Context: Recently National Medical Commission (NMC) has issued an advisory to all medical universities and colleges. It asked them to bring changes in the teaching methods and in the competency-based medical education (CBME) curriculum. It also asked to opt for methods that are not derogatory to the LGBTQIA+ community.

Why do the NMC issue guidelines?

• The NMC’s notification comes against the backdrop of several recent developments. A petition has been filed in the Madras High Court by a lesbian couple whose relationship was being opposed by their parents. In another incident, Dr Trinetra Haldar Gummaraju, a trans doctor, called out the rampant queerphobia in medical education.

Exclusion of LGBTQIA+ community in medication

• Medical education in India has focussed only on the binary of male and female, heterosexuality and cis-gendered lives, while excluding homosexuality and gender non-binary and transgender issues.
• This results in the exclusion of the LGBTQIA+ community.
• Even with the release of the competency-based medical curriculum in August 2019, the curriculum continues to include a queerphobic syllabus.

About the NMC notification

• The Transgender Persons (Protection of Rights) Act, 2019 mandates governments to take measures for the “review of medical curriculum and research for doctors to address their [transgender] specific health issues,” but no action has been taken since then.
• In June 2021, in response to a case filed by a queer couple, the Madras High Court laid down a set of guidelines and directed the NMC to ban queerphobic practices such as conversion therapy which aims to forcibly change the sexual orientation of a person.
• In its notification, the NMC has advised medical colleges to teach gender in a way that is not derogatory to the queer community.
• The authors of medical textbooks have also been asked to amend the books to remove any harmful contents regarding virginity and the queer community.

Issues with the NMC notification

• While the NMC advisory title mentions necessary changes in the competencies of its CBME curriculum, there are no specifications on what these changes are.
• At the same time, the CBME curriculum itself mentions queerphobic things that are to be taught to students.
• Certain acts are called as sexual offences even though the Supreme Court has read down Section 377. 
• Also, the competencies which will make a future Indian doctor respectful and empathetic in treating a queer patient are missing.

Suggestion and Road ahead

• NMC guidelines should consider a larger picture into account and draft the changes accordingly in the medical education curriculum.
• The NMC must start by recognising the flaws in its own CBME curriculum and explicitly state the changes required.
• Specific guidelines on how to make healthcare queer-affirmative are needed.
• The directive also needs to specify changes across several subjects and not just forensic medicine and psychiatry.
• For this, there needs to be a participatory stakeholder consultation towards the development of a queer-affirmative curriculum.
• Finally, there needs to be clarity on what the NMC plans to do for tackling queerphobia in the current set of health professionals.