Akkai Padmashali: A Voice for Inclusion and Empathy for Transgenders

Last Updated on February 23, 2024 by Shabnam Sengupta

Transgender individuals in India face significant challenges stemming from deeply entrenched social norms and legal hurdles. Discrimination, stigma and violence are pervasive, leading to limited access to education and employment opportunities. Many endure rejections from families and are left without a support system, contributing to high rates of homelessness, mental health issues and sexual abuse. Legal recognition and rights for transgender individuals have improved with the 2019 Transgender Persons Act, but implementation remains uneven. Access to healthcare, particularly gender-affirming procedures, is often limited. Advocacy and awareness efforts continue, but the struggle for equality and acceptance for India’s trans community persists, highlighting the need for ongoing change.

Akkai Padmashali is based in Bangalore, but her work is known across the country. She received an Honorary Doctorate for Peace and Education from the Indian Virtual University as well as Rajyotsava Prashasti, the second-highest civilian award bestowed by the state of Karnataka. Akkai is a male-to-female transgender. A small step in a long journey, her autobiography was released last year. She became the first transgender person in India to obtain a driver’s license with a female gender orientation. She married Vasu, a trans man, and became the first trans person in Karnataka to have her marriage registered. Akkai was invited to the White House by former US President Barack Obama.

Please tell us a bit about your journey and what inspired you to become an advocate for the rights of the trans community.

Akkai Padmashali: I’m a 10th-standard mathematics field and did not study beyond that. When we advocate for the rights of sexual minorities, it’s essentially to break stereotypes, fight against discrimination in all forms, including social exclusion, and challenge structural, systematic, cultural, and traditional barriers for those who lack the space to express themselves freely today.

Returning to India’s morality, fraternity, and the essence of its culture, tradition, and religion, we are integral to every aspect of its society. I may believe in God, or I may not believe God exists at all. What perplexes me is constitutional morality. Under constitutional morality, we are here to breathe, to speak for ourselves, and to challenge societal norms that reject our current identities. We confront how society can segregate or discriminate based on sex, gender, and sexuality. Each of us has stories and long journeys, whether as a woman, a Dalit, a member of a backward class, a religious minority, or from various ethnic or linguistic backgrounds, where we encounter multiple forms of discrimination.

Gender and sexuality are not something new. Our people have faced this structural discrimination for years. I remember the attack against my people at the Stonewall Pub in New York in 1960-61 because they were LGBTQI individuals. They were killed and assassinated on June 28th. So, on the 20th of June, internationally, we commemorate the whole resistance.

We fight against transphobia because people are discriminated against for reasons beyond their control, such as how they are born, how they express themselves, or their sexual orientation. How can society still discriminate in such ways? My people were killed, assassinated, and confined to limited spaces.

So these types of spaces were disturbing me a lot. Significantly, on the 20th of November, internationally, we come out on the streets to fight against and condemn the transphobia existing across the world. The Stonewall attack on the 28th of June has been brought to the forefront of society.

International Day Against Homophobia, Biphobia, and Transphobia, observed on May 17 is also relevant in this context. We have many days where we can resist against society, whether it’s related to Chandani’s murder case, my own experiences, or the 2004 gang rape of a transsexual woman in Bangalore by the police and local thugs.

I know, I think about Chandrika’s death in 2006, how it happened on the street, and in 2009, the Kerala murder incident, where the system portrayed us as child kidnappers. There are so many stories. Sharing a story requires passion and the way you want to express it. Today, in the 21st century, we are fighting and struggling for identity, recognition, and our fundamental needs. Despite having family, partners, and cultural acceptance on paper, in reality, we all face discrimination and lack access to public spaces, toilets, transportation, parks, malls, and bus stands.

I think, in a far better way, I could say Karnataka and South India are quite liberal and accepting because of various movements that have led, whether it’s the Periyar movement, the Savitribai Folis movement, or the Kempe Gowda movement, along with figures like Kitturani Channamma, Akka Mahadevi, and the Basavasa movement.

These thoughts have converged, especially in South India, which is different from other parts of the country. Especially Bangalore, Karnataka, is a hub of activism, knowledge, and people coming together to discuss the politics of gender and sexuality. I think I’m just one face of the movement. Many others have sacrificed and continue to sacrifice their lives to fight against all forms of discrimination and exclusion.

Akkai, you have also gone through a lot in your life personally. Could you tell me a bit about your struggle and how it encouraged and inspired you to fight the good fight you’re fighting today?

Akkai Padmashali: As I mentioned, we all have stories. I recall the year 2013 when I attempted suicide. The second time, I questioned why I should die. I am perfect and you’re not perfect. This sort of questioning of societal norms brought me to the point of accepting myself as I am today, instead of succumbing to societal pressure to conform.

Despite facing family non-acceptance, torture, violence within the family, and discontinuation of education, I remained motivated to pursue my dream of becoming a lawyer and practising in the Supreme Court or High Court. Even though I’m not a BA LLB advocate today, I find myself speaking on the politics of sex, gender, and sexuality alongside judges of this country.

