Asia
Cloud-based platform seeks to improve health care for LGBTQ, intersex Indians
Borderless LGBT currently operates in Bengaluru
The COVID-19 pandemic wreaked havoc and forced India into a strict lockdown.
The Indian government, through the Union Health Ministry, says upwards of 530,677 people died from COVID-19, and the country administered 2,200,212,178 doses of vaccines. The pandemic, however, exposed the truth about discrimination based on gender identity in the country’s healthcare system.
India’s transgender community, in particular, had a difficult time accessing the vaccine.
The country’s LGBTQ and intersex community often faces discrimination and stigma in both traditional private and government-run healthcare facilities. To tackle this, Borderless LGBT, the world’s first cloud-based health and wellness medical service that specifically focuses on LGBTQ and intersex healthcare, has launched a cloud clinic in India.
The cloud-based platform allows global experts to collaborate with local doctors who are interested in LGBTQ and intersex medicine to provide care to LGBTQ and intersex patients either in the clinic or at home via immersive telemedicine.
Borderless Health Care Group, Borderless LGBT’s parent company, provides a wide range of healthcare and wellness solutions to patients globally that includes general health, women’s health, men’s health, chronic disease management and pet care. But the idea behind Borderless LGBT came from the sense that the LGBTQ and intersex community is the most underserved, and there was a need for a platform that provides healthcare and wellness services to the community without any judgment.
“The goal is to democratize LGBT healthcare knowledge and services via the implementation of (an) LGBT clinic-of-the-future and technology-enabled LGBT home health,” Lani Santiago, vice president of the Borderless Healthcare Group’s Chairman’s Office, told the Washington Blade. “We have doctors from the U.S., Europe, Australia, (Southeast) Asia, India, etc.”
COVID-19 — and associated lockdowns, loss of employment and loved ones, the sudden overflow of patients and isolation from friends and family — affected mental health in India. This trend, however, is not new for the LGBTQ and intersex community.
Community members in a largely conservative Indian society have faced mental health issues all their lives, and researchers around the world have said the LGBTQ and intersex people face more mental health issues than heterosexuals. The stigma and prejudice in society have a different impact on the community.
Borderless LGBT in India, among other things, is providing mental health services for the LGBTQ and intersex community. The cloud-based platform is also providing health services for HIV, STD, sexual wellness, chronic disease management and family planning for the LGBTQ and intersex community in India.
Borderless LGBT is currently providing health care services in Bengaluru, the capital of Karnataka state in southern India. But in an interview with the Blade, Santiago said that the company has planned to roll out the services in other key cities in the country.
Santiago said that the traditional medical services that general hospitals offer do not cater to the specific needs of the LGBTQ and intersex community. In addition, the inefficiency and inherent conflict of interest in the traditional medical fraternity will take a long time to serve them.
“Borderless LGBT aims to create a new online-to-offline delivery channel to provide LGBT community unparalleled access to the best-of-class LGBT health and wellness knowledge and services where local doctors interested in LGBT healthcare can have instant access to global experts to support the management of their LGBT patients,” said Santiago. “The traditional provision of services is usually dependent on the knowledge and experience of the local doctor which in India, LGBT healthcare is still at its infancy.”
A 2021 report from National AIDS Control Organization, a division of India’s Health and Family Welfare Ministry, notes 2.4 million people are living with HIV in the country.
Stigma, societal pressure, and shame have pushed gay men underground, and not many of them seek help regarding HIV and other sexually transmitted infections. Borderless LGBT and other innovative healthcare solutions can provide an opportunity for patients from the community to seek medical attention without facing discrimination, shame, or stigma with their privacy intact.
“Borderless LGBT is positioned to support the local doctors with the latest knowledge in LGBT healthcare via a new online-to-offline global ‘co-care’ model with global experts,” said Santiago. “Thus, bringing the best of proximal local care and the best of global matured LGBT healthcare knowledge to the LGBT community.”
Vinay Chandran, executive director of Swabhava, an NGO in India that supports the LGBTQ and intersex community with health and advocacy, told the Blade that a generation of LGBTQ and intersex people who have not benefitted from public health services might hopefully benefit from these cloud-based efforts.
One concern that Chandran has is how people outside of urban areas will access these services. Chandran, however, believes time will tell whether Borderless LGBT’s efforts to ensure adequate health care outreach will prove successful.
“LGBT+ people have had personal and historical encounters with healthcare that range from the ignorant to the violent,” he said. “It is to the credit of a huge number of activists and legal challenges that the National Medical Commission of India have required a rewriting of curriculum and contemplate disciplinary action for those practising conversion therapy. However, implementation fo such measures will take time. Meanwhile, if the working LGBT+ population can have access to such clinics, I’m sure it will benefit quite a few of them.”
