India’s National Medical Commission has introduced an undergraduate curriculum that does not include protections for transgender individuals and people with disabilities.

The National Medical Commission on Aug. 31 released the Competency-Based Medical Education (CBME) Curriculum 2024, scheduled for implementation in the 2024-2025 academic year. The curriculum sparked controversy by introducing “sodomy and lesbianism” as unnatural sexual offenses in undergraduate programs, prompting two international organizations to threaten to seek the suspension of the National Medical Commission over the issue.

The International Council for Disability Inclusion in Medical Education and the World Professional Association for Transgender Health (WPATH) have called for global authorities to temporarily suspend the National Medical Commission’s recognition by global authorities. The two organizations claim the new curriculum violates exiting laws that protect the rights of people with disabilities and LGBTQ individuals.

The National Medical Commission reintroduced several regressive ideas regarding the LGBTQ community, with a complete omission of transgender rights that contradicts Supreme Court guidelines and previous regulations. Leaders from the disability and trans communities wrote a letter to Union Minister of Social Justice and Empowerment Virendra Kumar in which they criticized the curriculum.

The revised curriculum removed key disability competencies and critical components related to trans health. 

On Sept. 5, as India observed Teacher’s Day, the National Medical Commission temporarily withdrew the guidelines, only to reintroduce them on Sept. 12 without addressing the controversial sections. Terms, such as “dignity” and “transgender,” were notably absent from the 466-page document.

The revised curriculum allocates eight hours to sports but no longer mandates the previously required seven hours for disability training. It uses terms such as “gender identity disorders” and refers to intersex people as “abnormalities,” retaining language from earlier medical perspectives.

The revised curriculum no longer classifies sodomy and consensual same-sex sexual relations between women as “unnatural sexual offenses.” The earlier version, however, included descriptions cross-dressing as a form of sexual perversion. It also categorized a range of behaviors — including voyeurism, exhibitionism, sadism, and masochism — together with necrophagia (the consumption of the dead) and necrophilia (sexual attraction to corpses) under a single category.

The earlier version did not include LGBTQ-inclusive language.

The revised curriculum includes education on topics that include informed consent for sexual intercourse, the history of gender and sexuality-based identities, and the legal background surrounding the decriminalization of adultery and consensual same-sex relationships. It also introduces lessons on paraphilia and paraphilic disorders, covering a range of atypical sexual fantasies and behaviors.

The National Medical Commission has not provided a specific explanation for including outdated concepts in the curriculum. Senior officials have, however, attributed the changes to an unintentional oversight, stating it was an error that led to portions of the 2022 curriculum being mistakenly reintroduced.

The National Medical Commission in 2022 updated six modules in forensic medicine and psychiatry to reflect societal and legal changes. These amendments included the decriminalization of consensual same-sex relationships. They aimed to educate students on informed consent and, within psychiatry, to address the spectrum of gender and sexual orientations. 

The curriculum was designed to prepare students to manage issues, such as gender dysphoria, intersex conditions, and sexual dysfunctions. These changes were based on recommendations from an expert committee formed under a Madras High Court ruling in a case involving a lesbian couple whose parents opposed their relationship, leading to a police complaint about their alleged disappearance.

The Madras High Court ruling noted queerphobia was being incorporated into the education of future doctors. 

The 2022 changes were seen as essential for the daily practice of medical professionals, as misinformation about consensual same-sex sexual relationships could result in some patients receiving inadequate care and treatment.

While the revised curriculum released on Sept. 12 does not include references to trans rights, the Transgender Persons (Protection of Rights) Act of 2019 explicitly requires medical colleges to incorporate trans health and develop health manuals for gender confirmation surgeries. The revised curriculum, however, does not reflect current standards of inclusivity and care.

Ankit Bhuptani, an LGBTQ rights activist and founder of the Queer Hindu Alliance, during an interview with the Washington Blade expressed disappointment over the new curriculum.

“It is not just about the NALSA judgment, but also the current government has been very actively talking about trans rights throughout their policy and their various programs,” said Bhuptani. “So, it’s quite surprising that it was not included and the government should have been more mindful. I hope, they rectify the error that was done earlier in terms of lesbians and other elements which were problematic.”

Bhuptani also told the Blade the current government is open to receiving suggestions from the LGBTQ community.

