Ayurveda & LGBTQ+ Pride

Happy Pride Month! A few years back, I wrote a feature on how meditation can help create an inclusive world. Since then, things have only gotten worse for the LGBTQ+ (Lesbian, Gay, Bisexual, Transgender, Queer or Questioning and other sexual orientations and gender identities) community. Last year, the Human Rights Commission took the unprecedented step of declaring a national state of emergency for LGBTQ+ Americans with a record-breaking number of anti-LGBTQ+ bills, hate, and misinformation.

Pride is a time to celebrate our LGBTQ+ loved ones who have struggled over the centuries and continue to fight for their rights, against criminalization, human rights violations, and debilitating discrimination. 7–10% of the world has come ‘out’ as LGBTQ+ despite it being risky to do so. The word ‘minority stress’ was coined in their context. In healthcare, they face the dual impact of poor health because of unequal rights, and health inequity.

Public Health Crisis in the US

• Every 45 seconds an LGBTQ+ kid attempts suicide. This is the second leading cause of death in this age group. According to the Trevor Project, even one affirming adult can reduce this probability by forty percent.
• Being LGBTQ+ doesn’t inherently impact mental health or make them suicidal. Societal stigma, ill-treatment, added health challenges, lack of adequate healthcare, human rights, and structural and policy protections impact both physical and mental health.
• 40% of LGBTQ+ folks faced one negative healthcare experience in the past year.
• They are three times more likely to delay or avoid care due to healthcare discrimination.
• 69% Intersex, 49% Transgender, 17% LGBQ don’t come out to providers.
• The community experiences four times the violence others do.
• A structural and health inequity of this magnitude is a public health crisis.

In the words of Rev. Dr. Martin Luther King, Jr., “Of all the forms of inequality, injustice in healthcare is the most shocking and inhumane.”

“Spirit is all love, it’s all joy, and it is only one, “ Gurudev Sri Sri Ravi Shankar advocated for LGBTQ+ equality and decriminalization in India. In the past, Gurudev has talked about how “Each one of us is made of both mother and father and have qualities of both of them in us. Sometimes, the male energy is dominant though you are a female, and the female energy is dominant though you are a male.”

When asked about the incidence of suicide in the LGBTQ+ community, particularly the Transgender Community, Gurudev answered, “Absolutely true. We should not discriminate against anybody. Gender equality is the word we must always use. We must honor every gender.” He said that controlling the human psyche is a very wrong step that human society has taken in the past. Gurudev applauded the freedom that has come in this century and how welcome the decriminalization of the Transgender community is.

My story

When my child came out to me over ten years back, I was shocked at their trepidation and fear. Did you ever feel scared, about your sexual orientation or gender identity? I didn’t realize how tough things are and it broke my heart that compared to my child I have privilege. I got them a book on being LGBTQ+. I studied LGBTQ+ identities. I got involved with the Trevor Project, Free Mom Hugs, and became a board member of my local PFLAG. I wrote several articles and was featured in Ayurveda, as an LGBTQ+ ally. Around me, things were getting worse but I reminded myself, I’m just an ally. What do LGBTQ+ people go through? So I continued my advocacy. And I meditated…

Background and Research

Ayurveda is based on the philosophy of “One World Family” or Vasudhaiva Kutumbhakam, which is the vision of the founder, Gurudev Sri Sri Ravi Shankar. I have heard about a few cases of torturous conversion therapy in the US (forcibly trying to convert people out of their LGBTQ+ identity through ‘medication’, ‘marriage’, rape, ‘counseling’, electroshock therapy, ‘cleansing’, ‘praying’, ‘religion’, ‘boot camps’, etc., which led to mental health issues, suicidal ideation, and suicide). There is also a lot of lack of information, and misinformation. Vedic times were inclusive and I decided to do my AD Research Dissertation on, “Best practices for providing culturally competent, safe, and affirming Ayurvedic healthcare management of the LGBTQ+ community.