Amrita Sarkar of Alliance India, another NGO that works to bolster care for Indians with HIV, echoed Chandran’s concerns about lack of access to cloud-based health care outside of urban areas. Sarkar during an interview with the Blade encouraged Borderless LGBT to work with local LGBTQ and intersex organizations to raise awareness of these platforms.
Ankush Kumar is a freelance reporter who has covered many stories for Washington and Los Angeles Blades from Iran, India and Singapore. He recently reported for the Daily Beast. He can be reached at [email protected]. He is on Twitter at @mohitkopinion.
India
Expected India Supreme Court ruling could shape future LGBTQ rights cases
Decision to determine whether courts can use constitutional morality doctrine
India’s Supreme Court is expected to issue a closely watched constitutional ruling that could shape the future of LGBTQ rights litigation.
The decision will determine whether courts can continue to rely on the doctrine of constitutional morality, a principle that has underpinned several landmark rights decisions. During hearings in April, the Indian government urged the Supreme Court to reject the doctrine, arguing that it has no basis in the Constitution and should not guide judicial decision-making.
For years, the Supreme Court has relied on the constitutional morality doctrine to treat the Constitution as a living document: one whose enduring promises of justice, liberty, equality, and fraternity must be applied to the realities of a changing society rather than remain frozen in the era in which it was written.
The Indian government in April asked the Supreme Court to revisit the constitutional reasoning behind two landmark judgments: one that struck down the country’s adultery law and another that decriminalized consensual same-sex relations, arguing that both relied on a subjective invocation of constitutional morality and should no longer be treated as good law.
Arguing before a 9-judge bench considering constitutional questions referred from the Supreme Court’s 2018 Sabarimala temple case, which allowed women of menstruating age to enter one of Hinduism’s holiest shrines after a centuries-old ban, Solicitor General Tushar Mehta, India’s second-highest law officer, argued that “constitutional morality” has no textual basis in the Constitution and is instead a judicially evolved concept that is vague and indeterminate.
Mehta said the government did not oppose the Supreme Court’s decision to strike down Section 497 of the Indian penal code, which criminalized adultery, if it was based on Article 14 of the Constitution, which guarantees equality before the law and equal protection of the laws. Instead, he argued that the court should not have relied on what he described as the “vague and subjective” doctrine of constitutional morality to reach its conclusion.
Mehta told the Supreme Court that its 2018 Navtej Singh Johar v. Union of India ruling that decriminalized consensual same-sex relations wrongly equated “morality” with majoritarian or mob morality while relying on constitutional morality as the basis for its reasoning.
To support his argument against relying on constitutional morality, Mehta quoted extensively from then-Justice Antonin Scalia’s dissent in the U.S. Supreme Court’s 2003 decision in Lawrence v. Texas.
Scalia argued that courts should not import foreign legal trends or allow evolving social values to drive constitutional interpretation, contending that judges must remain neutral arbiters rather than participants in broader cultural debates.
Referring to the Supreme Court’s landmark decisions in Navtej Singh Johar and Joseph Shine, Mehta questioned whether the judgments reflected the constitutional vision of India’s founding generation.
“If these judgments, Navtej Johar, Joseph Shine, etc., were to be read by Dr. Ambedkar or Kanhaiyalal Munshi or Alladi Krishnaswamy Iyer, I do not know whether they would be surprised, shocked or they would say that this is what we wanted. I believe, they did not want this to happen,” he told the bench.
“A new trend starts, which is Naz Foundation v. Government of NCT of Delhi,” Mehta said. “This is the judgment of Delhi High Court which was ultimately affirmed in Navtej Johar, sodomy … ‘In our scheme of things, constitutional morality must outweigh the argument of public morality, even if it be the majoritarian view.’ In case of a country governed by democratic principles, the view which is always majoritarian will prevail. When it is question of testing a law, it is always the majority which passes the law. How can you define morality based on this?”
The Naz Foundation case marked the beginning of a landmark constitutional challenge to Section 377 of the Indian penal code, a colonial-era provision that criminalized consensual same-sex relations between adults as “against the order of nature.” The public interest litigation, filed in 2001 by the Naz Foundation, an NGO working on HIV/AIDS and sexual health, argued that the law violated fundamental rights guaranteed under the Constitution.
In 2009, the Delhi High Court ruled in the organization’s favor, holding that Section 377 violated the rights to equality under Article 14, protection against discrimination under Article 15, and life and personal liberty under Article 21 of the Constitution.
The Delhi High Court’s ruling was short-lived.