“The government has met a few community members already, and I was one of them,” noted Bhuptani. “After the meeting, we requested that the community need to be consulted for larger LGBTQ rights. They have given their email IDs publicly so that where general public can send suggestions. So, I hope the community members who are raising these issues, will reach out and take this ahead as well.”

Bhuptani said he plans to raise the issue with the government.

Ankush Kumar is a 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. 

In the vast expanse of India, a land steeped in ancient wisdom and culture, where the echoes of tradition sing of respect for all beings, there exists a paradox. Transgender people, known as hijras, for millennia have been woven into the fabric of society, acknowledged, even revered. Yet today, this same community stands on the precipice of suffering, their dignity bruised, their existence imperiled.

Despite the Supreme Court rulings and the Transgender Persons (Protection of Rights) Act of 2019, discrimination festers and crimes against trans people continue to rise unchecked. 

The 2019 law, once a beacon of hope, now seems a faint whisper amid societal prejudice. India, for all its storied past, must reckon with the reality that its ancient recognition means little if the present offers only misery.

The figures, as the National Crime Record Bureau presents, suggest a seemingly low rate of crime against trans people. At a glance, one might draw comfort from these numbers, imagining progress in a society long burdened by prejudice. But beneath this veneer lies a graver truth: Activists, ever watchful and weary, suspect gross underreporting. The numbers, it seems, tell only half the story.

In the sprawling ledger of tragedy that is the Crimes in India: 2022 report, the NCRB lists 29,356 souls lost to murder, and only nine of these were trans people. A mere number on a page, some might say. But this figure, far from reassuring, is chilling in its implication. 

Among the grim tally of 110,140 cases of adult kidnapping and abduction, only one trans victim emerges from the records — a stark and haunting singularity. The NCRB reports no instances of rape, sexual assault, or mob lynching involving trans people. This absence is, however, not a triumph, but a troubling silence. It raises the question: Do these crimes not occur, or do they vanish from the pages of the records? The silence of statistics can be as deafening as the violence they fail to capture.

Another NCRB report lists only 236 trans people as victims of rape — an astonishingly low figure in a landscape where so much remains hidden. The report does not include any cases of rape, nor the heinous crimes of buying or selling minors for prostitution, in which trans people were victims. The true scale of suffering, it seems, remains buried beneath a system that fails to recognize or record their plight fully.

Parliament passed trans rights law in 2019

Parliament on Nov. 26, 2019, took what seemed a bold step towards justice when it passed the Transgender Persons (Protection of Rights) Bill. 

The law, as written, promised protection and welfare for India’s trans community, declaring that crimes against them that range from forced labor, to denial of access to public spaces, and even removal from households and villages, would not be tolerated. The law also acknowledged physical, sexual, verbal, emotional, or economic abuse as offenses.

Penalties for these offenses — forced labor, denial of rights, or various forms of abuse — under the law are modest at best, ranging from six months to two years’ imprisonment, along with a fine. 

India in recent years has seen a disturbing rise in cases of mob lynching against trans persons. One such tragic incident occurred on Feb. 13, 2024. Raju, a 50-year-old trans person from Telangana state’s Nizamabad district, fell victim to brutal mob violence after a false rumor of child kidnapping swept through their village — a village they had called home.

Raju, a cattle herder and beggar, was simply trying to make ends meet when the mob, blinded by fear and ignorance, turned on them.

Authorities would later clear Raju’s name, confirming they had no involvement in any such crimes. But the truth came too late. Raju had succumbed to their injuries by the time they reached the local hospital, a life senselessly lost to hysteria and hatred.

A similar tragedy unfolded in Hyderabad in 2018. 

Rumors of child kidnapping and burglary sparked fear and suspicion, culminating in a brutal attack on a group of trans people. One was killed, and another severely injured as the mob, driven by unfounded accusations, unleashed their violence. 

A group of Kanwariyas, devotees of Lord Shiva on a sacred pilgrimage, on July 29 brutally beat a trans woman in Uttar Pradesh state and ripped her clothes off after they wrongly suspected her of theft. The woman’s fate seemed sealed as the mob grew angrier, but authorities intervened in time. They rescued her and brought her to a police station. Authorities confirmed what the frenzy of the mob had failed to see: She was not a thief, merely another victim of suspicion and violence.