LGBTQ+ people have always existed, Vedic Times and the Impact of Colonization

Before colonization, indigenous societies like Vedic times honored and included the LGBTQ+ community like the ‘Tritiya Prakriti’ or third gender in India, Hijra and Kinnar community, Two-spirit identities amongst Native American communities, Kathoey, Khanith and Nádleehi people around the world. The British banned homosexuality in India in 1833 and Ayurveda in 1861! While decriminalization in India occurred in 2018, homophobia persists and there is insufficient health data or education about LGBTQ+ healthcare. Today, 64 countries still criminalize homosexuality in some form, with 12 countries attaching the death penalty to being LGBTQ+!

Gender and Sex According to Modern Medicine

Sex refers to biological physical differences between male, female, or intersex folks (who have differences in sex development or primary or secondary characteristics that don’t fit into either classification). Sex is assigned at birth (natal sex). Two percent of the world’s population is intersex. This is not a pathology. It is an identity of people who deserve to live, thrive, and be happy.

Instead, many have non-consensual surgeries performed when they’re born or as toddlers so they can conform to society’s expectation of the binary. A 2018 US study showed the consequence of society’s bigotry against the Intersex community. 43% rated physical health as fair/poor, 53% rated mental health as fair/poor, and many had other chronic health issues.

Gender involves how a person identifies. People may identify with genders different from their natal sex or with none at all. These identities may include transgender, nonbinary, or gender-neutral, or other ways. Transgender and Non-binary people are the target of disproportionate misinformation, hate, and killings.

Status of the LGBTQ+ community in Ayurveda

Currently, protocols for equitable care depend on individual providers. There is a blurring of lines between pathology and LGBTQ+ identity. Globally, there is scope for cultural misappropriation of Ayurveda’s inclusivity

What do Vedic/Ayurvedic Texts Say?

This is based on secondary results of my study where I went through various texts and papers and talked to senior Vaidya’s

1. Three Prakrit’s exist: Pums or Male, Stri or Female, and Kliba (Napumsaka, Tritiya) or LGBTQ+. Napumsak is wrongly translated as infertile. I am infertile. A monk is. A child and an elderly person is. Many LGBTQ+ people and straight people are fertile and some are not. This is different from their identity.
2. 50+ LGBTQ+ identities were referenced in Vedic times and over 21 texts. There were extensive discussions about their conception and other aspects of their health in Ayurveda. These include include Transgender (Shanda/Shandi), Bisexual (Kami, Kamini, Paksha), Lesbian (Svarini, Nastriya), Homosexual men (Kliba, Panda, Napumsaka), Intersex (Dvireta, Vakri, Triputrika).
3. Ayurvedic references In terms of conception, the sperm and ovum being of equal strength, the period of conception, the stars or nakshatra, the sex position, and parental influences make a child LGBTQ+. In the second month, the fetal and abdomen shape and the primary and secondary reproductive organs help in identifying an LGBTQ+ fetus. Various gender identities and sexual orientations are referenced.
4. Why are people LGBTQ+? From all these texts, I concluded that there are four reasons for any identity,
   • Divine/Karma causes
   • Genetic—The ‘potency’ of the ovum and sperm
   • Natural causes—Ayurveda aligns with nature and we are surrounded by examples of LGBTQ+ animals (no homophobic ones though).
   • Maternal, Paternal causes (for instance, some hormonal or even dietary impact during pregnancy)
5. De-pathologize—Current literature sometimes blurs the lines between sexual dysfunction, infertility, mental illness, and LGBTQ+ identities. There are some dangerous conversion therapy attempts in India and outside—and no directive from the Ministry of Ayush to ban them, which is much needed.

Shloka: ata eva ca śukrasya bāhulyāj jāyate pumān |raktasya strī tayoḥsāmye klībaḥ

Translation: A male child will be produced when sukra (semen) is more potent, a female child when rakta (shonita) is more potent. When both are equal, a child is neither definitely male nor female but has features of both sexes; a Napumsaka child is born.

