By Rebecca Rosman
MUMBAI, Feb 4 (Thomson Reuters Foundation) - It started with a homophobic post on social media.
Dr. Prasad Raj Dandekar, a radiation oncologist based in Mumbai, was scrolling through his Facebook feed one evening several years ago when he saw a colleague had posted an anti-gay comment.
"I commented saying, 'This isn't appropriate; maybe you don't mean it,'" Dandekar told the Thomson Reuters Foundation.
Instead of apologising, his colleague then launched into a series of verbal attacks, claiming all homosexuals were criminals who belonged in jail.
"Maybe this incident came out of ignorance. Maybe he doesn't know better," Dandekar said he thought at the time. "And if that is the case, this can be changed."
Much has changed in India since these Facebook posts in 2012. In September, the country's Supreme Court overturned a 154-year-old ban on gay sex, known as section 377.
Several months before last year's landmark ruling, Dandekar founded the Health Professionals for Queer Indians (HPQI), an organisation aimed at educating healthcare providers to the needs of India's LGBT+ community.
To date, HPQI has trained nearly 1,000 medical professionals across India.
Demand for his seminars has gone up since September, leading him to struggle to keep up, Dandekar said.
In its ruling, India's Supreme Court declared that the "right to health is understood to be indispensable".
Under the rule change, all LGBT+ people in India would be guaranteed "the right to emergency medical care and the right to the maintenance and improvement of public health", the five Supreme Court judges said.
Yet five months after the landmark ruling, fears are growing that many gay and trans Indians are avoiding doctors' visits altogether out of a fear of discrimination.
BREAKING MENTAL HEALTH BARRIERS
Nakshatra Bagwe, a 28-year-old who runs a Mumbai-based travel company, said he still remembers an awkward exchange he had with his dermatologist after saying he was gay.
Bagwe said his doctor asked whether he was sure. "Do you think you can come back from this?" the doctor said, asking if it was likely Bagwe would change his mind.
Bhusan, a 28-year-old transgender physician whose name has been changed to protect his identity, said he faced similar questions from multiple physicians after starting his transition from female to male.
"Being a doctor myself, I was not expecting that there would be such a gap (in understanding)," he told The Thomson Reuters Foundation.
Bhusan said it took nine separate visits to different psychiatrists before one agreed to provide him with the necessary paperwork to start hormonal therapy.
"Until then, I had psychiatrists telling me it was all in my mind – that I should just get rid of these thoughts," Bhusan said.
In July 2018, the Indian Psychiatric Society (IPS) declared homosexuality was not an illness, partially in hopes of deterring psychiatrists from use of "conversion therapies" on LGBT+ patients aimed at "converting" them to heterosexuality.
Yet fears remain that many older physicians in particular might be resistant to the changing of society.
"Very few of us would have actually grown up in a society where people talked about being homosexual," said Dr Kersi Chavda, who in 2016 set up an IPS task force focused on the needs of India's gay and trans community.
"There needs to be more sensitivity," added Richa Vashista, a mental health practitioner formerly with the Mumbai-based LGBT+ rights organisation Humsafar Trust.
"There's not much awareness on sexual orientation and gender identity-related issues when it comes to counselling," Vashista said.
Vashista said that even when it came to her own training, there was no guidance on how to treat LGBT+ patients.
"I didn't know much about being lesbian, gay or transsexual. It's my clients who have taught me," she said.
In more than four years working as a counsellor, Vashista said she has repeatedly heard stories from gay and trans clients about unfavourable experiences during what were meant to be routine health checkups.
"This is what we want to break," Mumbai-based Dandekar said.
"We want doctors to be sensitive. We want doctors to be educated."
(Reporting by Rebecca Rosman @Rebs_Rosman ; Editing by Hugo Greenhalgh and Jason Fields. Please credit the Thomson Reuters Foundation, the charitable arm of Thomson Reuters that covers humanitarian news, women's and LGBT+ rights, human trafficking, property rights, and climate change. Visit http://news.trust.org)
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