A group of trans women on Aug. 16 set out for RG Kar Medical College to join a protest against the West Bengal government, outraged by the gang rape of a trainee doctor at the hospital. Their journey, however, took a dark turn at the Rabindra Sadan metro station. 

One of the trans women alleged a Railway Protection Force officer, under the pretense of “checking” her gender, groped her. The group later filed a case against him, exposing yet another instance of indignity faced by trans people in public spaces where even their very identity is subject to humiliating scrutiny.

Report: 92 percent of trans people have faced physical or verbal abuse

Souvik Saha, founder of Jamshedpur Queer Circle, an LGBTQ organization working on a grassroots level to bridge the gap by conducting sensitization workshops with law enforcement agencies and local communities to foster greater understanding and inclusivity, highlighted to the Washington Blade the severe challenges that trans people in Jharkhand state and across India face.

He noted trans people often encounter hostility, harassment, and dismissive attitudes from the police when they try to file First Information Reports. Shah said the crux of the problem lays in the lack of sensitization and awareness within the police force regarding trans identities. This systemic issue not only discourages the community from seeking justice but also perpetuates the cycle of abuse and marginalization they endure.

“As the founder of Jamshedpur Queer Circle, we have witnessed firsthand the systemic discrimination faced by transgender individuals, particularly when they attempt to interact with law enforcement,” said Saha. 

“A report by the National Human Rights Commission (NHRC) in 2018 highlights that 92 percent of transgender individuals have faced physical or verbal abuse, often by law enforcement officials themselves,” he added. “Many police stations lack gender sensitization programs that could foster respect and professionalism when interacting with LGBTQ individuals. As a result, transgender individuals are deterred from seeking justice, and crimes against them often go unreported or uninvestigated.”

Saha highlighted a particularly troubling case involving a trans woman in Jharkhand who officers relentlessly mocked when she attempted to file a domestic violence complaint at a local police station. Saha said her ordeal is a glaring example of how law enforcement practices not only fail to protect trans people but actively alienate and further victimize them. 

Saha remarked that NCRB data showing 236 trans victims without any registered cases is both alarming and unsurprising. He emphasized this statistic starkly reflects the deep-seated systemic issues that prevent trans individuals from accessing justice. 

Saha added the barriers to reporting crimes, combined with a lack of trust in law enforcement, create an environment where many victims remain unheard of and their cases unrecorded.

“While the Supreme Court’s NALSA judgment in 2014 and the subsequent Transgender Persons (Protection of Rights) Act, 2019, were landmark decisions for the transgender community, the reality on the ground tells a different story,” he said. “Despite these legal protections, violence against transgender individuals persists due to deeply ingrained social prejudices, lack of awareness, and failure in the implementation of these laws.”

Saha added one “of the biggest issues is the gap between policy and practice. Although the law mandates the protection of transgender individuals, societal attitudes are slow to change.”

He pointed to a 2018 International Commission of Jurists study that notes 73 percent of trans people said they have experienced violence from family members, while 47 percent faced physical assault from members of the public.  

“Even though the legal framework exists, enforcement agencies and local administrations often lack the willingness or training to implement it effectively,” said Saha.

He told the Blade that his organization has encountered numerous cases where authorities did not respond to trans people who faced mob violence or domestic abuse. Saha emphasized  societal stigma and deep-rooted biases, reinforced by inadequate law enforcement, contribute to ongoing violence and discrimination against the transgender community. 

“As a society, we need more awareness campaigns, stricter enforcement mechanisms, and a cultural shift to create an environment where transgender individuals feel safe and respected,” he said. 

Without these changes, he warned, the cycle of marginalization will persist.

Kalki Subramaniam, a trans activist, queer artist and actor who is a member of the National Transgender Council, during an interview with the Blade discussed the mistreatment of trans people in police stations across India.

She said law enforcement often do not treat trans people with dignity. 

“When a trans woman is raped, her FIR is almost never registered,” added Subramaniam. “That could be because the police are not sensitized enough about transgender people around the country.” 

“Across the country, the situation is the same,” she told the Blade. “Even though there are lots of changes legally, police personnel need to be sensitized on a wider network. A few states have done some work, but the majority of Indian states have not.”

Subramaniam in response to the reported number of trans rape victims expressed deep shock, emphasizing violence against the trans community is widespread across India. She pointed out the figures only represent documented cases, while hundreds of crimes — particularly violence and rape — remain unreported and undocumented. 