Reference: Garbha lingotpatti karana (cause of sex determination) Ashtanga Hridayam Sa 1.5

Ayurvedic Management of the LGBTQ+ Community

In my primary research, I interviewed 30 Vaidya’s/AD’s in India and the US. I also got to interview Ayurvedic doctor VS Priya, India’s first transgender doctor at Sitaram Hospital. She told me how representation matters and so many people come to her feigning gastrointestinal or other issues but talk about being LGBTQ+ and allied healthcare concerns.

The following are the vaidyas’ recommendations.

Best Practices and Public Health Measures in Ayurveda

Many best practices and public health measures were outlined and rated including ‘conversion therapy’ which some Vaidya’s mistook for transitioning. Still, when it was explained, many wanted it banned and asked for legal protections for the LGBTQ+ community. These are the main outcomes.

1. Educate Providers about the LGBTQ+ community and their healthcare
2. Inclusive Intakes
3. Non-discrimination policies and protections
4. DEI training, for providers and schools
5. Data Collection (while maintaining confidentiality)
6. These can be implemented by stakeholders; providers, associations, and Ayurvedic schools

Healthcare Management and Other Results

1. Providers in LGBTQ+ healthcare advised trauma-informed, personalized management, as many healthcare concerns stem from trauma, marginalization, and abuse. Health concerns by identity were rated based on GLMA’s top ten healthcare concerns and as expected, mental healthcare concerns rated high. Lack of access to care, cancer, and violence also came up as concerns.
2. Vaidyas consider being LGBTQ+ mainly Natural, Divine, or Unknown (Karmic), and Genetic
3. On transitioning, dietary and lifestyle support can be provided. It is important to note that all major mainstream Medical Organizations support gender-affirming care for transgender folks, and myths need to be debunked.
4. While 89% of US Vaidyas have LGBTQ+ clients; 27% in India (out to them), 80%+ Vaidya’s in both countries want a module in Ayurvedic healthcare.
5. 47% refer LGBTQ+ people out for allopathic care, to other Vaidyas or for psychiatric care.
6. 74% consider it relevant to handle age groups differently. Their healthcare concerns are different at different ages with youth experiencing greater mental health challenges.

Conclusion

Vedic Times and Ayurvedic Texts have multiple, inclusive references to the LGBTQ+ community. Knowledge dispels misinformation. An LGBTQ+ Healthcare Education Module in Ayurveda is sought by Vaidya’s (who are overwhelmingly affirming), just as it is being sought in mainstream medicine. We also need more studies on community healthcare needs while protecting their confidentiality. Beyond training—beyond everything—this is a journey from the head to the heart. How can we as human beings, and more importantly in the healthcare space, harm those who are just being who they are?

To the LGBTQ+ community, we see you, we are with you. There are effective tools to manage stress and we provide them through Art of Living’s Sky Breath Meditation. If you’re in crisis or need support, do not hesitate to reach out to these resources, call the 988 suicide or crisis helpline, or go to your nearest emergency room.

Acknowledgements

I’m grateful to my Research Guide, and Mentor, Vaidya Princy Prasad and the Director of Kerala Ayurveda USA, Vaidya Jayarajan Kodikannath. I’m grateful to Kerala Ayurveda, USA India, and everyone in the Ayurvedic community who were respondents in my study, including many of my faculty. My research findings were presented at Kerala Ayurveda, USA, peer-reviewed, and presented at the 2024 National Ayurvedic Medical Association Conference and have been selected by GLMA educators (Health Professionals Advancing LGBTQ+ Equality) to present at their conference in Oct 2024. I am grateful to Art of Living Retreat Center for letting me discuss significant results in this Pride Article.

Find references here. 

Disclaimer

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment or Ayurveda advice, assessment or management. 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.