I want to express my gratitude to the Indian judiciary, including Justice Altamaz Kavir, Justice Manjula Chando, Justice Mustafa Hussain Sahib, Justice M.K. Patil, Justice Vikram Jitsen, V.V. Angadisar, and many others who have contributed to this movement. The recent judgments of the Supreme Court declaring that LGBTQ+ individuals are no longer criminals boost our morale to continue the fight.

I come from a middle-class, non-English-speaking, working-class family. There were days when having a square meal was difficult, but compared to 25 or 30 years ago, the journey has been transformative. Each incident in my life has taught me valuable lessons about the meaning of life and resilience.

For me, there’s no single inspiration; rather, my life journey itself is my inspiration, battle, and challenge. I’ve constructed my own society within this world despite being told that I’m not eligible to live on this earth. I question those who hold such notions and assert my right to exist.

Through this forum, I want to challenge those who allege that we are urban elites and don’t belong. India has progressed from the Nehru period to today, and those who harbour such phobic mindsets should consider relocating to the moon if they cannot accept diversity on Earth.

What are some of the healthcare disparities that trans people face?

Akkai Padmashali: Today I have a cough. Normally, I don’t go to the hospital. As you were introducing me, very well recognized nationally. That’s all fine to share on the screen, on paper, to build a good profile and stuff. How is it good in practice? Even Akkai today faces discrimination, not directly entering a public toilet or a hospital.

You know, my voice is like this. My attitude, behaviour, and style are like this. My way of carrying is like this. So, you face, you know, this so-called socialized culture. There are so many social constructs of norms. It also says that if you’re a man behave like this, a woman behaves like this. If you’re a man, you have a masculine voice or a very strong voice. If a feminine woman, you have a very low voice with patience and stuff like that. I want to question that notion. You know, no two men have the same voice. No two women have the same voice. No men or women have the same gesture of existence.

In that context, if I open my mouth and speak, it surprises the whole hospital. You would want to go to the hospital if you have a fever, cough, cold, or some infection in your breast. We may have to consult a doctor if something happens in your sex change surgery process or if you want to go for follow-ups. You may even want to go and see your own parents or biological family members or any community member. It is not so easy.

We keep challenging society’s notions, and especially health is something so serious. My people who almost indulge in begging and sex work. As a social and political activist, I want to say that in India, the advanced health sector is not so friendly to marginalized sections of society. When I say that, transgender women, transgender men, intersex people, sex workers, including a whole bunch of identities, which includes gay men, lesbian women, pansexuals, and demisexuals. If I’ve had a sex change surgery, why do we urge medical institutions to have a separate ward for transgender and sexual minorities? It’s very simple because the sex we are born with is different from our current sex.

Though I may have been born male, I transitioned to female. The process of transformation involves undergoing various sex change surgeries, from vaginoplasty to breast implants, facial therapy, voice therapy, and hormone therapy. It varies depending on the individual. And I would not be comfortable speaking to a doctor who discriminates against me.

Forget about sex change. Let’s talk about HIV infection or AIDS-acquired people. I think in the last stage of their lives, people refused to touch their bodies. My friend, Umar passed away in that way. I remember in the last seven months of 2006, people refused to touch her body. Chandrika’s body was also refused.

There are many examples like this. I would like to share more stories like that. Because of the existence of such medical discrimination processes, the same system is not prevalent much today. NIMHANS, Bangalore Medical College, Victoria Hospital, Bowery Hospitals, and MS Ramayana Hospital are now coming forward. Various doctors are coming forward to understand what this community is all about. Twenty-thirty years ago, it was a very pathetic situation. We were not even going to hospitals. Even if you go to hospitals also, we were going to private hospitals.

Government hospitals are often low on funds, resulting in low-quality care and support. Private hospitals, on the other hand, always expect payment. Even if you pay, you may still face discrimination. I’m just highlighting the challenges in this aspect of healthcare. Additionally, there are individuals affected by tuberculosis, leprosy, cancer, and other ailments.

We’ve lost three to four people due to cancer caused by breast implants. So, how do we educate people about this medical process? The existing programs under government schemes and policies are too narrow, focusing only on men and women. Therefore, through this forum, I advocate for a separate health policy.

Do you think discrimination is the reason why many people from the trans community are hesitant to go to hospitals? That is a major factor. If I want to speak to you, I need to feel comfortable, right? Similarly, if I want to visit a doctor, I seek one who is friendly and accepting of me as I am.

See, if a doctor just empathises with you, I think half of the disease is alleviated, right? The smile you put on your face, the way you speak to people who are medically affected — I would say that you know, I think what I would ask here is to have a separate medical policy for India, addressing the needs and concerns of the community.

