For over a year now, Ruth John Paul, a Scheduled Caste transgender woman doctor from Telangana, has been fighting to gain admission in a postgraduate (PG) course in gynaecology in the state. Posing a roadblock to Ruth's ambitions is the Union Ministry of Education and the state Medical Council's delay in amending the rules to grant reservation for transgender persons. Despite the Supreme Court’s 2014 NALSA judgement that reservation be extended to trans persons, Ruth was not granted a seat during the counselling after the National Eligibility cum Entrance Test (NEET PG) exam in 2022. She appeared for the exam again this year. Two writ petitions and a contempt of court proceeding later, the situation has only seen marginal improvement.
In August 2023, after several representations to various departments of the Union and state governments and appealing to the Telangana High Court, Ruth was granted two seats — MD in Emergency medicine at ESIC College, Sangareddy, and MD in Pathology at Osmania Medical College. The seats were allotted exactly a day after the contempt of court proceedings. Even though neither were in keeping with the verdict of the High Court and were not in the field of her choice, Ruth chose to join the Emergency Medicine course at ESIC.
“I wanted to join the gynaecology course to help members of my community. Most transgender persons are not only uncomfortable with cis doctors, but also often face discrimination and judgement from them,” Ruth told TNM.
As per the notification sent to Ruth by the Kaloji Narayana Rao University of Health Sciences (KNRUHS), which is the competent authority for NEET counselling in the state, only Ruth’s caste status (SC Madiga) was taken into consideration during seat allotment this August. Her gender identity was ignored for a second time.
Additionally, she was allotted seats in colleges that were not of her choosing. This is in violation of two Telangana High Court orders granting her the choice to opt for gynaecology in any college, given that she is the only eligible trans person this year. If she forgoes her seat at ESIC, she has to cough up Rs 20 lakh as per a bond she signed with the medical college.
As per the 2014 Supreme Court judgement in National Legal Services Authority (NALSA) vs Union of India, not only should transgender persons be treated as "third gender", but Union and state governments should also consider them socially and educationally backward classes of citizens and extend reservation in case of admission to educational institutions and for public appointments. Yet, neither the Telangana state Medical Council nor the Union Ministry of Education have amended the rules in keeping with the NALSA judgement, which in turn makes the KNRUHS unable to reserve seats for trans persons in any medical college.
Explaining the reservation policy for transgender persons, Ruth’s lawyer Sagarika Koneru said, “The Union Ministry of Education and the state Medical Council have to amend the guidelines for reservation for transgender persons in keeping with the NALSA judgement. Until the Ministry of Education amends the guidelines, the KNRUHS is not in a position to implement any reservation.”
While the University blames the state government, the state government pins the blame on the Union government.
When she appeared for NEET in 2022, Ruth had been categorised as cisgender female. It was then that she first filed a writ petition in the Telangana High Court, after she was categorised alongside Scheduled Caste (SC) cisgender women. The High Court, on February 7, directed the Union Department of Health and Family Welfare, Union Ministry of Education, the Telangana Department of Family Welfare and Department of Education, the National Medical Council (NMC), the Medical Counselling Commission, National Testing Agency, and KNRUHS to consider the representations submitted by her, keeping in mind the Supreme Court judgement and pass an order in accordance with law.
It is worth noting that Karnataka has offered 1% horizontal reservation to transgender persons since 2021, after the Karnataka High Court ruling in Sangama v State of Karnataka. Tamil Nadu’s state Planning Commission, in its draft LGBTQIA+ policy, too has recommended 1% horizontal reservation for transgender persons in admission to all courses in government, aided and private educational institutions.
On May 18, the NMC issued a statement that said that as the PG Medical Admissions Regulations 2000 does not include a provision for reservation on the basis of gender, Ruth’s representation could not be considered. Further, the NMC stated that rules have to be drafted by authorities concerned in the Union and state governments that admit students to Medical PG courses. It also added that as the NEET PG admissions for 2022 closed in September 2022, Ruth wouldn't be able to get a seat in that batch.
Following this, Ruth approached the court with a second writ petition and wrote the NEET entrance again. In the hearing on June 16, the NMC argued that she couldn’t be allowed to avail “reservation within reservation” as she was also a person belonging to the SC community. In the documents for state counselling, she was classified as an SC cisgender woman.
On June 20, the High Court ruled that Ruth should be allotted a seat each in the state and central quotas, considering both the gender and caste markers, in a manner that would be beneficial to her.
“I applied for counselling in the central and state categories in early August. While the first list for the central quota acknowledged me as a transgender person, no reservation was made available,” said Ruth. She was unable to avail the second round of counselling for the central quota as she was unable to login until the date for applying had passed. Around 90% of students admitted to PG medical courses are granted admission in the first two rounds. This means that Ruth would be forced to choose a Diploma course if she sits for further rounds of counselling.
Under the state counselling list too, Ruth was categorised as cisgender female.
On August 14, Ruth moved contempt of court proceedings against the Union Ministry of Health and Family Welfare, Union Ministry of Education, Medical Counselling Committee, and KNRUHS. Two days later, the High Court ordered the respondents yet again to allot seats in both quotas in a manner beneficial to her.
Currently a medical officer at Osmania General Hospital (OGH) in the Antiretroviral wing treating patients afflicted with HIV/AIDS, Ruth hopes that she gets listed for the second round of state counselling for NEET 2023. “If that happens, I can still hold out hope,” she said, adding, “I have always wanted to be a gynaecologist.” Acknowledging the support she has received, Ruth said, “I am happy to be serving people in need and have received the support of several individuals, including the superintendent of OGH Dr Nagender, but there is still a long road ahead.”