What about the One-Stop Crisis Centre for rape victims in West Bengal?

Mailboxes in stairs, Calcutta Kolkata India

West Bengal continues to have the long drawn process for rape victims seeking any help or recourse. Speaking to Hidden Pockets Collective about the process presently followed with rape victims, Dr. P.S.Chakravorthy, Head of the Department of Gynaecology at the IPGMER & SSKM hospital, Kolkata says, “The victims have to first report to the police. Then they visit the gynaecology department here, after which the forensic department is involved in the process. Then if required, the victim is sent to the psychiatric ward for counselling.

Typically, any One-Stop Crisis Centre for rape victims is supposed to include medical, legal-aid, psycho-social counselling, shelter, police assistance, video conferencing facility to facilitate police and court proceedings. Having mapped One-Stop Crisis Centre for rape victims in several other states including Jaipur and Kochi, Hidden Pockets Collective went looking for one in the state of West Bengal. It appears that West Bengal has no One-Stop Crisis Centre (OSCC) for rape victims. There seems to be no information available on any centre that has been set up in West Bengal either.

Nation-wide plan for One-Stop Crisis Centres (OSCC)

According to the implementation guidelines released by the Ministry of Women and Child Development in April 2015, one OSCC was to be set up in every State and Union Territory during the first phase. The Scheme of One Stop Centre was approved for 36 locations, one per each state of Union territory for implementation from April 1, 2015. The Department of Women and Child Development were required to send its proposal for a centre to the Ministry of Women and Child Development and was to be approved by the Proposal Approving Body (PAB). According to the Revised One Stop Centre Scheme report from May 2016, ‘during the year 2015-16, proposals of 33 States/UTs had been sanctioned for setting up One Stop Centre. Out of these 33, 15 Centres were become operational by 30th May, 2016.’ The scheme has also been revised to include 150 OSCCs in phase two in addition to the 36 centres from phase one. The additional centres have been distributed amongst the different states including NCT of Delhi taking into account the number of registered crime, number of female population and the Child Sex Ration in the respective state.

West Bengal not to be seen? 

Interestingly, out of the 36 from phase one, only 14 sanction orders have been listed on Ministry of Women and Child Development’s website, all for the year 2015-16. West Bengal is not to be found neither on the sanctioned list or in the list of states mentioned in the minutes of any of the PAB meetings conducted so far. It is not clear when the website of Ministry of Women and Child Development was last updated. It is also not clear if the West Bengal government is one among the 33 states whose proposal was sanctioned by the Ministry. If it is one of the 33 states,  According to the Revised One Stop Centre Scheme report, 10 additional centres have been allotted for West Bengal in phase two.

Historically, how has West Bengal reacted to OSC centre – 2016 & 17?

  • In October 2015, Maromi met the Joint Secretary, Department of Women and Child Development of West Bengal to know the status of the OSC in the state. a place has been suggested in North 24 Barashat, Noth 24 Parganas, within the complex of DM bungalow.
  • In March 2016, Maromi sent a letter to the Chief Minister’s office to understand the status of OSC in West Bengal.
  • In November 2016, Maromi representatives met Dr. Shashi Panja to invite her for a seminar. During the meeting, speaking about the OSC, the minister said regarding the setting up of the OSC during which the minister mentioned that the government is not thinking about it at the moment.
  • The Ei Shamoy article on 26, November 2016 confirmed the statement expressed by the minister.
  • The state has rejected the Centre’s proposal for stepping up of the OSC. Shashi Panja says that we have already been doing this job so there is no need to take money from the Central government and set up a separate centre.

Where do women access services if both state government and central government refuse to take any responsibility?

Chandan Nagar goes on its fifth Pride March celebrating its LGBTQIA+ community

the images of a LGBTIQ flag

Atri Kar, a transwoman is a primary school teacher in Chandan Nagar. She got a job in 2014 before the NLSA (National Legal service authority) judgment of the Supreme Court with respect to transgender rights. The NALSA judgment simply states that ‘self-identification’ is more than enough if a person self-recognizes as a transgender. There is no need for any supportive document. When Kar approached the Block Development Officer (BDO) of Magra to change her voters ID and Aadhaar card, she was asked for supportive documents. Unclear about what needs to be done, Kar approached Amitie Trust for help. On Amitie’s suggestion, Kar approached the BDO requesting for the list of supporting documents that are required. However, the BDO had no list to give Kar since the Supreme Court has been clear in its verdict on the matter. Subsequently, Kar managed to get her documents done with help of the Sub-divisional officer.

“The crucial point here is that in spite of being educated, Atri Kar faced this problem, but there are many uneducated people who face similar problems and do not know what to do about it because they are unaware of their rights,” notes Deshapriya Mahapatra,AmitieTust.

Amitie is a French word meaning “Friendship” hence the Amitie Trust works towards building a tolerant society towards the LGBT community. Many continue to be intolerant towards the LGBT community and do not support them. In spite of these issues, the Amitie Trust has been organizing Pride Walks since 2013 in Chandan Nagar. Chandan Nagar district is in a rural area about an hour and a half away from Kolkata, the capital city of West Bengal. Chandan Nagar Pride Walk begins exactly opposite the Chandan Nagar police station, a beautiful site adjoining the river Ganges. Chandan Nagar had its fifth Pride March on July 1, 2017.

Photo credit: Kaushik Gupta

The history behind Amitie Trust dates back to nearly 10 years. Amitie Trust is an organization working in Howrah, Hooghly and other neighboring districts. On April 1, 2009, Amitie was registered as a trust, prior to which Amitie had functioned for almost 4 to 5 years as an informal organisation.

However, when it comes to the Pride walk ‘visibility’ becomes an important concern, several people are not comfortable in revealing their sexual orientation or gender identity. “We began our pride walk in Chandan Nagar in the year 2013 with about 50 to 55 participants and today we are about 160 participants, which is one of our biggest achievements” adds Mahapatra.

Photo credit: Kaushik Gupta

Problems faced by the LGBT community are numerous, it is not only the authority system of the country which poses a threat to them but they face different kind of problems on a regular basis, physical harassment, verbal harassment in local trains, health related issues and many more. Some people are also uncomfortable with their attire and the way they carry out themselves.

