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.
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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.
