Need to integrate trans-inclusive science in medical education, says study

Not only in India, but globally, many medical schools dedicate few to no hours to LGBT health
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Despite legal protections, Indian medical curricula still lack trans-affirmative competencies, skills essential for providing respectful, evidence-based care to transgender and gender-diverse individuals in the country, a latest study has said.

As transgender people in India routinely face discrimination in health care, often encountering prejudice and ignorance from medical providers, the need of the hour is that India’s medical curricula integrate trans-inclusive science early in medical training so that the medical needs of transgender people are met, said the study published in the American journal Advances in Physiology Education.

Not only in India, but globally, many medical schools dedicate few to no hours to LGBT health, as reported by Kavita Bajeli-Datt of The New Indian Express.

Legal protections yet insufficient

Concerned by discrimination in healthcare and education, despite the Transgender Persons (Protection of Rights) Act, 2019, which prohibits it, a first-of-its-kind study was conducted, bringing fresh hope - at least for India - if it is incorporated into medical education.

In India, the National Medical Commission (NMC), which regulates medical education, has failed to adequately address LGBT health, said Dr Satendra Singh, Director Professor of the Department of Physiology at the University College of Medical Sciences and GTB Hospital, Delhi, and one of the study’s authors.

“Unfortunately, the NMC has made repeated U-turns on including LGBTQI content in the Competency-Based Medical Education (CBME) curriculum, first in 2019 and again in 2024,” Dr Singh told TNIE.

As per the 2011 census, India has 4.88 lakh transgender persons.

Pilot study integrates trans-affirmative competencies into MBBS

“It is the first study in India to integrate trans-affirmative competencies into the MBBS physiology curriculum longitudinally,” said Dr Singh, who was recently selected for the prestigious WHO South-East Asia region award for Public Health Champion in the individual category for championing disability inclusion in health systems and medical education.

“This groundbreaking study's findings are crucial for the future of medical education in India.”

Innovative teaching methods enhance engagement

“The pilot study tried to integrate trans-affirmative competencies into the MBBS physiology curriculum using a mixed-methods approach,” said the primary author, Kozhikode-based Dr Athul KM.

“Using health humanities tools like poetry, trigger films, and Theatre of the Oppressed, the curriculum enhanced student engagement and empathy. The study offers a scalable model for incorporating transgender health into early medical education, bridging curricular gaps and aligning with legal and professional mandates for inclusive health care,” said the study.

Dr Prof (Dr) Aqsa Shaikh, Professor of Community Medicine, Hamdard Institute of Medical Sciences and Research, and co-author of the study, said, “Where there is a will there's a way. Through this pilot study, we have shown that even in the existing packed MBBS curriculum we can provide competencies that our future, global, inclusive doctors would need, when caring for historically marginalized groups.”

“From dehumanisation in the old curriculum to human-centered approach in this pilot, we have taken a small step in the right direction for making healthcare accessible for vulnerable individuals and communities,” Dr Shaikh, who identifies herself as a transgender woman, told TNIE.

Pilot study results and implementation

Delivered over 11 months, the pilot study effectively demonstrated that nearly 17 hours of gender-inclusive education can be embedded without disrupting existing teaching schedules.

The study showed a remarkably high response rate of 92.4%, compared to less than 52% in similar studies.

“Both facilitators and students expressed enthusiasm, with all facilitators agreeing that the competencies were suitable for first-year medical students and expressing a strong desire to incorporate them into future sessions,” Dr Singh added.

The study said that integrating trans-inclusive science early in medical training is not just a curricular improvement: it is a legal, ethical, and professional necessity.

“Without it, medical education remains complicit in the marginalization of the very communities it purports to serve,” the study said.

Healthcare needs of transgender people

Transgender people in India often require specialized care, including hormone replacement therapy (HRT), gender-affirming surgeries, and reproductive health services.

However, these services are frequently unavailable or inaccessible, forcing individuals to either go without care or seek unsafe options from unqualified providers.

This not only endangers physical health but also perpetuates stigma and marginalization.

“Yet, medical education in India continues to emphasize the gender binary. Competencies in physiology, for example, still largely follow this outdated framework. Since physiology is a foundational subject in medicine, it must incorporate the concept of a gender spectrum as a normal physiological reality. Integrating a trans-affirmative physiology curriculum at the preclinical level would ensure a stronger, more inclusive foundation for all future doctors,” Dr Singh added.

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