Central government hospital steps in to bat for transpersons’ health

India's 1st dedicated transgender OPD opened at RML Hospital to promote inclusive healthcare for LGBTQ+ community. It provides free treatment, investigations, sex change surgery, endocrinology, plastic surgery, dermatology, paediatrics, and a separate washroom.

“Visiting a medical establishment as a patient often translates to being harassed or humiliated. The public, and even some medical or support staff, are still unable to accept us as human beings who are in a hospital for treatment,” says 23-year-old Ruchi (name changed), seeking sex reassignment surgery (SRS) at India’s first dedicated transgender out-patient department at Dr. R.M.L. Hospital on Friday.

The establishment of the facility marks the Central government’s foray into providing a crucial, dedicated service for this vulnerable community. The facility is aimed at promoting an inclusive and easily accessible healthcare system for the LGBTQ+ community.

According to the World Health Organisation (WHO), transgender people are around 13 times more likely to be HIV-positive than other adults of reproductive age. It adds that overall, transgender people have low rates of access to health services due to a range of issues including violence, legal barriers, stigma, and discrimination. Experts note that while transpersons share many of the same health needs as the general population, they may have other specific healthcare needs, such as gender-affirming hormone therapy and surgery.

Inaugurated on September 17 and open every Friday from 2 p.m. to 4 p.m., the facility was started after understanding the difficulties encountered by the transgender community “in accessing healthcare services, largely due to discomfort and fear of discrimination and social apathy,” said Ajay Shukla, Director, Dr. R.M.L. Hospital.

In September last year, the Government of India included transpersons in the Ayushman Bharat scheme which provides them with an annual health cover of ₹5 lakh, and includes gender-affirming services. Also Transgender Persons Act, 2019 mandates that the government must ensure medical facilities provide care to transgender persons.

However, the reality is that transgender persons often face sociological, mental and physical health issues and “there is dearth of data regarding their major health problems”, noted a recently published study titled The Third Gender in a Third World Country: Major Concerns and the AIIMS Initiative. It adds that poverty, economic exclusion, rejection by family, mental abuse, workplace discrimination all contribute to preventing access to healthcare facilities.

They lack proper healthcare facilities due to social intolerance and stigmatisation often forces over 50% of transpersons to seek treatment with quacks or self-medicate, say experts. The study also notes that suicide rate in India for the transgender population is a staggering 31%, with about half of these attempts having been made before the age of 20. The study adds that 46.3% of transgender people have a lifetime presence of non-suicidal self-injury. Also 48% of transgender persons suffered from psychiatric disorders but none received consultation.