How Safe is the Healthcare System?: The Transgender Community
Healthcare is a fundamental human right. Every individual should have the birthright to protect their physical and mental well-being. However, how will this be possible if people are afraid to even approach the system that is supposed to help them? Healthcare for the transgender community is surrounded by social stigma and misinformation. Here to bring you more information on this is Perspectoverse’s Ishana Kandhari.
The 2011 Census estimated that 4.88 lakh Indian citizens identify as transgender, due to which the country has one of the most sizeable transgender populations in the world. Yet, they are an extremely marginalized and underrepresented section of the country. Most official gender and sex-disaggregated data only consider the binary, failing to provide provisions for the intersex, transgender or gender non-conforming individuals. This includes the healthcare sector.
Firstly, there is a lack of education. This year, the unscientific and prejudicial misconceptions about the LGBTQ+ community in the Indian medical curriculum has been highlighted. The textbooks described transvestism, or cross-dressing, as ‘sexual perversion’. They also included ‘Gender Identity Disorder’, which was previously used to describe a transgender person, in the psychiatry section. This can be extremely harmful and can strengthen the stigma around the transgender community. The National Medical Commission has ordered a revision of the content.
Sex reassignment surgeries (SRS) are often another cause of distress for transgender individuals, especially those from lower social-economic backgrounds. In India, SRSs are still considered ‘cosmetic surgeries’ and consequently, are not covered under health insurance. Although these surgeries are provided by both public and private medical institutions, it is common for doctors at Government institutions to be unskilled and uneducated about transgender persons. Experts at private institutions are often more skilled and experienced. However, private procedures are generally much more expensive, making them unaffordable for some.
Due to social stigma, it is a common occurrence for nurses and doctors to treat transgender patients extremely poorly. There have been accounts where nurses have refused to touch the patients to measure their pulse or meet their requirements. Other times, they are asked intrusive questions, especially regarding their sex lives due to them being highly prone to developing HIV, even if their symptoms do not have anything in common with an STI. Very often, these individuals are also misgendered, making it an uncomfortable experience for them.
The COVID-19 pandemic has been an especially distressing time for some transgender individuals. The poor treatment they are given has prevented several of them from coming forth and testing for COVID. Some tried to isolate themselves for the entirety of the pandemic. However, this is not a privilege that many can afford.
In June 2020, in the midst of the pandemic, the Trump Administration in the United States revoked the anti-discrimination laws enforced by President Obama to protect transgender rights to healthcare. These stated that there could be no discrimination based on a person’s gender identity. Under the new rule, doctors were permitted to deny a patient their assistance, and would also affect the community’s access to health insurance. This policy received severe backlash from Human Rights organizations. Thankfully in August 2020, the Trump administration was overruled by a federal judge.
There have also been multiple accounts of transgender people dying due to a medical emergency that could not be treated promptly due to hospitals inability to decide whether they should be put in the male ward or the female ward. The founder of the Civilian Welfare Foundation, Shuvojit Malik, mentioned one such individual named Saikat, who was involved in a train accident. In 2020, BBC reported the story of a transgender man named Cameron Whitley. His biological sex is female but his medical reports showed that he was male. Whitley needed an urgent kidney transplant. Although he had medical insurance and prospective kidney donors, his surgery was delayed by a year as his eGFR levels did not meet the ‘male’ cutoff. Although doctors should be inclusive and avoid misgendering a transgender patients, they need to keep in mind their biological sex as well.
It is clear that discrimination against transgender individuals in the healthcare sector exists at various levels and due to a myriad of factors. Education is a vital part of the solution. This includes training and equipping doctors with the skills to work with transgender patients, as well as education to defeat social stigmas and learn to be inclusive and accepting. As part of a global effort to make humanity a better race for each of its members, we must learn to disseminate and distribute each right, privilege and facility in equal proportion, irrespective of background or identity.
Why should healthcare, a fundamental right, be treated any differently?
Written by Ishana Kandhari
Illustrated by Rishita Banerjee
Youth Ki Awaaz. “India Needs To Make Healthcare Accessible For Trans People,” April 6, 2017. https://www.youthkiawaaz.com/2017/04/young-and-trans-will-our-healthcare-matter-to-india/.
The New Indian Express. “On a Quest for Queer Care.” Accessed December 8, 2021. https://www.newindianexpress.com/cities/chennai/2021/nov/11/on-a-quest-forqueer-care-2381958.html.
P, Neelam and ey. “Govt Panel for Transgender Persons Suggests Medical Curriculum Be Revised, Doctors Sensitised.” ThePrint (blog), November 17, 2021. https://theprint.in/india/govt-panel-for-transgender-persons-suggests-medical-curriculum-be-revised-doctors-sensitised/766806/.
Ramesh, Mythreyee. “‘Discriminated, Worried’: India’s Trans-Persons on COVID-19 Crisis.” TheQuint, April 9, 2020. https://www.thequint.com/neon/gender/coronavirus-transgender-community-impact.
Soumya, Elizabeth. “Indian Transgender Healthcare Challenges.” Accessed December 8, 2021. https://www.aljazeera.com/features/2014/6/18/indian-transgender-healthcare-challenges.
Swaddle, The. “What a Transgender-Friendly Health Care System Would Look Like.” The Swaddle (blog), October 5, 2019. https://theswaddle.com/what-a-transgender-friendly-health-care-system-would-look-like/.
“Trump Administration Scraps Transgender Health Care Protections | News | DW | 13.06.2020.” Accessed December 10, 2021. https://www.dw.com/en/trump-administration-scraps-transgender-health-care-protections/a-53793918.