In 2013, the Supreme Court, in Suresh Kumar Koushal v. Naz Foundation overturned the decision, recriminalizing homosexuality under Section 377.
The court held that the law affected only a “minuscule fraction” of the population and said it was for Parliament — not the judiciary — to decide whether the provision should remain on the statute books. Five years later, the Supreme Court’s Constitutional Bench in Navtej Singh Johar, unanimously overruled its 2013 judgment, holding that Section 377 was unconstitutional. The decision marked the culmination of the Naz Foundation’s long legal challenge to the colonial-era provision.
Anish Gawande, the first openly gay person to serve as a national spokesperson for a major political party in India, the Nationalist Congress Party (Sharadchandra Pawar), told the Washington Blade that the doctrine of constitutional morality, which he said underpinned not only Navtej Singh Johar but also forms one of the foundational principles of India’s constitutional jurisprudence, is “an incredibly important concept.”
“It provides a moral backbone to the document in a way that prevents any amendments to the Constitution from being out into place that would violate the very ethos upon which the Constitution was framed,” Gawande said. “Constitutional morality is an incredibly important antidote to societal morality. It’s been what has allowed us to clamp down on things like dowry. It’s been something that has allowed us to bar even regressive religious practices that might go against human dignity. It’s also been an incredibly important framework that has allowed for the advancement of LGBTQ rights in opposition to arguments made by practitioners and leaders of various religious denominations about the societal immorality of queerness.”
“The most critical part of constitutional morality, which is a doctrine that has been put in place by the courts, is that it is a very effective bulwark against majoritarianism and the unilateral diktat of the executive over the judiciary and, in some ways, also the legislature,” he added.
Gawande said those factors make constitutional morality “an incredibly important concept” in Indian constitutional jurisprudence.
If the Supreme Court were ultimately to narrow or reject the doctrine, he said, judgments that have relied on constitutional morality, including the landmark Navtej Singh Johar ruling could come under renewed scrutiny. He added, however, that he did not believe the Supreme Court would take that step because it would run contrary to its own institutional interests.
Gawande said the government has advanced several reasons for challenging the doctrine of constitutional morality. One of them, he said, is that the solicitor general has opposed the doctrine in cases involving religious issues, arguing that courts should not rely on it in constitutional adjudication.
“The downward repercussions of this, however, could extend to LGBTQ rights and to the rights of all sorts of persecuted minorities in the future,” he said.
“The second thing is that, in principle, the section 377 judgment, of course, rests upon constitutional morality, but it is also resting upon so many other fundamental rights, including the right to privacy that Puttuswamy upheld before the Navtej Singh Johar verdict,” Gawande added. “In Navtej, the right to privacy was also cited as an incredibly important condition upon which the decriminalization of ‘carnal intercourse against the order of nature’ could be permitted. In many ways, the fact that Section 377 does not exist on the statute books at all in the present updated penal codes, Bharatiya Nyaya Sanhita and Bharatiya Nagarik Suraksha Sanhita, provides some respite. The entry of Section 377, at least immediately after a reading down of constitutional morality, is not imminent yet. However, it opens the door for a new Section 377 to be introduced and the judicial mechanism available to counter that new section 377, if it were to be introduced, to be reduced significantly.”
Ankit Bhupatani, an LGBTQ activist, said he does not believe the Supreme Court’s reconsideration of constitutional morality would lead to the recriminalization of consensual same-sex sexual relations.
He argued the 2018 Navtej Singh Johar decision rests on multiple constitutional principles beyond constitutional morality, but warned that weakening the doctrine could make it more difficult to secure future LGBTQ rights through the courts.
“If we have to take an informed guess on why the government does not like the concept of constitutional morality, it is because it wants a narrower field of judicial review and an elected legislature restored as the primary author of social policy,” Bhupatani said. “But we have already seen parliament’s ability to make laws related to LGBT rights, and it does not give optimism.”
“The only practical way forward for LGBT rights in India is the judiciary,” he added. “But if the government’s argument is accepted by the Supreme Court, it means the next gay Indian who walks into a court for marriage, for adoption, for inheritance, or for a job they were fired from, finds it more difficult to secure these rights from the only institution from which we could hope for a positive outcome.”
Bhupatani said the decriminalization of consensual same-sex sexual relations would probably survive because the Navtej Singh Johar judgment also rests on the constitutional principles of privacy and equality. However, he warned that weakening the doctrine of constitutional morality could stall broader progress for LGBTQ rights.
“The community keeps the floor and loses the staircase,” he said. “Nobody is criminalized, but nobody moves up.”