Subramaniam highlighted the persistent stereotyping of trans individuals, adding only extensive government-led sensitization programs can undo it.

“As a member of the National Transgender Council under the Ministry of Social Justice, I have already emphasized in meetings that all ministries and departments must be sensitized on transgender rights and issues,” said Subramaniam. “Once again, I will talk about the rape issue in the meeting in the ministry.”

Ankush Kumar is a 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. 

A guideline from India’s National Blood Transfusion Council and the National AIDS Control Organization under the Health and Family Welfare Ministry permanently prohibits men who have sex with men from donating blood. This prohibition, however, may change with the Supreme Court reviewing a challenge to the constitutionality to the 2017 blood donor rule.

The Supreme Court on July 30 agreed to hear the challenge that a gay man from Delhi — Shariff D. Rangnekar, director of the Rainbow Literature Festival — brought. Lawyer Rohin Bhatt drafted the complaint and Ibad Mushtaq filed it.

The rule also applies to transgender people, female sex workers, and LGBTQ people.

Rangnekar pointed out these rules were rooted in a highly prejudicial and outdated perspective from the 1980s in the U.S. 

He noted many countries, including the U.S., UK, Canada, and Israel, have since revisited their guidelines, adopting new policies that no longer impose blanket bans on gay men or genderqueer people from donating blood.

“It is presumed that a particular group of persons may be suffering from sexually transmitted disease,” said Rangnekar in his lawsuit, according to the New Indian Express, a major English newspaper in India. “Medical technology and education, especially in the field of hematology, has progressed tremendously. The screening of donors is conducted for every donation before a transfusion.”

Rangnekar urged the Supreme Court to reconsider the blanket prohibition, arguing such a sweeping ban is unreasonable. He asserted this prohibition violates fundamental rights, including equality, dignity, and life, safeguarded under Articles 14, 15, 17, and 21 of the Indian Constitution. 

Rangnekar further argues the ban effectively denies LGBTQ people full participation in society, relegating them to the status of second-class citizens.

He contends that clauses 12 and 51 of the 2017 blood donor guidelines are both discriminatory and unconstitutional, because they permanently exclude LGBTQ people from donating blood. Rangnekar argues these provisions unfairly single out LGBTQ persons, barring them from contributing to a life-saving cause, and thus, violates their fundamental rights. Rangnekar also emphasized that such exclusion perpetuates stigma and reinforces inequality, contradicting the principles of justice and equality the constitution enshrines.

The Supreme Court on Aug. 2 took a significant step by issuing a formal notice to the Indian government regarding Rangnekar’s case.

Led by Chief Justice Dhananjaya Yeshwant Chandrachud, the three-judge bench sought responses from the National AIDS Control Organization and the National Blood Transfusion Council. This move marked the court’s recognition of the serious constitutional issues raised in the petition, setting the stage for a critical review of the rules that have long excluded LGBTQ people from donating blood.

The Union Health Ministry in 2023 responded to a Supreme Court petition that Thangjam Santa Singh filed, which challenged the 2017 blood donor selection criteria. Singh sought the removal of provisions that barred trans people, MSM, and female sex workers from donating blood. 

The Union Health Ministry at the time defended the exclusionary clauses in the Supreme Court, stating they are based on substantial evidence that demonstrates trans people, MSM, and female sex workers are at increased risk for HIV, Hepatitis B, and Hepatitis C. The ministry argued these guidelines were designed to protect the safety of the blood supply, though this stance has faced significant criticism for perpetuating stigma and discrimination against marginalized communities.

Rangnekar during an interview with the Washington Blade said India’s blood donation ban reflects a complete bias against the LGBTQ community. He emphasized this pattern of exclusion is not just about blood donation, but is part of a broader effort to deny the community basic rights and dignity. 

“There are many groups that could be high risk in certain areas, but you have a deterrence system in place,” said Rangnekar. “Globally, India claims to be a superpower, It is a country that has sold medical tourism to many parts of the world, and it is a hub for people coming from the developing world to have medical treatment, so what stops the government from having a testing system in place to allow us blood donation, but to have a blanket ban is absolute bias and nothing less than rubbish. We are in a country where there is a shortage of blood.”

Rangnekar also expressed optimism about his case.

Ankush Kumar is a 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.