course perspective, examining the health needs of LGBTQ+ individuals from adolescence to old age, while generating data that can guide service delivery and public health interventions. Qualitative research across socioeconomic groups is crucial, as stigma is experienced differently depending on age, gender, location (urban or rural) and other social identities. While many in Gen Z find support through online communities, older generations may lack access to such spaces, making them particularly vulnerable to isolation and silence.

Medical students and healthcare professionals receive little or no formal training in LGBTQ+ health, despite expressing a willingness to learn. Curricular reforms should integrate affirmative, evidence-based teaching into undergraduate and postgraduate education rather than confining these topics to isolated lectures or tokenism.

Sensitisation programmes, continuing medical education initiatives, and direct engagement with community members can help future clinicians develop the cultural competence required to provide respectful and equitable care. With the international medical community recognising conversion therapy as unethical and harmful, professional specialty bodies in India must also take a clear stand against it and integrate this understanding into clinical practice.

Ultimately, the goal is not to create a separate healthcare system for LGBTQ+ people but to build a healthcare system that treats them as equal citizens. Pride Month serves as an annual reminder of the struggle for but the larger challenge lies in ensuring that sexual and gender minorities can access healthcare, build families, live happily, grow old with dignity, and participate fully in society without fear of discrimination or exclusion.

Progress should be measured not by symbolic displays, but by whether every person, regardless of sexual orientation or gender identity, receives equal compassion, legal protection and continuity of care.

(The author is Associate Professor of Forensic Medicine and Toxicology, Siddhartha Medical College, Vijayawada)