Survivors Against TB Urges MoHFW and NETP to Rework the Gender Responsive Framework
Survivors Against TB, a community of TB survivors has written to the Minister of Health and the Joint Secretary, Health MoHFW to share their feedback on the recently released National Framework for a Gender-Responsive Approach to TB in India. We highlighted that we noticed several ethical, methodological and theoretical problems with this framework.
Our first concern was regarding the constitution of the expert committee. This committee should have included members who identify as transgender and LGBQI (lesbian, gay, bisexual, queer, intersex) persons. If this inclusion has not been made, this is a significant and unacceptable gap where the recipients of care have no say in the frameworks or interventions that are intended for them. This is against all principles of human rights, representation and inclusion.
Another key concern was the language of this document. While this may be subjective, we found that the language around trans persons in certain places, reinforces stereotypes identifying qualities and behaviours which are common across populations but remain significantly attributed only to them. This seems to indicate an inherent bias, which can influence the care behaviour towards transgender persons.
We also took issue with the key definitions in the framework. For instance, while the framework references the Transgender Persons (Protection of Rights), Act 2019, the challenge is that it clubs transgender and intersex individuals together – when their health needs might be different. This is a critical gap and one that is bound to result in poor understanding of the needs of these populations.
Finally, in the analysis of factors that influence health and the social and economic impact of TB, the framework mostly speaks only of men and women while marginalising other genders and communities especially those at higher risk of HIV-TB. Not surprisingly, certain suggested interventions ignore these risk groups as well. We believe, in its current form, this framework is exclusionary. If implemented, it will cause long-term problems in how gender inclusive care is defined in TB and create marginalisation and lack of inclusiveness for persons across genders, but especially for vulnerable groups like the LGBTQI (lesbian, gay, bisexual, transgender, queer, intersex).
“While we are advocating for inclusive and people-centric care, we seem to be excluding people from the process of defining what the care they need means” says Deepti Chavan, MDR-TB survivor and SATB fellow.
We urged the Ministry and NETP to take our concerns into account and institute a review of this framework with adequate and diverse gender representation from all affected groups. The Joint Secretary has kindly responded to these concerns and stated that he will get the framework reviewed in light of our suggestions.
Survivors Against TB Urges MoHFW & NETP to Rework the Gender Responsive Framework
Please write to us or get in touch with our press contact in case you’d like a copy of the Annexure with detailed inputs on each of the issues raised.