“In the year 2002, three boys were detained by the police in the name of eve teasing; we call them ‘koti’ (effeminate males) in the local language. The police had no evidence of them Eve teasing anyone and finally had to release them. When the magistrate saw the three detained boys, she smiled and told the police, if at all you had to arrest these boys you should have accused them of Adam teasing, not Eve teasing. It was then that we realized that we should have a formal group to raise our voices against such injustice. To organize members of different sexual orientation or different gender identities to come together in the quest for justice,” narrates Mahapatra.

Awareness about ones sexual orientation or gender identity is a crucial issue. Many people are unaware about such issue hence the pride walk takes place in order to educate people about such issues and make them more sensitive and tolerant. Amitie Trust also finds the need to take the pride walk further, from rural to urban areas and spread gender awareness to a larger area and not only keep it confined to Chandan Nagar.

Photo credit: Kaushik Gupta
Photo credit: Kaushik Gupta

About the writer:

Marian Dias is a sociology graduate who hopes to start teaching the subject someday soon. Apart from loving outdoor games like basket ball and cricket, she also loves to travel and visit new places.

Ratnaboli Ray on sexuality of persons with psychosocial disabilities

Pleasure, Politics & Pagalpan was a conference that happened on May 13 & 14, 2017, on ‘Sexuality, Rights and Persons with Psychosocial Disability’ co- convened by Anjali and ARROW (The Asian-Pacific Resource and Research Centre for Women) with support from CREA. Speaking to Hidden Pockets about the conference, Ratnaboli Ray, Founder of Anjali shared about Anjali’s experience and understanding to do with sexuality of persons with psychosocial disabilities. Listen to a fascinating conversation with Ratnaboli Ray where she explains the deeper nuances involved in the lives of people living with psychosocial disabilities. Hope you enjoy!

 

Disclosure: Hidden Pockets is Media Outreach Partner for Pleasure, Politics and Pagalpan

Read more on Pleasure, Politics and Pagalpan

Pleasure, Politics and Pagalpan: What do those words really mean?

Pleasure, Politics & Pagalpan: Abilities, independence and consent of persons with psychosocial disabilities

“Medication for psychosocial disabilities have effect on sexuality” – Ratnaboli Ray, Anjali

“Seeking pleasure is seen as a sin and self-indulgent” – Ratnaboli Ray, Anjali

Has the sexual right of persons with psychosocial disabilities been forgotten?

 

 

 

Pleasure, Politics & Pagalpan: Abilities, independence and consent of persons with psychosocial disabilities

“I feel that people in this room are converted to their own ideologies. I have converted to what I believe in and necessarily not converted to what others believe in. When we talk to the converted, do we have common viewpoints on anything that we have talked about? When we say conversations, there are two sets of people talking and listening. We come in here and often say things like- I will tell you what I feel, why aren’t you feeling what I feel, but I cannot feel what you feel because what you are feeling is what you feel but you should feel and this goes on. And then it becomes activism versus mental health professionals’ vs somebody else.” – Pramada Menon, Co-Founder Crea; Session: Do Din Ki Chandni

These words capture the depth and seriousness of the two-day conference: Pleasure, Politics and Pagalpan which began on May 13, 2017. The opening words of Menon’s talk during the concluding session, on May 14, 2017 also highlighted the difficulty of having meaningful conversations in the public sphere as evidenced in the issue around linking PAN card to Aadhaar. During the Supreme Court hearing of this case, the Attorney General had remarked that Indians have no right over their bodies: a remark carrying serious ramifications but which did not spark any serious debate, holding up high the remark by Menon that meaningful conversations in the public sphere have become difficult .It is in this light, Pleasure, Politics & Pagalpan took place in Kolkatta as a two-day conference enabling meaningful conversations to happen around two of the most-silenced issues in the country: sexuality and psychosocial disabilities.

Most of the sessions in the conference involved social activists, psychiatrists, writers and other media practitioners to bring in different perspectives on the issues of sexuality, rights and psychosocial disabilities.

On May 13th, Chayanika Shah, a social activist and Dr.ShyamBhat, a psychiatrist curtain-raised the conference by acknowledging the silence around sexuality and psychosocial disabilities: there is suspicion and fear of sexuality; there is a tendency for human beings to repress their sexuality; breaking of any set norm allows law, medicine and society to define any act of sexuality as illegal, ill and illicit, respectively and this could lead to criminalization, medication or stigmatization with confinement being the cure for any sexual problem.

This problem is further heightened when it is a woman: expression of sexual desire- which is an expression of power- by women are feared by society in general; confining women to the household and restricting their movements by ‘forced marriage or even rape’ stiffling this power. Can consent, autonomy and capacity be viewed in a way that no one gets excluded in the politics of pleasure and pagalpan?

Capacity for pleasure and its politics

“Sexuality is a grey area but in mental health, the grey area seems even more intense.” – Pramada Menon, Session: Do Din Ki Chandni

Blurring the strict boundaries of black and white, the conference opened the floor for some important issues to surface over the course of the two days delving deeper into areas that were grey. One of the first primary issues that surfaced was the acknowledgement of the need and the ability of any person ‘diagnosed’ with a psychosocial disability for pleasure. Panelists on different panels acknowledged the prevailing notion that assumes that people with psychosocial disabilities need no intimacy. ‘Just roti, kapada aur makhan’ is enough and this ignores the presence of a deep sexual need and the need for union which remains unaddressed.

“It starts with wanting to look good, go out with a gate pass (to go outside Banyan) and then flirting saying that boy looks good. Whatever the age, the women (at Banyan) desire men. They are tutored only to desire a man.” – Dr. Lakshmi Ravikanth, Psychologist & Visiting Faculty at Banyan Academy of Leadership in Mental Health (BALM); Session: Ajeeb Dastan hein Yeh, Kahan shuru Kahan Khatam

The need for intimacy of people living in institutions was acknowledged and so were the social stigmas associated with them finding a partner. The decision-making ability of people with psychosocial disability also raised questions around their capacity to be married.

