Madras HC slams NMC for terming Gender Identity a 'Disorder' in CBME curriculum

Justice N Anand Venkatesh, who has issued multiple directives supporting LGBTQIA+ rights, on February 3, 2025 observed that such terminology undermines efforts to foster inclusivity. He further emphasized that LGBTQIA+ individuals are natural and that their sexual orientation and gender identities are not “disorders.”

Also Read: 'Gender Identity Disorders' reference removed! NMC issues additional clarifications on CBME Guidelines post HC order

The petitioners contended that while an NMC-appointed committee had recommended positive changes in 2022, the current proposed curriculum disregarded those recommendations and reverted to outdated notions.

Justice Venkatesh censured the NMC for its reluctance to incorporate reforms and called for immediate revisions to remove discriminatory classifications. The court remarked that sexual orientations and gender identities are natural and not pathological. It noted;

"Efforts are actually being taken to water it down. The fact that you've used the word gender identity disorder shows the mindset. If you call it a disorder, then everything is a disorder. The nature has created them in such a way."

"Somehow, the impression is given that LGBTQIA+ identities are a disorder. Why should we use the term 'gender identity disorder'? It shows the mindset,"

The court orally expressed particular concern over the NMC’s argument that LGBTQIA+ topics need not be part of medical education as they are taught in schools. The judge questioned;

“Which school is teaching this? In fact in schools, all this (words like homosexuality) is considered to be bad words. I'm stunned. I'm flabbergasted. When institutions at the level of NMC are hesitating, you're expecting schools to do it? You're all people dealing with science, taking facts as it if. And you're going on and calling it a disorder. It'll negate the whole exercise because fundamentally we're not changing. We'll just be beating around the bush."

The court also addressed the issue of conversion therapy, noting that the NMC had placed its 2023 regulation—where conversion therapy was to be classified as professional misconduct—on hold. The judge suggested that interim changes be made to existing regulations to prohibit conversion therapy until the revised rules are formally implemented.

According to a recent media report in LiveLaw, the case has been adjourned to February 17, 2025, for further discussions on the policies and the progress in revising the medical curriculum.

Medical Dialogues had earlier reported that following the observations made by the Madras High Court bench regarding the gender identity issue mentioned in the recently released Competency-Based Medical Education (CBME) 2024 curriculum, the National Medical Commission (NMC) issued additional clarification.

As per the Corrigendum/addendum issued by the Undergraduate Medical Education Board (UGMEB) of NMC, the Commission has modified the topic titled "Psychosexual and Gender Identity Disorders" to "Psychosexual disorders and Sexual orientation, gender identity and expression". It also deleted the sub-topic that asked the students to demonstrate knowledge of medico-legal, societal, ethical and humanitarian principles on dealing with LGBTQA+ community.

For Physiology, the Commission has modified the sub topic titled "Explain sex determination, sex differentiation and their abnormalities and discuss the effects of removal of gonads on physiological functions" to "Explain sex determination, sex differentiation, and their physiological alterations and discuss the effects of removal of gonads on physiological functions".

Apart from this, NMC has also changed the sub-topic titled "Describe adolescent sexuality and common problems related to it" under Pediatrics to "Describe adolescent sexuality, diversity in sexual orientation and gender identity."

The UG Board of NMC also referred to Page 12 of the CBME Guideline 2024 which refers to Clincian, who understands and provides preventive, promotive, curative, palliative and holistic care with compassion. In reference to the recommendation "Clinical History-taking need to include approaches that elicit information on gender, sexual orientation and behaviour in a non-judgmental manner", the Commission clarified that the relevant clause us given as under (which is already a part of existing CBME guideline):

Case Background

State Policy on LGBTQIA+ Rights

During the hearing, the Tamil Nadu government informed the court that it was in the final stages of drafting policies for the welfare of LGBTQIA+ persons. It proposed two separate policies—one for transgender and intersex persons and another for the broader LGBTQIA+ community.

The court, however, cautioned that such a division might create confusion, reinforcing a misconception that transgender and intersex persons are distinct from the LGBTQIA+ spectrum. Justice Venkatesh advised the government to consider a consolidated policy to ensure clarity and comprehensive protection.

The state was directed to submit both proposed policies along with a note detailing any difficulties in merging them. The court emphasized that stakeholder consultation should be conducted to formulate an effective and inclusive policy, ensuring it is legally robust and not subject to future litigation.