Beyond the bench: LGBTQ+ health equity after India's “no same-sex marriage” verdict

LGBTQ+ people (e.g., lesbian, gay, bisexual, transgender, and queer or questioning people) experience systemic marginalisation and discrimination globally and throughout India. In October 2023, the Indian Supreme Court rejected the legal recognition of same-sex marriage, blocking marriage equality for LGBTQ+ people and contending that the right to marry neither qualifies as a fundamental right accorded by the Indian Constitution nor falls under the Supreme Court's purview. Although the Supreme Court declared opposition to discrimination based on sexual orientation, its failure to recognise same-sex marriage legally is a substantial obstruction to full LGBTQ+ equality. We propose that the refusal of the Indian legal system to honour same-sex marriage while calling for an end to societal violence and discriminatory behaviour against the LGBTQ+ community is inherently flawed and counterintuitive. Informed by our team's multidisciplinary orientation as healthcare professionals, researchers, and advocates, we delineate explicit challenges that LGBTQ+ people in India may encounter due to the Supreme Court's recent ruling. We subsequently put forth a series of interprofessional and intersectoral recommendations to mitigate this decision's immediate and long-term consequences, providing an actionable path toward LGBTQ+ inclusion, justice, and equity in India.