Often, a person with any form of disability can only marry a person with disability. There are exceptions but are far and few. People with psychosocial disabilities are abandoned on disclosing their disability. This gets further intensified for women with any form of disability. Families aren’t too open or willing to let the daughters find a partner or be married. While marriage is looked at as a panacea for any issue faced by a man, it does not seem to be the case with women.

Non-acknowledgement of the need for intimacy and relationship results in viewing any effects of medication on people with psychosocial disabilities as ‘normal’. The loss of libido or any other side effects due to medication is often normalized or never discussed by persons under medication.

Privacy is also an issue with persons with any disability, physical, intellectual or psychosocial, be it at home or inside institutions. Their need for space or privacy is not is never heeded, because they are not looked at as beings capable of understanding or making informed decisions. There is no privacy even to masturbate. This again stems from the medical model that looks at them as beings who need care. While the medical model only takes into consideration the right to care, the model built around psychosocial disabilities, moves away from the notion of care and towards the environment being accommodative for all. This also led to questions around homosexuality with respect to persons with psychosocial disabilities.

Is heterosexuality the only normal way in the practice of sex? When institutionalized, can and do people explore same sex relationships and intimacy? How is it viewed or dealt with inside institutions? How is it outside institutions? What about transgenders? How are they treated in institutions? Is there a policy at all for their institutionalization?

“Pursing a man is a sin and a woman pursuing a woman is not even in their imagination. If they are isolated for a long time then they crave touch. But we pathologise it and prohibit it for both, men or women in mental institutions. This may cause other issues or give rise to other mental issues.” – Ratnaboli Ray, Founder – Anjali; Session: Ajeeb Dastan hein Yeh, Kahan shuru Kahan Khatam

“I think we live in better times now. When I was an undergraduate student, homosexuality was seen as being pathological. By the time I was finishing college, homosexuality was to be treated only if the person who identified as homosexual wanted to no longer have it.” – Ajith Bhide, psychiatrist, psychotherapist and Vice President – Indian Psychiatric AssociationSession: Ajeeb Dastan hein Yeh, Kahan shuru Kahan Khatam

 Independence of persons with psychosocial disabilities

Understanding the ability of person with psychosocial disabilities requires the understanding of their independence and the power structures that control them, be it institutions, psychiatrists or even their families.

While institutions exercise their power in terms of administering medication, defining privacy of the patients and the capacity of the patients; among others, family as an institution also seems to wield its power in decisions around several issues. Psychiatrists acknowledged the requests often made by parents for their adolescent child going through puberty: the parents do not want their children to have sexual desires; they may also decide on the ability of their children to love or be married, especially if it is girl,and may even choose to institutionalize them without their consent.

Several psychiatrists, both speakers and audience, acknowledged the power that therapists hold in decision making for persons with psychosocial disabilities. Some also said that it appears to be so but the reality is quite different. There was also honest admission to the lack of answers to all questions or problems of all their clients. The psychiatrists have dilemmas too. Owing to the cultural factors at play, they are often unsure about the best possible route to take to handle a certain situation for their clients. There is also a certain power and gender dynamics that exists within the world of mental health practioners:

“Psychiatrist is usually a man and counselors are mostly women. It is still happening. In the advocacy (mental health rights advocacy) world, it still exists. There are very few ‘user’ (persons with psychosocial disabilities) advocates. There are very few of us (persons with psychosocial disabilities) even in the international space as well. In fact, very few psychiatrists want to sit in the same space as us. We are looked at as threats,” – Reshma Valliappan, Schizophrenist and Artist (As audience in the Session: Do Din Ki Chandni)

With institutions, psychiatrists and families deciding the ability of persons with psychosocial disabilities to seek sexual pleasure or companionship, what power do they hold? This steps into the terrain of consent.

Consent of persons with psychosocial disabilities

Consent is a conscious and unforced decision made by any individual to an offer to enter into a relationship or for sex with another human being. It includes her decision to say yes or no to invitations.

The conference then questioned the understanding of consent. What is consent to a person with psychosocial disabilities? Do they have a right to consent? Is their consent acknowledged? The speakers and audience delved deeper into these questions in an attempt to find some answers. Be it the ICD – 10 (Classification of Mental and Behavioural Disorders), the Mental Health Bill 2017 or UNCRPD (United Nations Convention on Rights of Persons with Disabilities), none acknowledge persons with psychosocial disabilities as sexual beings capable of desire and pleasure.

With this background, defining consent for persons with psychosocial disabilities becomes a complex issue especially with adolescents with psychosocial disabilities. What is the right age to educate them about contraceptives, safe sex and other concepts around consent and abuse? Consent also becomes tough for people with certain other physical disabilities like visual and hearing disability. There is also the need for clarity about valid consent and concerned protectionism. There have been boundary violations, both as abuse and denial of rights.

“Even if they (persons with psychosocial disabilities) give consent, in case of psychosocial disabilities it is not taken as consent and that is the problem.” – Ratnaboli Ray, Session: Ajeeb Dastan hein Yeh, Kahan shuru Kahan Khatam

“Even if a person (with psychosocial disabilities) gives consent, it is not considered valid. Competence to give consent is important. Incompetence to give consent should be proven. Unless proven, all are competent. So most inmates (in mental health institutions) are competent.” – Anirudh Kala, Intercourse-Outercourse-Discourse

Questioning these issues of ability, independence and consent, led to more questions over the course of the two days. Some of them were:

What do we want out of safe spaces?

What is an institution? What happens when you question it?

Whose story are we telling? How much of it is eligible to be talked about?

How do we start looking at sexuality in a way that it includes everything, all the intersectionality – caste, class, gender, religion etc.?

Is there any mechanism to prevention of abuse and right to pleasure simultaneously?

What is to be done about assisted masturbation for people with physical disabilities like cerebral palsy?