“The clever thing about this is that it lets the government have it both ways. To its so-called base, who think that making the law, especially on social issues, is the work of elected parliamentarians and not judges,” said Bhupatani. “It signals that the 2018 verdict was a judicial overreach that ought never to have happened. To everyone else, truthfully, that it never asked to recriminalize anyone. Both messages, one filing.”
Bhupatani said the implications of the government’s position extend beyond LGBTQ rights, arguing that asking the Supreme Court to treat the reasoning in Navtej Singh Johar as “not good law” raises broader questions about India’s commitment to constitutional rights. He said such a move could also affect how India’s constitutional democracy is perceived internationally.
Asia
LGBTQ rights gains in Asia come through courts, not legislatures
Marriage equality lawsuits filed in Japan
In recent years, some of Asia’s most significant legal developments involving LGBTQ rights have unfolded not in parliamentary chambers but in courtrooms. From marriage equality lawsuits in Japan to litigation over same-sex spousal benefits in South Korea and constitutional challenges in countries including India and Nepal, courts across the region have increasingly been asked to decide questions that lawmakers have yet to resolve. The trend raises a broader question: Why has constitutional litigation become a recurring pathway for LGBTQ people seeking legal recognition in parts of Asia?
The pattern has unfolded over nearly two decades.
In 2007, Nepal’s Supreme Court issued one of Asia’s earliest landmark rulings recognizing the rights of sexual and gender minorities, directing the government to end discriminatory laws and examine legal recognition for same-sex couples. A decade later, Taiwan’s Constitutional Court ruled that denying same-sex couples the right to marry violated the constitution, paving the way for the region’s first marriage equality law. In India, the Supreme Court recognized transgender people as a third gender in 2014 before striking down a colonial-era ban on consensual same-sex relations four years later.
The pattern continued across Asia.
Japan’s courts repeatedly questioned the exclusion of same-sex couples from marriage. The rulings intensified pressure for legal reform. Parliament, however, has yet to act.
South Korea’s judiciary expanded legal protections for same-sex couples. It recognized spousal health insurance benefits. A recent district court also awarded damages after a same-sex relationship ended. The ruling added momentum to the country’s marriage equality movement.
China’s courts took a different path.
Landmark constitutional rulings never emerged. Still, litigation prompted the Supreme People’s Court to acknowledge anti-LGBTQ discrimination. The developments reflected courts’ growing role in LGBTQ rights disputes.
The Philippines added another dimension.
Marriage equality remains unresolved, yet the Supreme Court recently recognized property rights for some same-sex couples. The ruling stopped short of recognizing marriage. Still, it acknowledged legal protections for LGBTQ relationships. The decision reflected another way courts have shaped LGBTQ rights across Asia.
Constitutional courts occupy a distinct place in democratic systems. Legislatures enact laws. They also respond to political priorities and public opinion. Constitutional courts serve a different function. They decide whether laws or government actions comply with constitutional guarantees. They resolve legal disputes brought before them. Their role is not to measure a policy’s popularity. It is to determine whether it is constitutionally valid. That distinction has placed constitutional courts at the center of many of Asia’s most consequential LGBTQ rights disputes.
Nepal offers an early example.
In 2007, LGBTQ activists turned to the Supreme Court through a public interest petition. They argued that discriminatory laws and government practices violated constitutional guarantees of equality. They also sought legal recognition for gender and sexual minorities. The government urged the court to dismiss the petition. It argued existing laws already protected all citizens. It also said the claims relied on assumptions rather than specific instances of discrimination. The court disagreed. It held that sexual orientation and gender identity are natural variations of human identity. It directed the government to eliminate discriminatory laws and policies. The ruling also ordered a study on legal recognition for same-sex couples, laying the foundation for future reforms.
“Since it is the absolute jurisdiction of the legislature to decide as to what type of law should be made and amended on a particular issue, and as this matter does not fall under the jurisdiction of this office, therefore, there does not seem any pertinent reason and valid ground to make this Office a respondent,” said Office of Prime Minister and Council of Ministers in its 2007 affidavit. “Let the writ petition be dismissed on the ground that the unconcerned office is being made as an opposite party in the case.”
In India, a prominent leader of the ruling Bharatiya Janata Party, Subramanian Swamy, described homosexuality as a “genetic disorder” in 2015. He also wrote on social media that it was a “genetic handicap,” reflecting the political discourse surrounding LGBTQ rights before the Supreme Court’s landmark ruling in 2018.
The Supreme Court’s landmark 2018 ruling decriminalized consensual same-sex relations. The decision did not end the debate. Soon afterward, the Rashtriya Swayamsevak Sangh, a right wing, Hindu nationalist volunteer and paramilitary organization, an ideological parent of the ruling Bharatiya Janata Party, said it did not consider same-sex relationships a crime. It added, however, that it did not support such relationships.
