Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Dr Mohan Z Mani

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Believers Church Medical College,
Thiruvalla, Kerala
On Sep 2018




Prof. Somashekhar Nimbalkar

"Over the last few years, we have published our research regularly in Journal of Clinical and Diagnostic Research. Having published in more than 20 high impact journals over the last five years including several high impact ones and reviewing articles for even more journals across my fields of interest, we value our published work in JCDR for their high standards in publishing scientific articles. The ease of submission, the rapid reviews in under a month, the high quality of their reviewers and keen attention to the final process of proofs and publication, ensure that there are no mistakes in the final article. We have been asked clarifications on several occasions and have been happy to provide them and it exemplifies the commitment to quality of the team at JCDR."



Prof. Somashekhar Nimbalkar
Head, Department of Pediatrics, Pramukhswami Medical College, Karamsad
Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
Ex-President - National Neonatology Forum Gujarat State Chapter
Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018




Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."



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Professor and Head
Department of Pathology
Sri Devaraj Urs Medical College
Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
On Sep 2018




Dr. Saumya Navit

"As a peer-reviewed journal, the Journal of Clinical and Diagnostic Research provides an opportunity to researchers, scientists and budding professionals to explore the developments in the field of medicine and dentistry and their varied specialities, thus extending our view on biological diversities of living species in relation to medicine.
‘Knowledge is treasure of a wise man.’ The free access of this journal provides an immense scope of learning for the both the old and the young in field of medicine and dentistry as well. The multidisciplinary nature of the journal makes it a better platform to absorb all that is being researched and developed. The publication process is systematic and professional. Online submission, publication and peer reviewing makes it a user-friendly journal.
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I wish JCDR a great success and I hope that journal will soar higher with the passing time."



Dr Saumya Navit
Professor and Head
Department of Pediatric Dentistry
Saraswati Dental College
Lucknow
On Sep 2018




Dr. Arunava Biswas

"My sincere attachment with JCDR as an author as well as reviewer is a learning experience . Their systematic approach in publication of article in various categories is really praiseworthy.
Their prompt and timely response to review's query and the manner in which they have set the reviewing process helps in extracting the best possible scientific writings for publication.
It's a honour and pride to be a part of the JCDR team. My very best wishes to JCDR and hope it will sparkle up above the sky as a high indexed journal in near future."



Dr. Arunava Biswas
MD, DM (Clinical Pharmacology)
Assistant Professor
Department of Pharmacology
Calcutta National Medical College & Hospital , Kolkata




Dr. C.S. Ramesh Babu
" Journal of Clinical and Diagnostic Research (JCDR) is a multi-specialty medical and dental journal publishing high quality research articles in almost all branches of medicine. The quality of printing of figures and tables is excellent and comparable to any International journal. An added advantage is nominal publication charges and monthly issue of the journal and more chances of an article being accepted for publication. Moreover being a multi-specialty journal an article concerning a particular specialty has a wider reach of readers of other related specialties also. As an author and reviewer for several years I find this Journal most suitable and highly recommend this Journal."
Best regards,
C.S. Ramesh Babu,
Associate Professor of Anatomy,
Muzaffarnagar Medical College,
Muzaffarnagar.
On Aug 2018




Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".



Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
Bengaluru.
On Aug 2018




Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".



Dr. Mamta Gupta
Consultant
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018




Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.


Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."



Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011




Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."



Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011
Anuradha

Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.


Dr. Anuradha
E-mail: anuradha2nittur@gmail.com
On Jan 2020

Important Notice

Original article / research
Year : 2022 | Month : December | Volume : 16 | Issue : 12 | Page : VC12 - VC15 Full Version

Attitude of Doctors Towards Homosexuality at a Medical College, West Bengal, India: A Cross-sectional Study


Published: December 1, 2022 | DOI: https://doi.org/10.7860/JCDR/2022/59134.17302
Ashis Debnath, Shuvankar Mukherjee, Ranjan Das, Sudipa Mandal

1. Associate Professor, Department of Psychiatry, Raiganj Government Medical College and Hospital, Raiganj, Uttar Dinajpur, West Bengal, India. 2. Associate Professor, Department of Community Medicine, Calcutta National Medical College and Hospital, Kolkata, West Bangal, India. 3. Assistant Professor, Department of Psychiatry, Institute of Psychiatry- Centre of Excellence, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India. 4. Clinical Psychologist, Department of Psychiatry, Raiganj Government Medical College and Hospital, Raiganj, Uttar Dinajpur, West Bengal, India.