Were all these and other questions answered? Abhijit Nadkarni, in his concluding remark during Pleasure, Politics & Pagalpan, summed the answers to all those questions:

“I don’t know if I have got any answers but I have got a lot of questions for which we have few answers. We have got fewer answers that will satisfy all of us. Some answers will satisfy some of us and there are some that will satisfy others. If we keep the dialogue going between the different stakeholders then we will find answers to many more of these questions. As we know, a lot of these things happen in small incremental steps. This conference is one such step and mostly the first step is hugely the most important step.” – Abhijit Nadkarni, an addiction psychiatrist Session: Do Din Ki Chandni

Disclosure: Hidden Pockets is Media Outreach Partner for Pleasure, Politics & Pagalpan

Has the sexual right of persons with psychosocial disabilities been forgotten?

Married for over 14 years now, Purnima was 28 when she was sent off to her parents’ home: soon after her wedding; since her husband had to leave domicile for work. After six months, when her husband returned home, in a moment of fun, Purnima had locked her husband out of their bedroom triggering a series of events that toppled her life:

She was admitted to a mental hospital in Ranchi.

She believes she was admitted to the mental hospital in Ranchi as her  behavior of locking her husband out of their bedroom in a moment of fun was deemed unacceptable by her in-laws and they complained of her being a- “mental patient.” 

From thereon, she has had several instances of admission to and discharges from several mental hospitals; while she was intermittently made to stay with her husband though the intermittent staying with her husband did not result in her becoming pregnant.

Purnima complains of never having sexual attention from her husband and thinks of that as the reason why she has never become pregnant. She yearns for affection, touch and sexual fulfillment.

*****

Due to the stigma around the mental wellbeing of individuals, any person with psycho-social disabilities (or perceived psycho-social disabilites like Purnima) is considered ‘mad’ and a disregard for the person’s sexual identity sets in, explains Debayani Sen, Documentation Officer & Research Associate at Anjali Mental Health Rights Organisation, a non-profit organisation working mainly in the areas of mental health rights.

“If a person is diagnosed with mental illness / psychosocial disability, the person is often labelled to be hyper-sexual or even asexual. This comes from the belief that in a state of ‘madness’ the person loses his/her inhibitions (so called proper behavior) and when these uninhibited expressions of sexuality come out in the open, they are deemed inappropriate to a ‘civilized society’; hence deemed hyper-sexual. There are times when an individual, known to live with mental illness, is simply de-sexualized, based on the assumption that he/she does not have the capacity to be a sexual being,” she adds.

Anjali operates in 3 government run hospitals in West Bengal namely Pavlov Mental Hospital, Lumbini Park Mental Hospital, and Bahrampur Mental Hospital.They also run a community mental health service.

A concern that seems to have emerged in these 15 odd years of work in mental health for Anjali is the non-recognition of sexuality as an important aspect of the person under treatment for psycho-social disabilities. Instead, precedence and preference in government run institutions is confined to addressing :issues of accessibility to medicines, proper facilities, treatment and infrastructure.

Social exclusion and life in an institution for years could lead to varied kinds of consequences. “The duration of a person’s stay in hospitals or (mental health institutions) could range from a minimum of a month or two to 10-15 years at a stretch, in some cases. During the person’s stay at a hospital, nobody even touches them affectionately. There are no loved ones or anyone they could say they love. They essentially suffer from what Ratnaboli Ray terms as ‘skin hunger’,” explains Sen.

This is further accentuated when it comes to women. Many perspectives and opinions have emerged during several Focus Group Discussions (FGDs) on sexuality organized by Anjali with female participants over time:

“In several focused group discussions with our female participants, they have articulated that, yes, they are sexual beings, they like to be sexual; yes, they miss their husbands; and they are in a constant fear of being reprimanded for any sexual expressions; they are even afraid to masturbate,” says Sen sharing some of the dominant experiences shared by the participants.

According to Treated Worse than Animals, a report on India by the Human Rights Watch, medication is often forced on women and girls with psycho-social disabilities to keep them in check ie within what is considered ‘appropriate behaviour’. This report highlights the issues faced by women and girls with psycho-social and intellectual disabilities in different mental health and residential institutions and hospitals in India. It notes cases of forced medication meted out to persons with psycho-social disabilities in both residential care institutions and mental hospitals. The report notes the common use of physical, verbal abuse and sometimes even sexual abuse.

“In case of rape, sexual assault or abuse, the perpetrators find it easier to make a person, known to have psycho-social disabilities, their victim, because they can get away with it saying that the person is ‘mad’; his/her words do not hold any weight! It becomes very difficult to seek justice for the matter,” adds Sen.

With the threat of being put to sleep or being abused, patients find it hard to voice their concerns especially with respect to their sexual needs. Apart from silencing people, medication could have other serious implications even in the case of people who are not institutionalised. Dr. Aniruddha Deb, a practising psychiatrist with over two decades of experience, notes that almost all mental conditions have some effect on the sexual health either directly or indirectly:

“Almost every psychological disorder has some sort of effect direct or indirect on sexual activity. Very often the treatment itself can have effect on the sexuality. It starts with people losing their sexual stability when they become ill and spreads down to the kind of relationship issues that they go through when they are mentally affected. This makes it difficult for them to develop a relationship or an existing relationship could go sour,” explains Deb.

Medication, if not done appropriately, could also have a serious effect on the sexual health or other health conditions of individuals: mental health or otherwise. Deb notes that the sexuality of individuals may get affected under any form of medication (for any conditions) including conditions like hypertension if not done appropriately. Some of the effects of inappropriate medication for sexual health are reduced libido, difficulty in achieving orgasm, difficulty in achieving erection, delayed ejaculation, among others.

“One of the issues that we face is: unawareness of these (sexual deficit) difficulties existing. Unless we directly look for it, people, any average person in our country, does not talk about their sexual deficit. Yes, there is a taboo around mental health but when it comes to a combination of mental health and sexual issues, the taboo is greater,” says Dr. Aniruddha Deb.

He adds that often the presence of the female partner with a male patient or the patient being a female also has an effect on the openness to discuss sexuality related issues with a male therapist.(The induction process with any therapist usually requires history taking which includes abuse of drugs or alcohol, bowel and bladder habits, other habits, menstrual cycle in case of women, sexual activity irrespective of marital status-only if the patient has reached the expected age for sexual activity-, among others.)

