Ayurveda is Inclusive: Creating Safe Healthcare Spaces for the LGBTQ+ Community

Sarve Bhavantu Sukhinah—May all beings be well.

One of the most important issues facing the LGBTQ+ community—in addition to violence, abuse, self-medication, discrimination, and homelessness—is unequal healthcare. Despite it being 2022, the fight continues for equal treatment by doctors and health insurance companies. Lack of access to important medical care means more health issues, substance abuse, and mental health problems.

No Vedic sciences are meant to harm, whether Ayurveda, yoga, vastu, or Vedic astrology. If they’re used for conversion therapy, to impose hatred, biases, or prejudices, or appropriated or maliciously translated as such, that is not just a distortion but unethical malpractice. In any medical practice, an oath has been taken—Do no harm. When we understand what we can do within our scope of practice, and open our arms and hearts in hopes of the best outcome for the patient—for all who need us—we become part of the solution.

Ayurveda is LGBTQ+ Affirming

Ayurveda, the 5,000-year-old holistic and natural “Science of Life,” is a medical science in India where it originated, and a form of complementary medicine in the US. Ayurveda, like all Vedic Sciences, is LGBTQ+ (Lesbian, Gay, Bisexual, Transgender, Questioning/Queer) affirming—in the words of Vaidya Jayarajan Kodikannath, President of the US National Ayurvedic Medical Board, “Ayurveda has traditionally supported everyone, irrespective of gender identity and orientation.”

A History of Ayurveda & Gender Identity

In Vedic times, there was a concept of Tritiya Prakriti (the ‘third’ Prakriti) and the LGBTQ+ community was integrated into society. Vasudev Kutumbhakam, or one consciousness, is a key Vedic concept from the MahaUpanishad, honoring everyone from all ethnicities, races, genders, and sexual orientations as a ‘one world family.’

“Ayurveda tells us that we are one unified field of pure consciousness and if it is the same light that shines in each one of us, it is our responsibility to practice and make this ancient wisdom a living reality in our daily lives. If we fail to understand this, we are not practicing Ayurveda!”—Vaidya Kamya Pillai

According to the Vedas, the concept of consciousness is ArdhNareshwar or half Purusha, half Prakriti, half male, half female. Gurudev Sri Sri Ravi Shankar, global humanitarian and founder of Art of Living, asserts, “Its pronouns are, he/she/they/them”; this is an affirmation that rejects heteronormativity (or the concept of just two genders which form the basis of anti-LGBTQ+ rhetoric).

Indian mythology, culture, and epics are replete with references to the LGBTQ+ community with many LGBTQ+ Goddesses, Gods, and temple sculptures. Gurudev advocated for a long time for the decriminalization of homosexuality (Section 377 of the Indian Penal Code), tweeting (@SriSriSpeaks) on Dec 11, 2013, “Homosexuality has never been considered a crime in Hindu culture. In fact, Lord Ayyappa was born of Hari-Hara (Vishnu and Shiva).” The British Law criminalizing homosexuality in 1861 was finally overturned in 2018, but biases do persist in society, in India, and in most other parts of the world.

45% of LGBTQ+ youth have seriously considered suicide in the past year, and every 45 seconds one attempts suicide—the second leading cause of death in this category. The LGBTQ+ community suffers from minority stress, trauma, and mental health issues because of how they’re treated—many are marginalized, abused, and even rendered homeless; often by their own families!

Ayurveda believes not just in preventive health or disease management, but in helping people live to their fullest potential. It takes its cue from nature in following circadian and seasonal rhythms, natural formulations, therapies, and a lifestyle that honors the five elements, community, and sustainability. In nature, no two leaves on a tree are the same, gender can be non-binary in the animal world, and 1500 animal species are LGBTQ+—how could humans not be?

Ayurveda believes that being LGBTQ+ is not a disease, but natural and genetic as reiterated by Vaidya Sheena Sooraj. Additionally, some translate that LGBTQ+ could be the result of past life karma. And while others use a harmful, willful mistranslation, calling it a sin, there is no concept of sin in Vedic sciences.

For those who believe in reincarnation as part of healthcare, there is a theory that one reason for being LGBTQ+ could be many past lives of a particular gender identity, so the identity in this birth may differ from the sex assigned at birth.

2% of the population is intersex, some kids have non-consensual surgeries and the community suffers from inordinate anxiety and depression. How can we, in healthcare, ever consider harming an entire community?

Why do we need LGBTQ+ affirming healthcare?

Here are five reasons we need to provide LGBTQ+ affirming healthcare.

1. The LGBTQ+ population has major healthcare disparities and barriers to healthcare.
2. There are unique mental and physical health challenges exacerbated by being part of a marginalized community.
3. Many healthcare professionals are not adequately trained to handle LGBTQ+ health—or may be biased.
4. The community continues to face stigma and discrimination and lacks equal rights in healthcare, housing, employment, and education.
5. The current political climate and pandemic have worsened LGBTQ+ healthcare.

What Can We Do?

