Justice Venkatesh highlighted several other concerns raised in this regard by Doctor L Ramakrishnan in an article titled Curriculum Content Disorder. (Representational image: Unsplash) 
MedBound Blog

Gender Identity And Medical Education: New Guidelines

NMC's Gender Identity Clarifications: New CBME Guidelines Following High Court Mandate

Swati Sharma

Madras High Court observed the gender identity issue mentioned in the recently released Competency-Based Medical Examination, CBME 2024 curriculum. The bench comprising Justice N Anand Venkatesh clarified that there was no psychological disorder involved in a person belonging to the LGBTQIA+ community. It suggested corrections by making appropriate changes in the curriculum. Justice Venkatesh highlighted several other concerns raised in this regard by Doctor L Ramakrishnan in an article titled Curriculum Content Disorder. He directed the Apex Medical Education Commission to submit a report.

What is the LGBTQIA+ community?

The LGBTQIA + community is a collection of people with diverse sexual orientations, gender identities, races, ethnicities, and socio-economic status. The acronym LGBTQIA + community stands for lesbian, gay, bisexual, transgender, queer or questioning, intersexual, and asexual. The + in the Community acronym represents the evolving and new understanding of different gender and sexual identities.

Why need to make changes in the curriculum?

With changing times, LGBT community individuals are becoming increasingly open, acknowledging and being a visible part of the society. Clinicians and researchers face incomplete information about the health status of this community.

LGBTQIA+ individuals often face stigma and discrimination because their identities differ from societal norms, resulting in health disparities. This otherness is the basis for stigma, prejudice, and discrimination. It underlines society's general lack of health needs and health disparities.

Celebrating themselves. (Representational image from Pexels.com)

NMC Responds

The NMC deleted the sub-topic asking students to demonstrate knowledge of medico-legal, societal, ethical, and humanitarian principles in dealing with LGBTQIA and the community. It modified the topic title Psychosexual and gender identity disorders to Psychosexual Disorders and sexual orientation gender identity and Expression.

In Physiology

Explain sex determination, sex differentiation, and their psychological alterations, and discuss the effects of removal of gonads on physiological functions instead of Explaining sex determination, sex differentiation, and their abnormalities, and discuss the effects of removal of gonads on physiological functions. 

In Pediatrics

Describe adolescent sexuality and common problems related to it is changed to Describe adolescent sexuality, diversity in sexual orientation, and gender identity.

In UG curriculum

Demonstrate ability to elicit and record from the patient and other relevant sources, including relatives and caregivers. A history is contextual to gender, age, vulnerability, social and economic status, patient preferences, beliefs, and values. NMC says that UG curriculum parts do not need to be changed.

Implementing the directives

NMC has clarified since it does not publish its books, universities need to direct the respective publishers.

The NMC has now provided additional guidelines to ensure that medical students receive accurate and inclusive education on gender identity that fosters understanding and sensitivity in patient care. This move reflects the growing recognition of the need for inclusive healthcare education that respects diverse gender identities.

Reference

1. Institute of Medicine (US) Committee on Lesbian, Gay. “Introduction.” In The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Better Understanding. National Academies Press (US), 2011. https://www.ncbi.nlm.nih.gov/books/NBK64810/.

(Input from various sources)

(Rehash/Dr. Swati Sharma/MSM)

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