Correspondence Address :
Dr. Shuvankar Mukherjee,
House No. 18, East Road, Jadavpur, 2nd Floor, Kolkata-700032, West Bengal, India.
E-mail: mukherjeesm2012@gmail.com

Abstract

Introduction: Attitude towards homosexuality varies differently in different parts of the world. But, almost everywhere social stigma and marginalisation make them vulnerable to poor health and social outcomes. So, physicians should be made aware and sensitive about this issue in order to provide optimal care without any prejudices and discrimination.

Aim: To assess the attitude of the doctors towards the homosexuality at a Medical College, West Bengal, India.

Materials and Methods: A cross-sectional study was conducted for three months from August 2021 and October 2021 at Raiganj Government Medical College and Hospital, West Bengal, India. A predesigned, pretested, structured questionnaire was distributed to each of the faculty members of this medical college. The questionnaire was kept anonymous for name, religion, department or academic qualification and began with asking questions on age and sex. It consisted of 18 statements, nine substatements of relevant attitude along with additional specific comments on the subject. The faculty members were requested to put the filled up questionnaires in a drop box placed at a designated area in the Department of Psychiatry. In this way responses were finally obtained from 56 out of total 69 faculty members. All of them were postgraduate degree holders. The attitude scores were compared on the basis of age and sex using Kruskal-Wallis and Mann-Whitney U tests. A p-value was calculated to find the association of attitude score with age and gender groups.

Results: Among the study participants 21 (37.5%) were in ≥50 years age group, 18 (32.1%) in 40-49 years age group and 17 (30.4%) in ≤40 years age group. Males were 41 (73.2%) and females were 15 (26.8%). Forty six (82.2%) participants agreed that homosexuality is “constitutionally determined” (an inherent fundamental right as per Indian constitution). However 34 (60.7%) did not believe it to be a “sexual orientation”. Half of the participants are of the opinion that “homosexuals are easily recognisable”. Forty three (76.8%) respondents are of the opinion that “homosexuals should not be employed in school”. Also 41 (73.2%) believed that “homosexuals are danger to children”. Only 23 (41.1%) generally agreed that they “did not feel embarrassed while talking about homosexuality”. Just above half of the participants agreed that they “really did not understand homosexuality”. The attitude scores did not however vary according to age (p-value=0.25) or sex (p-value=0.09) groups.

Conclusion: Majority of the study participants had inadequate knowledge on the issues of homosexuality with a more or less neutral stance in their attitude.

Keywords

Gender identity, Homosexual, Medical faculties, Sexual orientation, Sexual minorities

Originating from both Greek and Latin languages, the term “homosexual” means “same sex” (1). It refers to sexual attraction, sexual behaviour or even romantic attraction between individuals of the same sex. According to American Psychological Association, (2015) sexual orientation refers to an enduring pattern of emotional, romantic, and/or sexual attractions to men, women, or both sexes (2). Hence, it is a part of an individual’s sense of identity based on those attractions and behaviours related to it. Research conducted through several decades has revealed that both “nature and nurture” play a vital role in determining the sexual orientation of an individual (3).

But throughout their upbringing individuals are unknowingly taught that homosexuality is unnatural phenomenon that leads to negative stereotypes, prejudices, and discrimination towards persons with homosexual orientation.

