Transgender Healthcare

Why in news:

The All India Institute of Medical Science (AIIMS), New Delhi, announced its plans to open a Centre of Excellence for transgender healthcare in 2024.

Synopsis:

• Transgender people have been historically discriminated against, marginalized— pathologies, and labelled mentally diseased.
• They have been subject to unscientific and inhuman practices like “conversion therapy” by medical practitioners.
• The community lacks access to healthcare because of structural barriers like exclusionary infrastructure, lack of services and trained and sensitized healthcare workers.

Different steps taken to ensure inclusion of transgender:

• The community was first given legal recognition in India in NALSA v Union of India(2014).
• The Supreme Court endorsed their rights as fundamental rights.
• The judgment directed central and state governments to ensure medical care for transgender people and cater to their mental, sexual, and reproductive health.
• In 2019, Parliament enacted the Transgender Persons (Protection of Rights) Act.
• It re-emphasized the role of governments in holistic healthcare services to the community — providing sex reassignment surgery, hormone therapy, counselling services, HIV sero-surveillance and mental health services.
• It also asked for a review of the medical curriculum and medical research that caters to transgender persons.
• Most importantly, it called for facilitating Trans peoples’ access to hospitals and healthcare institutions.

The Transgender Persons Rules, 2020:

• It added that state governments shall ensure the provision of separate wards and washrooms for transgender people in hospitals by 2022.
• It asked states to undertake the sensitization of healthcare professionals and directed the publishing of an equal opportunity policy and notification of a complaint officer by every establishment.
• It also suggested that at least one government hospital in a state should provide safe and free gender-affirming surgery and related services.

The key concerns that remains as it is:

• Transgender people are legally guaranteed equal access to healthcare. Yet, it is denied.
• State policies in primary and secondary healthcare have made no effort to ensure access for the community.
• Mental healthcare continues to be dominated by tertiary institutes that have failed to provide for gender-diverse people.

• Gender-affirming procedures and lucrative market of sex reassignment surgeries is totally dominated by private healthcare providers.

• The Transgender Act makes it mandatory for a transgender person to undergo surgery to change their gender within the binaries of male and female.
• Certain documents in India, such as the passport, still do not have the provision of transgender as a gender marker.

The way ahead:

• One centre cannot cater to the needs of transgender people across India. All government medical colleges and hospitals in India should provide gender-affirming services.
• This must be in addition to quality, inclusive, and accessible primary and secondary healthcare.
• Institutions aiming to be Centre of Excellence must comply with legal necessities like transgender-inclusive wards, washrooms, equal opportunity policy, and grievance mechanisms.
• The medical curriculum needs revision to serve the needs of gender-diverse people.

Subject: Society and social justice

Topic: Welfare schemes, mechanisms, laws and institutions related to LGBTQIA+

Issues: Center of excellence for transgender persons

Source: The Hindu