Each state has its dependence on its health system. I think we need to address that. Karnataka state is in the process of developing a separate medical policy for transgender individuals and intersex people. I think the Minister of Health and Family Welfare, Mr Dinesh Gundu Rao, is quite keen on working with the communities with which we closely associate. I think we are collaborating with NIMHANS, Bangalore, Victoria Hospital, and MS Ramya Hospital.

How has the health misinformation affected the community?

Akkai Padmashali: The assumption people make even today is that HIV/AIDS is only for transgender sex workers, female sex workers, and divorcées. This is the notion.

Okay, I’m HIV positive. If you are a man having sex with me without safe protection, you understand that it automatically infects you, especially if you have multiple partners. So having sex with multiple people is not my problem; how protected you are is my concern. These notions are clear in society. Transgender people are perceived as HIV infected, so people are discouraged from having sex with them. There’s also a misconception that if you’re HIV positive and engage in anal sex with transgender women, HIV/AIDS will be cured.

During the recent coronavirus pandemic, society treated us very harshly. It was difficult; there were accusations that we were spreading the virus because we were always on the streets. Another said you are struggling for bread and butter. Once, I met people who were infected because of COVID-19 but did not receive proper care, support, or treatment. These individuals struggled a lot to access medical supplies and other necessities. You get it. And we challenged before the Honorable High Court.

Thanks to the Honorable High Court for delivering nine interim judgments on various points. Okay. So, there is one side to combating social norms, and the other side is to also build your self-esteem, self-confidence, and self-respect to live in this society and consistently confront your identity, sexuality, and existence.

Why should we be discriminated against? Health is for all, right? Health is the priority, correct? But I would say the right to health is my fundamental right. I need access. No discrimination should be tolerated under my right to health. I should have access to my injections, medicines, nutritional support, and beds.

Providing free treatment to staff, any government should be supportive and friendly towards medical staff, and social protection or social security schemes should be implemented in that context. Excluding transgender people, sexual minorities, sex workers, and Deva Dasis goes against the principles of justice.

Can you speak about the mental health challenges faced by the community and trans individuals to be particular, and the resources or initiatives?

Akkai Padmashali: Mental health is an utmost priority worldwide because as a single woman, you face different levels of mental health challenges. Whether you’re a black woman, a Dalit, divorced, a sex worker, or a sexual minority, there are numerous reasons why people experience mental challenges, especially those living on the streets.

Particularly among sex workers and sexual minorities, individuals often face significant mental health challenges when their sex and psychology conflict, or when their sexuality, sexual orientation and gender identity conflict, causing them to question who they are and why they are like this.

In this process of understanding gender and sexuality, society often responds with numbness rather than understanding, resulting in judgmental attitudes that contribute to mental illness or poor mental health. Addressing mental health issues requires access to professionals such as psychologists, psychiatrists, and counsellors, as well as institutions dedicated to mental health support. However, such resources are often scarce and commercialized.

If I’m traumatized due to family torture, partner abuse, police harassment, or any form of societal-sponsored discrimination, where can I seek help? You see, I’ve been mentally traumatized many times, but there wasn’t a support system in place. Instead, what we did was sit in front of the mirror and share our experiences. This strategy helped build confidence by reaffirming our worth and beauty, despite society’s negativity.

This approach, involving group discussions and self-affirmation, is crucial. However, there’s still a long way to go, especially in India or Karnataka. There is a need for mental health professionals to address the issues faced by the most marginalized groups, particularly transgender individuals, sexual minorities, sex workers, and Deva Dasis.

And personal disabilities, you know, that’s very much essential. Yeah. And the mental health policy, in particular, because I can speak to you in this confidential room, and I can share my feelings, thoughts, and challenges. I don’t want my people to die because of mental health issues or to carry trauma until their demise. Mental health is a serious matter, involving self-conflict, social pressure, relatives’ expectations, and family and partner stress. It’s a long road to combat these challenges.

What are the most important or pressing issues and obstacles that need to be overcome soon for the community?

Akkai Padmashali: I think we need a safer and more accepting societal environment. You are different, I am different. If this attitude prevails in society, that’s fine. And regarding your question, especially for our community with multiple identities, everyone face different challenges and struggles.

We all face different challenges and struggles in life. So, each age identity has its importance. And what we’re saying is that to lead a life with dignity, you need to be socially accepted. Economic sustainability is a must. Okay. If I want to see it in the practical world, I need my own house, a 30,000 rupees salary, good health facilities, and a good environment in my local community. If that is provided, why would I be traumatized? Why would I be killed? Why would I be discriminated against? So, the government must ensure that its citizens have access to these conditions for a peaceful society.

Disclaimer: Medical Science is an ever evolving field. We strive to keep this page updated. In case you notice any discrepancy in the content, please inform us at [email protected]. You can futher read our Correction Policy here. Never disregard professional medical advice or delay seeking medical treatment because of something you have read on or accessed through this website or it's social media channels. Read our Full Disclaimer Here for further information.



Subscribe to our newsletter

Stay updated about fake news trending on social media, health tips, diet tips, Q&A and videos - all about health