“Asking these details gives the patient or the patient’s partner the opening to later come back and talk about it with more ease,” explains Deb.

Even with in-detail note taking, people may hesitate to share details regarding their sexual activity. It may also take years before the effect of medication on sexuality can be identified. This sometimes could be a challenge.

“After 12 years of treating a man, the wife asked me if the fact that the man does not want to have sex be related to his mental health or medication. They had waited 14 years to muster up the courage to ask me,” says Deb recollecting the issue faced by a patient.

While several mental institutions administer medication to keep the patients under control, there are also cases of over dosage of medication requested by family members to curb the sexual urge of their relative. The request could be made by a husband, wife or even the parent of an adolescent with intellectual disabilities. According to Dr. Aniruddha Deb, in case of an adolescent with intellectual disabilities, if the individual reaches puberty and starts masturbating in public, the parent/guardian requests for medication to curb this behavior. Due to the biological nature of the need to masturbate, though medication is the solution to handle the situation, training is imparted to the parent to give the person with the said disability privacy to satisfy his or her sexual urges and also train the adolescent to understand that masturbation is to be done in private and not publicly, he adds.

In case of other psycho-social disabilities, the symptom of the illness could be excessive sexual activity as in the case of mania (bipolar disorder). Over time, with stability in the condition, the excessive sexual urge scales down. “The treatment is not to reduce the sexual urge but when the (severity of the) condition reduces, the sexual urge also scales down,” says Deb.

With illicit treatment meted out by institutions and requests-many a times inappropriate- made by family members, what protects the rights of the patients against any violation that they may face in terms of their sexuality and sexual health:

  • The Mental Health Bill 2016 was passed by the Lok Sabha in March 2017.
  • The Bill confers the rights on every person with mental illness to be protected from all forms of physical, verbal, emotional and sexual abuse.
  • With respect to right to access: the Bill confers right to access to mental health, care and treatment; and right to be treated equally: meaning the right to be treated on par with persons with physical illnesses and irrespective of gender, sex or sexual orientation. It is worth noting that Section 377 of the Indian Penal Code criminalises homosexuality.
  • Electro-convulsive therapy, chaining and sterilisation have been mentioned under the list of prohibited treatments. The Bill also prohibits the provision of medical treatment without informed consent with an exception of emergencies.

However:

  • The Bill does not have any specific provisions for sexual and reproductive health except that it prohibits sterilisation of men or women when such sterilisation is intended as a treatment for mental illness. There is no mention about the need to address the sexual needs of persons with psycho-social disabilities. ‘Right to life’ guaranteed by Article 21 of the Indian Constitution was used in the NALSA Vs Union of India 2014 with respect to transgender rights. Does it also apply to persons with psycho-social disabilities? Can this right be stretched and extended to include sexual health of persons with psycho-social disabilities?

Editor’s note: All the above said complex network of inextricably interwoven issues are having a direct or indirect impact on the non-recognition of sexuality as an important aspect of the person under treatment for psycho-social disabilities. In view of these complex issues, Pleasure, Politics and Pagalpan, a two day conference on sexuality, rights and persons with psychosocial disability” is being co- convened by Anjali and ARROW (The Asian-Pacific Resource and Research Centre for Women) with support from CREA on May 13 and 14, 2017 at the Taj Gateway Hotel, Kolkata. For more information, click here. 

Disclosure: Hidden Pockets is Media Outreach Partner for Pleasure, Politics and Pagalpan. 

 

Pleasure, Politics and Pagalpan: A conversation on gender, sexuality and psychosocial disabilities

Anjali Mental Health Rights Organisation is a non-profit organisation working mainly in the area of mental health rights for over last 15 years. The organisation operates in 3 government run hospitals in West Bengal namely Pavlov Mental Hospital, Lumbini Park Mental Hospital, and Bahrampur Mental Hospital and also runs a community mental health service.

Debayani Sen, Documentation Officer & Research Associate at Anjali Mental Health Rights Organisation, talking about the lack of any human relationship for persons institutionalised due to psycho-social disabilities says, “In institutions, the sexuality of persons with psycho-social disabilities is an aspect that is entirely unrecognized. If a person is under medication then there are chances that sexual urges, performance, etc. may get affected. For a person living with psycho-social disabilities, any free expression of sexuality tends to get pathologized by others. It is seen as a symptom of the illness.”

In view of the different challenges and stigmas faced by persons with psycho-social disabilities and the need for an open conversation at the intersection of gender, sexuality, psycho-social disabilities and sexual rights, Pleasure, Politics and Pagalpan, a two day conference on sexuality, rights and persons with psychosocial disability is being co- convened by Anjali and ARROW (The Asian-Pacific Resource and Research Centre for Women) with support from CREA to be held on May 13 and 14, 2017 at the Taj Gateway Hotel, Kolkatta.

Further, according to ‘Treated Worse than Animals’, a report on India by the Human Rights Watch, medication is often forced on women and girls with psycho-social disabilities to keep them in check ie within what is considered ‘appropriate behavior.’ The report also notes the common use of physical, verbal abuse and sometimes even sexual abuse in different mental health institutions in India. Fearing the medication and abuse, people admitted in these institutions never voice their concerns. Though the Mental Health Bill was passed in the Lok Sabha in March 2017, the Bill does not address the sexual health or sexuality of persons with psycho-social disabilities.

With the kind of issues faced by people admitted in different hospitals and institutions, it becomes necessary to look deeper into the issues faced by people, especially, from a clinical as well as social perspective.

“Anjali tries to move away from the medical model because we believe that psycho-social issues or any kind of emotional distress cannot only be a result of your clinical condition. The social factors also responsible for the suffering that the person might be going through. Keeping both the aspects in mind, we support the practice of rational medication clubbed with alternative interventions as opposed to the pill-popping culture. The kind of environment that you are living in, the kind of issues that you have to deal within your family or your workplace or society at large may serve as triggers that lead to a ‘meltdown’  or to a point when you have to admit the person to an institution. As much as the psychiatric perspective is important, the social perspective is also important and that needs to be brought into the discourse,” explains Sen.