In 2009, the Delhi High Court decriminalised homosexuality, but in 2013 the Supreme Court of India upheld section 377 of the Indian Penal Code which criminalised consensual acts of same sex in adults (4),(5). However, in 2014, the Supreme Court granted constitutional recognition to transgenders as the third gender and any discrimination towards them was considered a violation of their constitutional rights (6). Later on in 2018 a historic judgment of the Supreme Court made Section 377 unconstitutional and recognised adult gay sex as an outcome of natural sexual orientation over which people have no control. Since then, homosexuality got legal approval and recognition in India (7).

Attitude towards homosexuality varies differently in different parts of the world. However almost everywhere the sexual minorities, including Lesbians, Gays, Bisexuals, and Transgenders, Queer, Intersex and Asexual (LGBTQIA) community) are universally subjected to verbal and physical violence and hence experience a higher degree of psychological distress like depression, anxiety and attempted suicide compared to the general population (8),(9),(10). Moreover, social stigma and marginalisation make them vulnerable to poor health and social outcomes (11),(12),(13).

The doctor-patient relationship plays a vital role in improving the health of individuals. It has been seen that the ways of interaction of physicians or other health professionals with individuals from the LGBTQIA community can greatly affect their perception and utilisation of health services (14). Many a times individuals from the LGBTQIA community have to face negative behaviour and hostility from health care professionals upon disclosing their sexual orientation for any reason whatsoever and due to this they often hesitate to access health care services even in the time of emergency (15),(16),(17),(18). So, physicians are needed to be made aware and sensitive about this issue in order to provide optimal care without any prejudices and discrimination (19). In this backdrop, the United Nations in 2019 emphasised the need to educate the healthcare providers on LGBT issues (20). Furthermore, medical teachers also play a crucial role in better preparing medical graduates to interact and communicate with these marginalised communities and enabling them to access the services without the fear of discrimination (21). As per authors’ knowledge though there are many studies on attitude towards homosexuality in India among medical students, youth groups and others, very few involved medical faculties. The present study dealt with this subject matter from the perspective of medical teachers cum doctors.

The authors of the present study had a previous experience in conducting a similar study on undergraduate students but not with medical faculties (22). The attitude of medical teachers cum doctors towards homosexuality plays a pivotal role in providing respectful health care services to the sexual minority group. A medical teacher’s positive attitude in this matter is also supposed to have a positive influence on the attitude of their students who will be the future consultants. So, the assessment of knowledge and related attitude of the medical teachers would in turn aid in assessing their orientation and training needs on this very vital issue. As such there is no hypothesis of the study. With this background, the present study was undertaken to assess the attitude of the doctors towards the homosexuality.

Material and Methods

This cross-sectional study was conducted between August 2021 and October 2021 among the faculty members, all of whom had postgraduate degree in their respective subjects (as was observed prior to the beginning of the study from the academic record section of the institution), posted at Raiganj Government Medical College and Hospital, West Bengal, India. The ethical clearance was obtained from the Institutional Ethics Committee (IEC/RGMCH/21).

Inclusion criteria:

• Medical teachers with postgraduate degrees.
• Permanently posted in the said medical college.
• Who gave consent to participate in the study.

Exclusion criteria: General duty medical officers who were not involved in teaching and those faculty members who did not give consent or responded back were excluded from the study.

Study Procedure

All the faculty members available at the time of the study were approached and given the questionnaire and an informed consent form. They were requested to fill this anonymous, predesigned, pretested, structured questionnaire and put them in a drop box placed at a designated area in the Department of Psychiatry. Those who gave consent and also responded back with the duly filled-up questionnaire during the study period were included in the final analysis of the study. In this way out of the total 69 faculties of different departments (present at the beginning of the study), 56 responded back and included in the study with a response rate of 81.2%.

