Understanding discrimination against LGBTQIA+ patients in Indian hospitals using a human rights perspective: an exploratory qualitative study

Abstract

Globally, LGBTQIA+ individuals experience several health disparities. This qualitative exploratory study aimed to understand the experiences of discrimination faced by LGBTQIA+ patients in Indian hospitals using a human rights perspective. Self-identified LGBTQIA+ patients, cis-gender heterosexual employees, and administrators attending/working at public, private, and non-profit trust hospitals were interviewed in Mumbai and Delhi. The “right to non-discrimination” emerged as the central theme, with systemic and organisational discrimination as core themes. LGBTQIA+ patients faced intersectional discrimination, which had implications for their dignity and wellbeing. Discrimination in public hospitals was explicit, whereas discrimination in trust and private hospitals was subtle. Employees of core departments like psychiatry, dermatology, and HIV services, which routinely catered to LGBTQIA+ patients, were more sensitised than other departments. Most administrators and doctors were not familiar with the varied needs of the LGBTQIA+ spectrum and treated them as a homogenous group. Public hospitals did not have separate human resource departments, and most of the gender-affirmative guidelines/policies were not inclusive of the entire LGBTQIA+ spectrum. Trust hospitals, especially those with religious affiliations, tended not to have LGBTQIA+ inclusive policies. Some administrators believed that serving the minuscule LGBTQIA+ population may adversely affect business in private hospitals. Policymakers, government, and executives need to be accountable at the systemic level for better enforcement of ratified treaties and laws, designing inclusive public health policies, and reforming medical curricula. Hospital and healthcare administrators must be accountable for implementing inclusive policies and practices and creating a non-discriminatory environment for LGBTQIA+ patients.