Understanding the intersectional conversation on psycho-social disabilities, sexuality and gender requires a deeper understanding of policy, law, culture, society, history, economics and politics. The conference on May 13 and 14, 2017 at The Taj Gateway Hotel, Kolatta will also delve into these different perspectives.

The practice, concerns and dilemma dealing with sexual expressions by persons living with psycho-social disabilities need to be discussed before addressing them for solutions. Issues around sexuality, gender, psycho-social disabilities have come up before. It is important to know how institutions have already formulated a way to deal with them. Social activists and psychiatrists will discuss the concerns and dilemmas that they face to get an idea of the kind of issues that have come up and the temporary solutions provided.

“In order to explore and articulate pleasure, danger, eroticism and fantasy, we wanted subject experts, who have been engaged with this dialogue for a long time. On the panel we have with us, feminists, queer individuals, writers, a kinky activist, a film maker and a member of National Mental Health Policy Group.”

Though often forgotten or ignored, any discourse around sexuality will be incomplete without taking into consideration the perspective of the queer community. Section 377 of the Indian Penal Code criminalises homosexuality. This questions the sexuality of all from the queer community which subsequently leads to several psycho-social stigmas that the community faces. The conference will also delve into the issues faced by the queer community -including queers’ being looked at pathologically- the psycho-social disability label of people with different orientation, the coping mechanisms of queer people with psycho-social disabilities, implications of these stigmas, among others. The session will focus on addressing the queer and LGBT community.

What is the sexual reality of a person with psycho-social disabilities? The fantasies, pleasures, desires and eroticism of persons with psycho-social disabilities also need a voice, place and expression. To explore these ideas and others, the conference will engage with different audiences including writers and authors.

Disclosure: Hidden Pockets is Media Outreach Partner for Pleasure, Politics & Pagalpan

Where to get an abortion and other sexual and reproductive health services in Kolkata?

a public hospital in Kolkata

Recently Hidden Pockets set out to find different sexual and reproductive health (SRH) services in the city of joy, Kolkata. A primary research of the different health services provided in the city was done before the mapping exercise was undertaken. This research included Internet research and conversations with different individuals, activists and organisations working in the space of public health. The research showed that the status of public health services was inaccessible, unhygienic and crowded. So we decided to picked out a few of the available public health service providers in the city to understand the state of SRH services in the city. Since Family Planning Association of India (FPAI) usually features on our list of recommendations in the cities that we map, we decided to start with FPAI.

What happened to Right to Information?

The FPAI centre in Kolkata is located in Etally. The nearest bus stop is located at 5 minutes walking distance. The centre is located on the inside of a market road. It is a rather old building with a board outside that says Family Planning Association of India and lists all the services provided at the centre. It was hard to miss the strong smell of urine on entering the building premises. It wasn’t the cleanest of centres that we have been to so far, in the country. The first floor has the ward and the office is on the second floor.

On requesting for information about the services provided at the centre, the categorical response given by the medical officer was “Go to the Kolkata headquarters for any information about the services provided here. We will not give you any information.” The staff seemed clearly quite unapproachable. It was quite strange considering that the list of services provided at the centre is listed on the name board displayed outside on the door.

With FPAI off the list, it became important to look into other sexual and reproductive health service centres in the city that were approachable and also provided different services at a reasonable cost. More importantly, were there any reasonable government hospitals in the city providing SRH services?

How good are the government hospitals?

In an attempt to find some answer to that question, SSKM hospital, (located about half kilometer from Rabindra Sadan metro station) was chosen as the next destination. This is a referral hospital along with a medical college attached to it. Reason enough, the hospital is quite large and also usually crowded throughout the day. Located in the centre of the hospital campus, the gynecology department is difficult to locate without any support from the hospital staff. The guard at the gate was quite helpful giving directions to the gynaecology department. Gynecology department is located opposite to the Eye department and diagonally opposite to the Ronald Ross block. However, even with help, it was hard to locate considering the constant crowd on the hospital campus. It is a large department that has a separate building for the neonatal services provided at the hospital.

The cost of acquiring an OPD card in the hospital for all departments is Rs. 2. On checking the OPD registration desk on the ground floor of the building for services provided by the gynecology department and cost involved, we were told to check directly with the gynecology OPD. The administrative staff did not seem approachable. That said, the OPD registration had a constant queue throughout the day. The gynaecology OPD is a clean ward with air conditioning. On requesting from a doctor on duty (an intern), we were asked to talk to the Head of the Department (HOD) of Gynaecology whose office is in the Ronald Ross block. Though Ronald Ross block sounded easy enough, locating the HOD’s office in the building was not easy. The staff and interns that we spoke to, on the ground floor of the building either refused to give any information or said that they are not aware of the office. Being utterly confused in the large hospital, we had to check with several departments including Eye and ENT to be doubly sure of the HOD’s office. Due to sheer exhaustion of locating the different departments and heavy rains, we decided to meet the HOD on day 2.

Eventually on day 2, the HOD’s office was located on the second floor of Ronald Ross building. On landing up at the HOD – Dr. P.S.Chakravorthy’s office, we were asked to come the next day to have a conversation to understand all the sexual and reproductive health services provided in the hospital. Unlike other staff, the HOD was quite approachable and friendly. On day 3, an interview was conducted to understand the different SRH services provided in the hospital. The doctor was willing to answer all questions that were put forth.

Excerpts from the interview conducted:

Sexual and reproductive health services available for men:

“There is a STD clinic in the hospital close to the skin clinic that includes STI and RTI services as well.”

Process of accessing these services:

“The person has to go to the OPD STD clinic and register and see the doctor.”

Most common concerns for men:

“Mostly urethral discharge, burning sensation and gentile ulcers.”

HIV testing centre:

“There is one HIV testing centre that is attached to the blood bank, one to the microbiology lab, one to pathology department and there’s another attached to the antenatal clinc. There may be even more.”

Cost of accessing these services

“Buying the OPD card at Rs. 2 gives access to all services in the hospital including HIV testing centre at no additional cost, for both services and medication.”

