There is a long history of discrimination and stigmatization against the transgender community, which has led to many challenges in their daily lives and in terms of healthcare services. This has significantly impacted their mental health, leading to higher rates of anxiety, depression, and other health challenges.
India being the largest democracy in the world, being the most populated country, has recorded the population of third gender in India approximately 5 lakhs as per 2011 census. But it is difficult to depict the actual population of the transgender individuals, as some of them prefer to identify themselves as male and female in their identity cards. The history of Transgenders people reflects from the various Hindu scriptures, art and idols.
The transgender community in India, often referred to as Hijra, encompasses a diverse group of individuals with non-normative gender identities. The term ‘Hijra’ historically refers to a traditional third gender in South Asia, including India, but it’s important to note that the transgender community is diverse and includes various identities beyond Hijra such as Transgender Male, Transgender Female, and Intersex, where the explanation is complex if we try to understand the emic perspective of the community.
Understanding the term ‘Transgender’
It is important to recognize and respect the individual identities within the broader transgender umbrella. Hijras, in particular, have a rich historical and cultural significance in India. They have been a visible part of Indian society for centuries, often playing specific roles in rituals and ceremonies. However, despite their historical presence, the community has faced social marginalization and legal challenges.
To understand the term transgender we first need to understand the difference between the sex and gender:
- Biological status that is assigned at birth by doctors and parents is mostly correlated with physical characteristics like chromosomes, hormone predominance, and internal and exterior anatomy.
- Whereas gender is the socially constructed roles where actions, pursuits, and characteristics for boys and men or girls and women are taught by society. These affect how people behave, communicate, and view themselves.
- Aspects of gender may vary among cultures, although aspects of biological sex are common. Therefore, the community prefers to address them by using pronouns as he/she/they as per individual liking to avoid the misgendering that can be hurtful for them.
- An intensely felt internal sense of being male, female, or another gender—which need not correspond with the sex assigned at birth—is known as gender identity.
- Gender identity and biological sex are not the same.
- Gender expression refers to how a person expresses their gender externally through behavior, attire, hairstyles, and other elements. It might or might not fit the expectations of society or the gender-specific norms.
- Physical characteristics or traits that are used to classify people at birth as male, female, or intersex are referred to as ‘sex characteristics’.
- People who identify as intersex have sexual traits that defy conventional ideas of what constitutes a male or female.
HEALTHCARE CHALLENGES
Healthcare accessibility is a critical aspect for transgender individuals, addressing both their physical and mental health needs. Unfortunately, unique challenges and a history of doubts and lack of awareness among healthcare providers have hindered access to necessary medical care.
Unique Healthcare Needs of Transgender Individuals
Transgender individuals often grapple with distinct mental health challenges and identity-related issues. Doubts among healthcare providers, coupled with a historical lack of awareness, have been barriers to seeking essential medical care.
Importance of Transgender Healthcare
Access to gender-affirming care, such as hormone therapy or gender confirmation surgeries, is crucial for aligning physical bodies with gender identity. Improved accessibility helps mitigate health disparities, promoting health equity and ensuring that transgender individuals receive care without discrimination.
Legal Recognition and Protections in India
India has taken significant steps to recognize and protect the rights of transgender individuals. The landmark 2014 Supreme Court decision recognized them as a third gender, affirming their right to equality. The Transgender Act 2019 and the NALSA ruling aim to address discrimination and improve the socio-legal status of the transgender community.
SOCIOECONOMIC CHALLENGES
Transgender individuals in India often confront significant socioeconomic challenges, including limited access to education, employment discrimination, and a lack of healthcare resources. These challenges contribute to higher rates of poverty within the transgender community, impacting mental health and overall well-being.
Family Rejection and Forced Migration
Due to stigma and discrimination from family, friends, and neighbors, the majority of transgender persons are forced to leave their homes, leading to self-sufficiency challenges. Forced migration results in a need for individuals to provide for themselves, facing difficulties, especially in public sector employment due to discrimination.
Distinct Living for Hijras
For Hijras, a distinct way of living involves residing in ‘deras’ with Gurus, following the ‘Guru-Chela’ system. They visit marked locations in a ‘toli’ for ‘badhai’ or similar activities. Their livelihood relies on the support of others, creating unique challenges and dependencies.
Growing Movement for Transgender Rights
Over the years, there has been a growing movement for transgender rights in India. Activists and advocacy groups work towards challenging stigma, discrimination, and promoting inclusivity. Their efforts have contributed to legal reforms and increased awareness.
Public Health Ramifications
Ensuring the health and well-being of transgender individuals has wider ramifications for public health. Significant health disparities, mental health conditions, discrimination, and difficulties accessing healthcare are frequently experienced. Legal provisions, including the Transgender Act 2019 and NALSA ruling, aim to reduce these differences and enhance overall health outcomes.
Implementation of Legal Provisions
Legal provisions following the NALSA Act, the Transgender Act (2019), and rules (2020) have led to the establishment of the National Council for Transgender Persons (NCTP). The National Portal for Transgender Persons (NPTP) issues transgender IDs, providing opportunities in various sectors and aiming for inclusivity.
Equal Right to Healthcare
Every individual, regardless of gender identity, deserves equal healthcare. Legal provisions are being implemented to reduce differences and enhance general health outcomes. The emphasis is on treating every person equally while maintaining their dignity, whether for routine medical needs, serious illness, or cosmetic surgeries.
The landscape of transgender healthcare in India reflects a dual narrative—progressive legal reforms and persisting challenges. Advocacy efforts, legal provisions, and increased awareness play crucial roles in fostering inclusivity and ensuring the well-being of transgender individuals. The journey towards equal healthcare access continues, with a focus on eliminating discrimination and promoting dignity for all.
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