There are ways Ayurvedic healthcare can be adequate, competent, and affirming. In October of 2021, I interviewed Stevie Inghram on creating an LGBTQ+ affirming space for the series, Representation Matters. During the process, I reached out to NAMA, the National Ayurvedic Medical Association, and a few state boards in the US, all of which reiterated their support, as did leading Vaidya’s and institutions. We all agreed that we must elevate LGBTQ+ voices and be open in our stance as allies.

This would mean the entire industry being affirming, including national and state boards, healthcare practices (could have an equivalent of the Healthcare Equality index?), and schools educating students about the LGBTQ+ community—their history, gender identity, expression, sexual orientation, healthcare needs, and inequities—and creating a safe community for their LGBTQ+ students. 

LGBTQ+ patients should have access to competent care. It isn’t an impossible ask. There are easy ways Ayurvedic practices (and the healthcare industry as a whole!) can be welcoming and inclusive.

1. Provide education to staff and employees about the LGBTQ+ community, their healthcare needs and inequities, and closing the gap.
2. Have a strong DEI policy in place and provide training to all employees.
3. Adopt a visible non-discrimination policy so the onus of finding out whether you’re a safe space is not on an LGBTQ+ person who may have anxiety or trepidation in seeking healthcare.
4. Make your workspace and communication openly LGBTQ+ inclusive. Some ways to do that could be
   • Using symbols and cues like same-sex couples in literature and posters
   • Honoring important events and celebrations like Pride
   • Using inclusive statements and the progress pride flag in media and marketing
   • Creating gender-neutral bathrooms
   • Making resources for the LGBTQ+ community for healthcare and wellness available and easily accessible
   • Honor pronouns and chosen names, and use inclusive language when dealing with clients, employees, and customers.
5. Including gender identities and sexual orientations on Ayurvedic intake forms, assessments, employee forms, and surveys; will also help collate data for future care or best practices.
6. Be sensitive. Avoid microaggressions and give people space to come out at their pace and avoid making assumptions—anybody can be LGBTQ+.
7. Adopt clinical protocols and best practices, and train wellness staff on culturally competent care and healthcare issues, for instance, those that pertain to different LGBTQ+ populations (lesbian, gay, transgender, nonbinary, asexual, etc.) and different ages (youth who have increased suicide or substance abuse risk or the elderly with palliative care). Also,
   • Be sensitive to the added stress of intersectionality
   • Be sensitive that a previous experience with healthcare may not be positive.
8. Consider how professions may impact health (a homeless child that has taken to sex work, a military person who experiences greater stigma and trauma despite the repeal of “don’t ask, don’t tell”)
9. Find ways to help someone who is socially or medically transitioning; including sex education for different orientations.
10. Mental and physical health challenges and trauma-informed care—overall higher incidence of suicides, abuse, substance abuse, cancer and cardiac risks, and mental health issues on account of trauma or denial or delay of care. Also, HIV (which is not just an LGBTQ+ issue but has been stigmatized as such) and STDs.
11. Stay current on case studies like a trans man who has menstrual abnormalities or breast cancer risk, post-surgical care after top surgery, a youth that is self-harming, has mental health, or substance abuse challenges
12. In the holistic health model, intake is more detailed and supports people’s life journeys in a safe, non-judgmental way without projecting biases or pathologizing queer experiences. This helps nurture resilience while attending to preventive health and disease management.
13. Maintain confidentiality and follow HIPAA guidelines strictly which matter a lot to LGBTQ+ populations (Ayurveda as a legal but unlicensed practice in the US is currently not governed by HIPAA, but we should be ahead of the curve and follow privacy guidelines).
14. Understand the scope of practice based on the healthcare laws in your state relating to Ayurveda. Work in an integrative manner and have a set of resources (like the Trevor Project or suicide prevention helpline) and referrals, don’t hesitate to refer people out.

Remember: Do no harm. Don’t attempt to influence anyone based on your ideology or biases, or attempt conversion therapy.

Discrimination can be Life-Threatening—Support, Life-Affirming.

Healthcare is for everyone. No one should have to worry about access to care, being mistreated, or not having their needs met. Given the challenges faced by the LGBTQ+ community, gaining the competence and confidence to support them on the healing journey is an embodiment of dharma. We have the gift of helping people live their truths.

“Spirit loves diversity. Let’s enjoy the diversity in creation by honoring, respecting, and loving all.” —Gurudev Sri Sri Ravi Shankar

The future is inclusive and filled with hope because each one of us being affirming can cause a shift in human consciousness.

Ayurveda is a holistic Science where we honor everyone’s life story and validate their identity; physical, mental, and spiritual. It is also a consciousness-based science that goes beyond the physical and material to recognize the subtle and causal. To be healthy is to be established in the Self. Providing a safe, accepting, and nurturing space is a fundamental tenet to promoting health and incorporating all aspects of consciousness.

Disclaimer This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health providers with any questions you may have regarding a medical condition and seek the advice of your Ayurvedic practitioner for any disease management-related queries using the Ayurvedic process. Any links to third-party websites are provided as a convenience only and neither the author nor AOLRC is responsible for their content.