Healthcare and the oppression of sexual and gender diverse communities in Bangladesh : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy at the School of Social Work, Massey University, Albany, New Zealand

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Since Bangladeshi society is socio-culturally and religiously conservative, sexual and gender diverse communities live with stigma, violence, and discrimination. One form of discrimination lies in the healthcare system. The purpose of this study is to investigate the healthcare experiences of these communities to depict the oppression they face, and to understand the continuing influence of colonialism and patriarchy that maintain this oppression. To investigate this, healthcare is argued as either a human right from the social justice point of view or a tool for oppression for marginalised communities. The methodology used is phenomenological to examine the lived healthcare experiences of the participants. To collect data, I used qualitative methods including participant interviews, a focus group discussion, and key informant interviews. I worked as a volunteer with one local agency that works with sexual and gender diverse communities in Bangladesh. Volunteering helped to build networks and recruit participants. Thematic methods are used for data analysis and full ethics approval is obtained from Massey University, New Zealand. The participants live in a repressive environment with stigma, harassment, limited education and employment opportunities, lack of family support, mental health issues, and inadequate health support. They frequently experience — depending on their disclosure — humiliation, neglect, insults, and discrimination in healthcare settings. Lack of awareness and an unsupportive attitude from government representatives and institutions further contribute to their oppression. Although healthcare, in theory, is regarded as a human right, it is not fairly and equally provided for marginalised communities and thus cannot be claimed as a universal human right. Discriminatory healthcare experiences, stigma, colonial law, and sexual assaults imply that colonial values and patriarchy have an influence on the overall oppression of these communities. The most significant contribution of this study is to expose the patriarchal nature of Bangladeshi society as a legacy of the British Regime. This study offers methodological insights into how to conduct research in politically sensitive environments, which is another unique contribution to methodological knowledge. As a result of this research, it is clear that the Bangladeshi government needs to change its attitude, acknowledge the existence of these communities, and take initiatives to provide equal healthcare facilities for all.
Sexual minorities, Medical care, Discrimination in medical care, Bangladesh