- According to census 2011, the total population of transgender is 4.88 lakh
- Healthcare, in general, needs to be made more inclusive: Experts
- Many of us feel uncomfortable at hospitals: Anita Vashi, transgender
New Delhi: “The transgender community in India has faced discrimination almost everywhere for years and healthcare is not an exception. What is believed to be a basic human right to others, is still a challenge for many of us,” said 44-year-old Shabnam Bua, a transgender person from Ujjain, Madhya Pradesh. According to her, the non-recognition and non-acceptance of their gender identity is a major barrier that makes not only access to healthcare but also to food security, employment and education more difficult than others. India has almost 4.88 lakh transgender persons, as per the Population Census, 2011. To give them recognition and address their issues, the Parliament of India had recently enacted the Transgender Persons (Protection of Rights) Act, 2019 which calls for changing the negative attitude of the general public, prohibition of discrimination and access to welfare measures including healthcare. NDTV spoke with transgender individuals and experts to learn about the issues related to access to healthcare among transgenders.
Barriers To Healthcare: Reality Transgenders Face
While talking to NDTV, Anita Vashi, a 33-year-old transgender individual from Mumbai said,
The primary healthcare system has failed many transgender Indians. Many of us feel uncomfortable while visiting government hospitals because a lot of times, hospital staff especially males make derogatory remarks and ask us to sit among men even after telling them that we identify as women. I think there should be some facility like a ward specifically for transgenders in each hospital. We are made to run around various departments pointlessly because of which our treatment gets delayed. Also, there should be some discount for the transgender community to make it affordable for them. The third gender in India is still not given enough opportunities to get into mainstream jobs and is largely dependent on begging at traffic signals, giving blessings and congratulations at social gatherings and even paid sex work. How can they afford to get treatments for diseases like cancer or some sexually transmitted disease or if there’s a bone fracture?
She also highlighted that the stigma associated with HIV/AIDS is a fundamental barrier in seeking healthcare for HIV-positive trans people. She said that not only co-patients, the HIV-positive transgender people face stigma from healthcare providers as well. She also revealed that transgender individuals are asked uncomfortable questions about their sexual lives and their genitals. They also face staring and unwanted curiosity from other patients, she said.
Salman Choudhary, a 20-year-old transgender who has been advocating for the right to sanitation and health for tans-community in Varanasi, Uttar Pradesh said that while hospitals and doctors do not refuse medical care to transgender people, there is some uneasiness in approaching medical professionals for consultations. He said,
Medical professionals are extremely important and are always helpful. I don’t want to blame anybody or offend them, but I have had some bad experiences with doctors. When I was younger, I was told by a doctor, whom I visited to get treatment of fever and cold, that there is a lack of male influence in my life because of which I am frail get ill frequently.
For 36-year-old Chandani from Ghaziabad, Uttar Pradesh, who earns a living from celebrating birth of a child or marriages in her area, the society helps her get food on the table and it is the society only that makes her feel inferior.
I am on the streets most of the time. I see and meet numerous people every day. People treat us like we are less humans than them. They act like they are scared of us. Policemen mistreat us. They think that we are beggars by choice but who wants to beg? We don’t have a choice. Struggling everyday makes me feel lonely. I am sad all the time. It has definitely affected my mental health. But I don’t know where to get help from? I don’t have money to seek professional help.
The transgender persons we spoke to do not have any health insurance. There is a lack of awareness among the trans community about Pradhan Mantri Jan Arogya Yojana (PMJAY) which is also called Ayushman Bharat scheme which is a health insurance scheme of the Central Government.
According to Charit Jaggi, founder of We The Young, a youth content platform that aims to encourage the youth to talk about mental health, gender inequality, sexuality and identities, healthcare in general needs to be made more inclusive He said,
From our interactions with people from the trans community, we realised that a lot of them grow up feeling isolated. Healthcare needs to address their needs in a more inclusive manner. The healthcare system needs to become more aware. This essentially means that young and budding healthcare professionals must be equipped with the right understanding and knowledge about the different terms, experiences and trauma a trans individual might associate with. They need to understand gender fluidity and trans allyship.
COVID-19 Pandemic Has Worsened The Issue Of Access To Healthcare Among Transgenders
For more than a year, the COVID-19 induced lockdown and the ongoing pandemic have left transgender people even more vulnerable to hunger, poverty and diseases. Because of social distancing protocols, travel restrictions, curfews, loss of livelihood and lack of support from the society and civil society organisations, many people in the transgender community witnessed poor health and even faced disruptions in getting treatment of HIV called antiretroviral therapy (ART) on time.
I have seen people dying of HIV during the lockdown. I sent bodies of 8 transgenders from my area to their respective villages. Their situation worsened because they could not get ART therapy as the medical official incharged refused to give it due to the lockdown. In two of such cases, hospitals in Mumbai refused to admit the patients as their jaundice had worsened. They told us that the chance of survival is low and admitting them would only take up hospital resources and beds which were already short due to high number of COVID cases, Anita Vashi.
While talking about access to vaccination against COVID-19, she said that people in her community who are above 45 years are going for vaccine shots and are not facing any kind of discrimination on the vaccination site. She said,
At the vaccination site, everything happens smoothly. None of the persons from my community has faced any side effects. There are just two elderly people I know who have contracted COVID-19 even after taking the second dose of the vaccine. So they are quarantined right now and are getting the treatment.
Ankita Wagle, representative of a Mumbai based non-governmental organisation Identify-The World For Transgenders that aims to work towards the wellbeing of transgenders highlighted that traumatic experiences like discrimination and assault which the transgender community faces often, have health implications. She said that because of the fear of rejection, transgenders often remain in the shadows. Ms. Wagle suggested that support and guidance from NGOs can help transgender persons live better and healthier life.
NDTV – Dettol Banega Swasth India campaign is an extension of the five-year-old Banega Swachh India initiative helmed by Campaign Ambassador Amitabh Bachchan. It aims to spread awareness about critical health issues facing the country. In wake of the current COVID-19 pandemic, the need for WASH (Water, Sanitation and Hygiene) is reaffirmed as handwashing is one of the ways to prevent Coronavirus infection and other diseases. The campaign highlights the importance of nutrition and healthcare for women and children to prevent maternal and child mortality, fight malnutrition, stunting, wasting, anaemia and disease prevention through vaccines. Importance of programmes like Public Distribution System (PDS), Mid-day Meal Scheme, POSHAN Abhiyan and the role of Aganwadis and ASHA workers are also covered. Only a Swachh or clean India where toilets are used and open defecation free (ODF) status achieved as part of the Swachh Bharat Abhiyan launched by Prime Minister Narendra Modi in 2014, can eradicate diseases like diahorrea and become a Swasth or healthy India. The campaign will continue to cover issues like air pollution, waste management, plastic ban, manual scavenging and sanitation workers and menstrual hygiene.