As the world celebrates Pride Month this June, TMM asked Dr. Yuvrajsingh Jadeja, M.D Obstetrics and Gynaecology, DIAGE(CICE, France), FRM(ISAR-ASPIRE, Japan), DRM(SKUH, Germany), and infertility specialist, the most common and frequently asked questions that LGBTQIA+ community faces.
Self-acceptance & focus in life
I think self-acceptance is the key to most of the internal troubles that the queer community face. It is important to acknowledge that society penalizes anybody outside of the charmed circle and especially folks in the margins. Self-acceptance can be really challenging but things are changing. More queer and trans folks are visible now than ever before thanks to social media.
Focus in life should be to find your safe place, be it in a closet or otherwise, to live and let live. Self-acceptance isn’t a point you arrive at it’s almost a life-long process, there are days that will be easier than others and that’s okay. Surrounding ourselves with people and messages (via media, literature and even wallpaper in our phones) which remind us that we are worthy is something all of us should try to do. You are not too much! You are enough! and something I think is important for the queer community today is to take that extra step and focus towards eradicating homophobia, transphobia, create awareness and try making the world a better place for the next generation of queer community.
How to deal with anxiety and stress of being closeted?
Anxiety and stress are very pertinent issue amongst closeted individuals. The very nature of being closeted keeps them away from seeking help. Studies show LGBTQIA+ youth are 4 times likely to attempt suicide than their straight peers.
The first step to help alleviate this stress is to understand that it’s alright if you need to stay closeted. Sometimes, the closet is the safest space.
Second, find a community online, you will feel a lot at a place interacting and being surrounded by out and proud queers of all stripes and ages, also other closeted people giving you a sense of reassurance that you are not alone. That energy and their stories can really uplift you and help you survive the closet.
Third, open-up to someone you can trust if you feel safe. It will relieve some pressure.
Fourth, if you think your mental health is getting the better of you, always reach out and seek professional help be it a counselor or a psychiatrist before it escalates.
Fear of coming out to the society and rejection
Fear of coming out is real, 85% of LGBTQIA+ students are victims of verbal or other forms of harassment. Coming out should not be an obligation, because you can feel shame or be shamed for not being ready to come out but remember coming out is a continuing, sometimes lifelong process. Coming out could be a gradual move or very sudden.
How to have safe sex and how frequently one should get tested for STD?
Prevention is always better than cure. The first step to safe sex is getting vaccinated to all available options such as Hepatitis vaccine and the HPV vaccine and now COVID, especially for the queer community. Unfortunately, STDs are still found to be a higher occurrence amongst the LGBTQIA+ community. The idea of not being able to get pregnant accidentally in same-sex couples makes them indulge in unprotected sex.
Second, consistent and correct use of barrier contraception is the key to safe sex and protection (condoms/diaphragm/dental dams).
Third, remember oral and anal sex is also a big route of contracting STDs, so never take it lightly always use a condom or dental dams.
Fourth, regular STD checks (every 6 months) are important, if you are into frequent casual sexual encounters. Also, it is now a routine practice to ask your date, etc honestly about their STD check-up status before engaging.
Fifth, if you are into a relationship with an HIV positive individual, consulting a doctor and staring PrEP (Pre Exposure Prophylaxis) medicines are a good option.
What to do after accidental unsafe sex encounter?
If you have accidentally had unprotected sex or an episode of failed protection such as a condom breaks during a sexual act and think you are at high risk of contracting an STD, it is always wise to:
- Visit a doctor and consider PEP (Post Exposure Prophylaxis) to decrease your chances of getting the infection.
- Contact the doctor or clinic as soon as you can, preferably within 48 to 72 hours, sooner the better.
- Contact the person you had sex with and request him to get tested alongside.
- If you are not able to get hold of that person, ideal to get yourself checked and keep a follow-up and repeat tests at 3 and 6 months.
Surrogacy and child adoption/fertility options
Being a fertility specialist, I cannot stress enough the importance of fertility options for LGBTQA+, because it just assumed that there isn’t any, and if at all only adoption. There a few more options for especially people who would desire a biological child of their own.
