Trans-persons feel excluded at health centres, says study

Aksheev Thakur

New Delhi, March 3

Transgender persons experience stigma and discrimination from health providers and feel excluded in health facilities that are designed in the binary of male and female, revealed a study published in the journal PLOS Global Public Health.

The study states that such negative experiences with health providers can adversely affect their mental health and wellbeing.

‘Prevailing discomfort’

• A participant recalled an incident when a trans-woman activist was asked to give a sponge bath to a transgender patient because the nurse said “they were not comfortable doing such things”
• A trans-man spoke about how a gynaecologist joked that he would not be allowed in the gynaecology clinic once he transitioned completely, which made him feel uncomfortable and unwelcome.

The experience of 63 transgender participants from different regions of India was collated in the study, ‘Experiences of transgender persons in accessing routine healthcare services in India: Findings from a routine participatory qualitative study’.

One of the participants said health professionals did not understand transgender identities and the medical transition process. “One doctor did not understand the difference between a neovagina, vagina created surgically, and vagina naturally present at birth. This showed that the medical curriculum does not cover transgender health topics sufficiently,” the participant added.

Some transgender participants were reportedly denied care even before getting to see the healthcare professional. The researchers said this indicated neglect and exclusion of trans-persons by health professionals because of the stigma attached with the community.

“The watchman would never allow us to even sit there and people would shoo us away. The nurse will not even touch our body because they feel it is obnoxious to touch the body of a trans-person,” a trans-woman said in the study.

Some of the participants said travelling to a health centre itself was a challenge because of the experiences of stigma en route to the hospital. Several participants in the study spoke about the way people stared and cracked jokes at them, prompting them to avoid going to hospitals.

The study highlights that hospitals and clinics are structured in a way that is often exclusionary to transgender people. Participants also spoke about hospitals “not expecting a trans-person to come”. They assert that it is because most hospitals segregate spaces based on the gender-binary of male and female, thus excluding people who are non-binary or don’t appear to fit within the conventional norms of the gender expression in the binary.

The spaces inside hospitals, including wards, outpatient clinics, waiting rooms, washrooms, and queues for registration, are usually designed keeping in mind the gender binaries of male and female.

When transgender people arrive at such binary spaces there is confusion about which side to go to because of chances of being told they are in the ‘wrong place’ even when they identify in the gender binary.

The study highlights that even the registration forms are usually designed for male and female patients, without a separate option for transgender, non-binary or other column.