Traditionally in Indian society, same-sex relations were tolerated though not accepted as an integral part of the society (Chakrapani et al, 2007). The persons who engaged in same sex relations have always been on the periphery of the community. The last century saw increased stigmatisation and discrimination against men who have sex with men and transgendered persons (Narrain, date unspecified; UNAIDS, 2006). The Indian law with Section 377 indirectly supported the negative perspective, forcing the men who have sex with men (MSM) and transgenders (TGs) into invisibility even from discourses on health issues and rights. The special sexual and reproductive health needs of these groups do not find mention in the social and medical health literature. Their needs were acknowledged only as recently as in the 1990s in the context of HIV epidemic when the groups were identified globally as one of the vulnerable and invisible groups (Chakrapani et al, 2002; GOI MOFHW, 2007; Khan, 1998).
In terms of disease control policies, focus on MSM and TGs intensified only in the third phase of the National AIDS Control Programme (NACP III) – almost a decade after India launched the national programme for controlling the AIDS epidemic. The State AIDS Control Societies were mandated to organise MSM into community based organisations (CBOs) and to actively engage with these for prevention activities. However the focus of the activities has remained limited to promotion of safe sex by distribution of condoms and ky jelley along with some inputs for behaviour change communication, STI treatment, creation of an enabling environment. to the MSM and TGs. The larger sexual – reproductive health needs and rights of these groups do not find a mention in the policies (NACO, 2006).