AIDs & HIV related services:

“When we find that a person is HIV positive, we send them to the ART centre where they are provided counseling, both the patient and the spouse, medications, lifestyle advices, health education.”

Sexual and reproductive health services available for women

“Same as men and in addition, gynaecology OPD, skin OPD (because of wart). There is an adolescent clinic also – usually for teenage girls related to reproductive problems – menstruation – regular, irregular, pain, discharge etc.”

Medical Termination of Pregnancy (abortion): (Both married and unmarried women)

“We definitely provide abortion services to both married and unmarried women. To us, they are all patients. Irrespective of whether they are rich, poor, no matter the caste or creed, we try to help them.”

Cost of accessing this service

“Even MTP is included in the OPD charges of Rs.2, for MTP involving both medication or surgical intervention.”

SRS services

“The Plastic Surgery department runs the SRS service. It is again, free. In West Bengal, all services provided by the government are free. This also means that we have a lot of crowd here for all services.”

Other sexual and reproductive health services provided

“Family Planning services and Adolescent Friendly Health Clinics are also available.”

A reality check!

Though the doctor confirmed the availability a wide range of sexual and reproductive services, the concerns raised and expressed by people we spoke to accessing the services included:

  • Constant crowd
  • Need to have connections inside or outside the hospital to get access to high quality services
  • Often junior doctors or interns tend to the patient

On having spoken to the Plastic Surgery Department on the SRS service at the SSKM hospital provided in the hospital, Abhirup Kar, President of Civilian Welfare Foundation said, “The concerned person did not know what SRS was. We had to explain it to them and then  We had to explain it to them. We were then told that SRS is not done there and is only a subject of research in the hospital.”

Owing to the concerns raised about government institutions, we thought it necessary to also check with the private institutions on the different SRH services provided. Speaking to Hidden Pockets, a senior gynecologist* with 20+ years of experience said that the price of getting an abortion could range between Rs. 3,500 to Rs.30,000 in any private institution depending on the location. While the cost of getting an abortion could be anywhere between Rs.3,500 to 10,000 in Northern Kolkata, it costs Rs.15,000 to Rs.30,000 in Southern Kolkata depending on the institution and seniority of the doctor.

The senior gynecologist’s (hospital’s) cost breakdown for an abortion was as follows:

Rs. 4,000-5,000 for consultation

Rs.1,000-2,000 for the services

Rs.1,000 or so for medication

____________________

Total: Rs. 7,000-9,000  (cost estimated for his hospital’s services)

____________________

Note: Hidden Pockets studies focus on recommending at least one SRH service provider in any city that we go out after personal assessment of the centre for different parameters. However in Kolkata, owing to the crowd and unfriendly staff, we could not go beyond 2 government service providers during our time there. 

PS: “FPA India clinics may charge, what we prefer to call as a ‘partial user fee’ to the clients for seeking abortion or any other SRH service. This fee is very subsidized and helps the Association meet some running costs. However, all FPA India clinics also have a “NO REFUSAL POLICY”, which states that no client walking into any FPA India facility is denied any service, especially if he/she is unable to afford even the subsidized fee. Thus, poor and marginalized clients can also access quality services in FPAI clinics. Only when the facility is not equipped to provide a particular service (for example some client may need a specialized service, or admission or higher level emergency care) are clients to other facilities.”

Adult toys: Only time I was comfortable with being told that women ask for it!

images of books with sex toys words on it

The only time I have ever felt comfortable with being told that women ask for it was in an adult toy store in Kolkata. I was almost inspired and quite thrilled to learn that women in Kolkata had asked for adult toys even about two decades ago.

“Fetish garments and adult toys happened with more demand from women customers,” said Dharam Nathvani, Proprietor of La Lingerie, adding that the store began selling adult toys 18 years ago.

“They (women) would buy fantasy products like exotic night wear. Along with lingerie, we also sold products like fetish garments, soft handcuffs. From then on, women felt comfortable asking even for toys since they were used to buying these products from us. Why not buy it all from the same place instead of another store was the reasoning that they gave,” Nathvani explained.

Having visited the store personally, I would agree with him. It took me a while before I was certain that I was in fact, in a store that sold adult toys. Third floor of a lavish Forum Courtyard Mall in Kolkata! Doesn’t sound like an inconspicuous location for an adult store now, does it? It sounded easy enough to find or so I thought. Knowing the name of the store, I went looking for it on the third floor. It was easy enough to spot. The board read, ‘La Lingerie.’ I walked in only to find shelves and racks filled with lingerie and night ware, both ordinary and extraordinary ones. I walked around the place and found no adult toys. I was certain about walking into the wrong store. I should be honest here. Even for someone who writes about ‘sexual and reproductive health,’ I wasn’t quite uncomfortable with asking for adult toys in a regular lingerie store. (Later I understood that this feeling is also why women feel comfortable buying adult toys there).

My friend, who had suggested that I visit this store, had also asked me to have a chat with the storeowner. Taking the suggestion, I asked to talk to the storeowner. Another confession! Talking to the storeowner about adult toys wasn’t as uncomfortable as it was to talk to the staff about it because I was there to interview him. It turned professional. (I wasn’t there to buy! Basically, I won’t be judged.) He then took me to the adult toys section in the store called the Couple Corner on the first floor and we sat there for a chat.

“18 years is a long time to be in business. What has changed over these many years?” I asked.

“Back then the men would stand outside and the women would ask for the products. Then we found out that it was their male ego,” said Nathvani with a laugh.

I didn’t quite understand it.

So he explained,

“We had to educate them saying that these toys are not a replacement for you but just some add-ons to spice it up on a special night. I wouldn’t say much has changed except that they aren’t shy anymore. More awareness has happened with men to please their partners. We also see men coming and picking up products. A lot of men have size problem. Some have pre-mature ejaculation. There are travellers who stay away for family for long. Even doctors recommend that women masturbate to release stress if you are not with multiple partners. So the toys work as medical aid too.”

What caused the change?