After the Supreme Court’s landmark 2018 ruling, Arun Kumar, a senior Rashtriya Swayamsevak Sangh leader, told the media that same-sex relationships and marriage were neither “natural” nor “desirable.”
During the 2023 marriage equality hearings, the Indian government repeatedly argued that the issue belonged before Parliament, not the judiciary. Solicitor General Tushar Mehta told the Constitution Bench that the case involved a “very complex subject” with “profound social impact” and that “all the questions in this case must be left to the Parliament.” He argued that recognizing same-sex marriage through judicial interpretation would require rewriting the Special Marriage Act and could have unintended consequences across multiple laws. During the hearings, Mehta also questioned how existing marriage laws would operate for same-sex couples, asking, “Who will be the wife in a lesbian relationship?”
The Washington Blade covered these arguments as the hearings unfolded.
Three years have passed since the Supreme Court declined to recognize same-sex marriage, holding that creating such a legal framework was a matter for Parliament. Marriage equality, however, remains unrecognized in India. Parliament has not enacted legislation extending civil marriage to same-sex couples. The legal position has remained unchanged since the court’s 2023 ruling.
Similar tensions have surfaced elsewhere in Asia.
In Japan, a growing number of courts have questioned the constitutionality of denying marriage to same-sex couples, even as Parliament has yet to amend the law. In South Korea, courts have steadily expanded legal protections for same-sex couples, while the government has argued that recognizing same-sex marriage is up to lawmakers. In the Philippines, marriage equality and civil partnership bills have repeatedly failed to secure congressional approval amid religious and political opposition. The legislative stalemate has prompted advocates to pursue constitutional litigation before the Supreme Court.
Indonesia presents a different picture.
Rather than debating legal recognition, much of the political discourse has focused on restricting LGBTQ rights. In a landmark 2017 case, however, rights groups successfully opposed a petition that sought to criminalize all consensual same-sex relations nationwide. The Constitutional Court rejected the petition, ruling that creating new criminal offences was a matter for Parliament, not the judiciary.
Nepal
Nepalese Supreme Court issues landmark marriage equality ruling
Same-sex couples since 2023 allowed to marry under ‘temporary registration system’
The Nepalese Supreme Court on June 18 ruled the country must extend full marriage rights to same-sex couples.
The Supreme Court in 2023 ordered the country’s government to allow same-sex couples to temporarily register their marriages, but this recognition did not guarantee full marriage rights to gays and lesbians.
“Since the Supreme Court’s landmark 2023 decision, dozens of same-sex couples have legally married in Nepal under a temporary registration system,” said the Blue Diamond Society, a Nepalese LGBTQ advocacy group, in a June 19 press release. “However, the lack of national legislation has created uncertainty and fear for couples who want to register their marriage.”
“Many couples have been denied marriage licenses by local clerks who claim there is no national law instructing them to register marriages of same-sex couples,” further noted the Blue Diamond Society. “Other couples have been forced to file legal cases and endure costly legal battles simply to register their marriage. And even among couples who have registered their marriages, there is concern that their marriages may not be respected when it comes to adoption, inheritance, and other important protections they need to care for their families.”
Thailand and Taiwan are among the countries that have extended full marriage rights to same-sex couples.
The Japanese Supreme Court in March said it will consider six marriage equality lawsuits. The South Korean marriage equality movement in recent years has gained momentum with several court rulings that recognized same-sex relationships.
The Blue Diamond Society in its press release notes the June 18 decision is the fourth time the Supreme Court has ruled in favor of marriage equality.
“Today is a day of celebration for LGBTQIA+ people and families across Nepal,” said Blue Diamond Society Executive Director Manisha Dhakal. “The Supreme Court has once again affirmed that same-sex couples deserve the same dignity, respect, and legal protections as any other couple.”
“We are grateful for the court’s continued leadership,” added Dhakal. “With a newly elected government more committed than ever to equality, now is the time to complete this important work by updating Nepal’s civil code and ensuring marriage equality is fully and clearly protected in law.”
Dhakal in the press release said the Blue Diamond Society “looks forward to working constructively with the government of Nepal, lawmakers, and civil society partners to ensure the court’s vision of equality is fully realized.”
“The Supreme Court has spoken clearly,” Dhakal said. “The government has expressed its support for equality. We are encouraged by that commitment and urge Parliament to act swiftly so that every LGBTQIA+ couple in Nepal can access marriage with certainty, dignity, and respect. Nepal has already taken a historic step. Now it is time to finish the job.”
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