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A case for inclusive public health campaigns

Posters, visuals, texts, and films have the power to persuade people’s thinking and behaviour. Over centuries, as the idea of public health grew, they have played a critical role in communicating actions, precautions, and consequences of illnesses and diseases to publics. They also reflect the changing health priorities, advertising trends, and government regulations.

Older themes visible in the STD campaigns included religious iconography, disability, and images of pregnant women and innocent children.

Stigmatised and non-inclusive health campaigns impact queer-trans people and further push them to the margins. For instance, there have been many instances in the past and current health campaigns of having limited target groups. Infant and childcare health campaigns often portray cis-het women as not only the primary caregiver but also someone who has to take the complete onus of a child’s health. This has twofold consequences. First, it stereotypes who could identify as a mother or a parent, and second, it puts the mental load of childcare on women.

Traditionally, an approach of negatively framed messages was taken in public health campaigns. Older themes visible in the STD campaigns included religious iconography, disability, and images of pregnant women and innocent children. An American poster from 1937 describes syphilis as “the Great Crippler” and depicts an unhappy young girl with crutches, suggesting that irresponsible sexual behaviour can lead to childhood disability in the next generation. This showcases the uneasy relationship between public health, sexual health, and disability. Public health has tended to work from within the medical model of disability, which pathologises disability as a medical and individual problem needing cure, prevention or rehabilitation. While this is changing, we still have a long way to go in terms of understanding and articulating destigmatised and non-pathological public health messaging.

The medicalization of queer bodies has historically and continues to influence how queer individuals interact and communicate within healthcare settings. If queer bodies are acknowledged, they are positioned as something exotic and not presented as a typical patient. In the HIV/AIDS intervention programs where the first phase of the National AIDS Control Program (NACP) was officiated in 1992, “men having sex with men,” or more commonly “MSM,” was identified as a high-risk group. This subsumed various transfeminine identities. While there was a disaggregation of MSM and transgender people later, this was not based on self-identification and did not take into account subtle nuances of various cultural trans identities whose direct Anglophonic translation is not possible (for example, people who identify as kothi, hijra, dhupli).

Inclusive public health messaging is important to building an equitable and accessible public health system for queer-trans and people with disabilities.

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