Questionnaire

The questionnaire was in English and used earlier by Kar A et al., among Indian medical students after it was validated and checked for reliability (Chronbach’s alpha of 0.91) (22). Necessary permission was obtained for using this questionnaire in the present study. The questionnaire was kept anonymous for name, religion, department or academic qualification and began with asking questions on age and gender. It consisted of 18 statements, two of which had altogether nine substatements (four substatements in statement one and five in statement 17) for additional specific comments on the subject. There were five responses for each statement: strongly agree, generally agree, unsure, generally disagree, and strongly disagree on a 5-point Likert scale. In order to reduce response bias, the phrasing of statements, in positive or negative sense, was balanced and reverse scoring was assigned for statements that showed unfavourable attitudes. These statements were “I believe that homosexuality is an illness”, “Homosexuality in general is result of disturbed relationship with one or both parents”, “Homosexuals in general are neurotic”, “Homosexuals in general are easily recognisable”, “Homosexuals in general are promiscuous”, “Most male homosexuals have effeminate trait and female homosexuals have masculine trait”, “Most male homosexuals would prefer to be females”, “Most female homosexuals would prefer to be male”, “Homosexuals should not be employed in schools”, “Homosexuals are danger to children”, “Scientific material and reading of homosexuality has not really affected my views on subject”, “In my opinion causes of homosexuality are seduction experiences in childhood, fear of heterosexual activities, insufficient contact with the opposite sex at puberty, unsuccessful heterosexual experiences” and “I do not really understand homosexuality”.

In case of favourable attitudes a score of 5 was assigned to the response “strongly agree” and 0 to the response “strongly disagree” like in statements 1a, 1b, 1c, 7, 8, 14, 15, 16, and 17a. Whereas, in case of unfavourable attitudes a score of 5 was assigned to the response “strongly disagree” and 0 to the response “strongly agree” like in statements like 1d, 2, 3, 4, 5, 6, 9, 10, 11, 12, 13, 17b, 17c, 17d, 17e and 18.

Statistical Analysis

Data were analysed using Statistical Package for Social Sciences (Windows version 20.0; IBM Corp, Armonk NY, United States of America). The attitude scores were compared on the basis of age and sex using Kruskal-Wallis and Mann-Whitney U tests at 5% significance level.

Results

Among the study participants 21 (37.5%) were in ≥50 years age group, 18 (32.1%) in 40-49 years age group and 17 (30.4%) in ≤40 years age group. Majority were male (n=41, 73.2%) and only 15 (26.8%) were female (Table/Fig 1).

Majority (n=46, 82.2%) of the participants agreed that homosexuality is “constitutionally determined”, but did not believe it to be a “sexual orientation” (n=34, 60.7%). Thirty two (57.1%) did not consider it “an illness”. Seventeen (30.4%) participants had the opinion that “homosexuals in general are neurotic”. Half of the participants were of the opinion that “homosexuals are easily recognisable”. Among the participants 21 (37.5%) had the idea that “homosexuals in general are promiscuous”. It was observed that 24 (42.8%) remained unsure whether “most male homosexuals have effeminate trait and female homosexuals have masculine trait”. Only 3 (5.4%) participants agreed to the statement “in general homosexuals are capable of forming stable relationships”. A large proportion of the participants did not feel that “homosexual doctors would treat homosexual patients with better understanding”. Also, 43 (76.8%) are of the opinion that “homosexuals should not be employed in school” and 41 (73.2%) believed that “homosexuals are danger to children”. Altogether 35 (62.5%) participants opined that reading scientific materials about homosexuality had not really affected their views on the subject. It was also found that 26 (46.4%) were unsure whether “the problem of homosexuality could be reduced if the society were to liberalise its attitudes” (Table/Fig 2).

Only 23 (41.1%) generally agreed that they “did not feel embarrassed while talking about homosexuality”. While 17 (30.4%) did not agree to the statement “homosexuality is an innate predisposition”, 16 (28.6%) did agree to it. Majority did not believe that homosexuality was caused by “seduction experiences in childhood” (n=26, 46.4%) or “fear of heterosexual activities” (n=38, 67.9%). However, a good number of participants were also unsure whether homosexuality was an innate predisposition (n=21, 37.5%) or resulted from seductive experiences in the childhood (n=18 32.1%) or unsuccessful heterosexual experiences (n=22, 39.3%). Just above half of the participants agreed that they “really did not understand homosexuality” (Table/Fig 2). The attitude scores did not however vary according to age (p-value=0.25) (Table/Fig 3) and gender (p-value=0.09) groups (Table/Fig 4).