- First step is to find a fertility doctor and legal consultant sensitive and well-versed to fertility options for the LGBTQA+ community in your area, state, or country because remember rules are different.
- IUI-D (Donor Intrauterine Insemination) for people who have a uterus and functioning ovary, one of the most basic, cost effect,ive and less invasive option. It can be done multiple times.
- IVF- Invitro fertilization.
- Egg and Sperm cryopreservation/Freezing for the transgender community before HRT/SRS.
- Surrogacy.
- Adoption.
Surrogacy and child adoption is a boon for the LGBTQIA+ community, and an option for them to become parents. Since a lot of countries, like ours still don’t give these couples legal status, going ahead as a single parent is the only option that remains, be it adoption or surrogacy.
Surrogacy
Surrogacy is an important method of assisted reproductive technology wherein a woman under a legally binding contract carries a pregnancy for another couple. It could be altruistic or commercial. The woman is called a surrogate and the couple is called intended parents or commissioning couple. It requires IVF with your sperm or egg along with a donor and forming your embryo which is then transferred to a surrogate uterus. Unfortunately, a lot of countries do not allow it, and rules are different, so it is very important to be aware of it. For folks without a uterus and wanting a biological child of their own surrogacy is the only viable option
Adoption
It is always through registration in CARA agency, you can also seek help from your district child protection officer, again it needs to be single parent adoption, single female can adopt a child of any gender, but for a single man he can only adopt a male child. Maximum age for adopting a child up to 4yrs is 45 years, between 4-8 years is 50 years and above 8 year up to 18 years old child is up to 55 years.
Live-in concepts and limitation
In a country like ours, live-in relationship remains the only viable option for couples of LGBTQIA+ community, since they legally cannot get married. Pros are you have a sense of companionship and don’t have to stay alone, a support system, shared expenses, mutual understanding, and freedom from the obligations of a quintessential societal marriage.
Limitations of course is apart from the major fact that it is not legally recognized, lack of stability and commitment to some extent and also the societal pressure criticism and taboo that surrounds it.
Workspace school and bully
Statistics show almost more than 85% of LGBTQIA students face some form of abuse or bullying, students and employees all around the world hide their identity in fear of discrimination. Most claim to have experienced discrimination based on sexual orientation or gender identity when applying for jobs and it even varies by race and ethnicity, Pays can also be affected, and LGBTQ people are often subjected to biased jokes. Unfortunately, most countries do not provide legal protection for LGBTQIA+ communities.
Comprehensive Sex Ed in school along with inclusion seminars and sensitization in workspace and some strict policies are the need of the hour. LGBTQIA individuals struggle with a lot more mental health issues and suicidal thoughts due to a hostile environment. Homophobia and transphobia are still very much existent.
Is Indian healthcare very gendered? What can health care professional do to make the service inclusive?
Unfortunately, yes, healthcare services are gendered. It unknowingly imposes cis heterosexual Identity in anyone that walks in. It is changing but we are a long way from where we need to be.
Steps that can be taken:
- Mentioning in your scope of services (Websites, SM, Holdings, Banners, Pamphlets) that you cater to LGBTQA+ health will ease and encourage the person immediately and create awareness.
- Make sure your registration forms have pronoun options, which will immediately infuse confidence that the clinic is sensitive and inclusive.
- Educate yourselves, learn the correct terminologies if you deal with LGBTQA+ in any way.
- Don’t shy away from asking questions.
- Ensure Confidentiality and Counselling services.
- Speak up and Propagate gender and sex education where ever possible and relevant.
Feminine behavior and self-confidence
Gender stereotype kills confidence. I think the world definition and perception of feminine behavior have changed and people need to understand, accept and embrace it. The stereotype of what a female needs to behave like and what a man needs to behave like has to be broken. We need to encourage Gender fluidity and uninhibited expression of oneself. Femininity cannot and should not be defined homogenously. Everyone needs to understand the basic difference between gender and sex.
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