“Education over Internet and frank, open minded discussions related to sexual pleasures between partners. Taboo around issues like women masturbating has changed. That said, even now women don’t want to touch themselves and masturbate. But there is also the problem of porn that is changing people’s minds from pleasure to vulgarity.“

This was a new one, especially coming from the proprietor of a store that also sells adult toys. Wasn’t porn supposed to be good for business? Or so I thought. Good for business may be but for a couple, may be not. According to Nathvani, usually BDSM (Bondage Domination Submission and Masochism) sex comes at a later stage after experimenting with different pleasure products. He feels that this is changing now because of porn.

“I feel porn can help with educating yourself, understanding your lover’s need and trying to understand pleasure. But hardcore porn or BDSM porn is non-educative because people don’t understand if it (BDSM) is consensual or accepted by both partners. But they want to experiment and it often brings bad experiences to your sex life. Sexual wellness is about understanding consent and individual pleasure points and then gradually maturing to use the right sexual products.”

His words confirmed similar experiences recalled to me by other women before. I was glad that someone was finally talking about consent. However, my question was, would this attitude help the business of selling adult toys? He says it does and his reasoning made absolute business sense.

“Satisfactory sexual health helps you buy exotic nightwear. We help women experience pleasure so that they also buy exotic nightwear. Even using toys requires right education to get the right results. So we are trying to sell in an educative way.”

If the focus was to sell ‘educationally’, then what were the common sexual problems/concerns and what was their solution?

(Strap on! This is a big one! Might hurt some men but ladies, aren’t we glad someone said it?)

“Five years ago we started selling flavoured condom because women said that men don’t understand that they need to use something for oral sex. They need to be clean or understand that may be she likes a different flavour. That’s how we introduced flavoured condoms. It was not possible for women to go to medical stores to pick it up themselves. It was easier for them to pick it up from our store.”

What came next was even better (and beautiful)!

“Life doesn’t end after becoming a mumma and this needs to also be taught in India. The need for sexual health even after having a child is coming up in a big way.”

The store also claims to provide lingerie conselling for post-pregnancy, liposection and pre and post weight loss programs. It has also started making lingerie for women with breast cancer and breast removal. The store is also trying to associate with schools to educate young girls about wearing the right size lingerie for sports, work etc. The store’s product line includes toys for young couples like couple games, edible lingerie edible lingerie for women and men, other adventure products like vibrating panty with remote control, flavoured condoms, lubricants.

“Once you are matured enough to handle toys, then you can use gels and creams, clitoris stimulators, vibrators for more matured users. New couples usually don’t need it. New launches are couple toys that can be remotely controlled with mobile apps. That can work for couples who talk over video calls. The husband operates the app and the video can be live,” he added.

I had had enough!

That was too much information for a single woman not intending to shop there that day. Enough with the excitement and details for one day, I thought. With that, the interview about happy endings ended and I was happy to leave. But then came the icing on the cake.

Student No.1

Nathvani then narrated an incident with a college student living in a hostel who had come to buy a portable vagina.

After working the price out, the student asked him a pertinent question.

Student: What if my father finds out.

Nathvani: Ask him if he’d rather have you have illicit relationships than use this toy. I’m sure he’d understand.

Convinced the boy left for the day but came back the next day.

Student: Sir can I have another portable vagina?

Nathvani was now shocked and worried.

Nathvani: Sure but I won’t give you this one on a discount. You get only one discount as a student.

Student: Sure Sir.

Nathvani: (Out of curiosity) Why do you want another one?

Student: I stay in a college hostel. There is great demand for a portable vagina in my hostel. So I started giving it out on rent along with a free condom.

And the Startup of the Year award (along with a free condom) goes to…

On that note, I walked out of the store still with no toy in my hand or a happy ending.

 

 

Disclaimer: Writer does not vouch for the products or services offered by the store. It is left to the user/buyer’s discretion. 

Young autistic children walk the ramp of SMAYAN, Kolkata

It was a Tuesday morning that glowed with smiles, glamour, energy and confidence as six children walked on the ramp of SMAYAN at Vidya Mandir, Kolkata. The program conducted by Sushila Birla with the aim to promote inclusion and equality rights to education of each and every children cheered for these six young autistic children. Accompanied by their ‘shadow teachers’, they displayed perfection sporting the designer dresses of Manas, one of the renowned fashion designers of the city. In the dark auditorium, the little children outshone everyone overshadowing the challenges they face in communicating with others. The only group of autistic children in the competition, they belonged to the age group of 6.5 years to 9 years and represented Wonder House, a unit of the NGO, Transcending Knowledge Society, run by Dr. Amrita Roy Chowdhury and her team.

‘I am very happy with their performance,’ beams Amrita. ‘I know this is just a beginning for them. We didn’t win the title but we won hearts. We won our challenges. That’s what matters.’ The other participants had Down syndrome and some were pro learners. What makes their participation special is their performance. When socialization is one of the primary challenges these kids face, it takes a lot of hard work on their part and also on the part of the caregivers to overcome these hurdles.

‘They lack eye contact but they have been able to overcome this problem today,’ explains Amrita who is the Director of Transcending Knowledge Society. However, it has not been so easy for the kids and the team. Established in January 2015 with the vision and mission to enhance the skills of children with autism spectrum disorder through different expressive art therapies, soft skill training and independent living skills, the NGO has been working with these 6 children introducing new methods to help them take active part in the various functions of the mainstream society. Participating in the fashion show and also in the dance competition of SMAYAN has been a learning experience for the whole team. Rehearsals started a month earlier with friends offering their help to Amrita.

‘I am really grateful to Minakshi Nag, our dance movement therapist and Manas who volunteered to help us with his exemplary ‘gamcha’ collection,’ narrates Amrita.

Among the five boys and a girl, a few were first time performers. In a country where only a very small section of people shrug off the taboo associated with autism and come out in public with their autistic children, these six talented kids made everyone proud. Their participation and their performance revealed the possibilities and instilled the hope that provided they get the right training and support, they too can live like others, they too are able to do things like everyone else. Amrita feels very positive. She plans to build a ‘group home’ for supported living of these children.

Author profile:

Aparajita Dutta is a writer and a social activist.

Disclaimer: Opinions expressed are that of the writer.

Photo credit: Autism-India.org