Discussion

Not much is found regarding homosexuality in Indian medical journals. This is one of the few studies where attitude of doctors toward homosexuality in Indian context was explored. The present study revealed an inadequate knowledge among the study participants regarding homosexuality, though majority maintained neutral stance regarding their attitude towards this issue. In the present study, majority (82.2%) of the participants agreed homosexuality to be constitutionally determined but did not believe it to be a normal sexual orientation (60.7%). Also, 48.2% strongly disagree that this is an acquired behaviour. Vijaylaxmi et al., in their study among college students across India recorded that 45.2% of the participants agreed that homosexuality could come as a choice, 49.04% had the opinion that “it happens” (23). Only to 7.2% homosexuality was not an acceptable phenomenon (23). In the present study, 26.8% generally agreed and 3.6% strongly agreed that homosexuality could be caused as a result of disturbed relationship with one or both parent. Another, 33.9% subjects were unsure about it. Also 33.9% generally agreed but 23.2% strongly disagreed that they are promiscuous. Among the respondents, 28.6% generally agreed that male homosexual are effeminate trait and female are masculine trait in the present study. In a study conducted by Kar A et al., 58.8% of the participants believed that male homosexual showed effeminate trait and female homosexual had masculine trait while 28.1% believed that homosexuals were promiscuous (22). In the study by Vijaylaxmi et al., reported that majority of the study participants believed that they could detect the sexual orientation of individuals just by looking at them (23).

The present study did not reveal any significant difference of attitude towards homosexuality with respect to age or sex. A survey conducted by Mathews WC et al., on physicians’ attitudes toward homosexuality reported that male doctors were more homophobic than female doctors (24). In a survey conducted by Smith DM and Mathews WC on physicians’ attitudes toward homosexuality and HIV also found significant differences in prevalence of homophobic attitudes by gender (25). In a study conducted by Matharu K et al., observed that male students and students younger than 25 years were more likely to have negative attitudes towards homosexuals (26). A study by Grabovac I et al., also reported more positive attitude towards homosexuality among the female medical students (19). In a similar study Banwari G et al., observed that female medical students had lesser negative attitude towards homosexuality (27).

Due to lack of availability of research articles regarding this in Indian context, it is very difficult to comment on how much stress is given in medical curriculum regarding homosexuality and their health related issues in India. Sometimes Indian medical textbooks give misleading information about homosexuality that promotes bias among medical professionals (28). It is quite apparent that the subject does not get its due importance in medical textbook or medical curriculum which is reflected in the low level of knowledge regarding this in the present study. It is recommended that the subject of homosexuality and the relevant health issues be included in the medical curriculum and the need for necessary faculty orientation and training programmes be duly emphasised in order to render discrimination free health care services to the community.

Limitation(s)

Sample size was small. Structured questionnaire could not get into the reason behind the observed attitude and its perspective. Qualitative analysis with in-depth interview could have been a better alternative to delve into issues. Nevertheless, the present study has definitely provided some basic insight to the level of awareness and related opinion among the medical faculties regarding homosexuality.

Conclusion

It can be concluded from the present study that the majority of the study participants had inadequate knowledge on the issues of homosexuality with a more or less neutral stance in their attitude. Quite a substantial proportion of the participants expressed an unfavourable attitude towards the employment of homosexuals in school and children not being safe in their presence. However, the overall attitude did not significantly differ between age and sex groups.

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DOI and Others

DOI: 10.7860/JCDR/2022/59134.17302

Date of Submission: Jul 17, 2022
Date of Peer Review: Sep 03, 2022
Date of Acceptance: Nov 16, 2022
Date of Publishing: Dec 01, 2022

AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. NA

PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Jul 18, 2022
• Manual Googling: Sep 28, 2022
• iThenticate Software: Nov 15, 2022 (8%)

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