“Slip Between the Cup and the Lip”: Glaring Gaps in the Healthcare System’s Implementation of Rape Law Reforms in Two Districts, India

In response to the national and global public outcry over the ghastly Nirbhaya gang rape case in Delhi in 2012, India witnessed reforms in a set of extant laws to deal with sexual violence, sexual harassment and child sexual abuse. The Ministry of Health and Family Welfare released guidelines in 2014 to respond to cases of sexual violence. These developments prompted the authors to study gender policy in “practice,” that is, the preparedness of the healthcare system, where a plurality of actors is involved, and gender justice has to traverse multiple administrative hoops. This chapter is based on a study conducted between 2016 and 2021 in one district each in Maharashtra and Telangana, India, to assess the response of public healthcare facilities situated at the district, sub-district, and village levels while handling medico-legal cases of sexual violence. We found deficiencies in infrastructure, equipment, and laboratory facilities mandated to respond to sexual violence. More significantly, the rampant practice of unscientific, outdated, and outmoded medical evidence gathering, including practices like the two-finger test, gathering of sexual history, looking for physical injuries, and documenting reports with non-standardized forms, continue. The chapter highlights the need to recognize health systems, as social institutions embedded in prevailing social and gender norms and power relations, as a major obstacle to effective implementation of progressive changes in laws. We argue that such a recognition warrants a systematic intervention for the healthcare system and providers to break away from adhering to the prevailing social and gender norms and update themselves on the changed legal framework.