Study reveals systemic barriers in healthcare access for trans, non-binary, and gender-diverse persons in India

These findings stem from one of the first-of-its-kind and largest qualitative studies conducted in India with TGD communities, shedding light on the challenges faced by diverse TGD persons and the impact of the Covid-19 pandemic on mental health.

The study was conducted by Initiative for Health Equity Advocacy and Research (iHEAR), a cross-organizational platform hosted at Sangath, Bhopal, which has been working with the LGBTQIA+ and disability communities for the last three years.

A qualitative descriptive approach was used in the study between May and September 2021 with transgender persons in different regions of the country that was published on February 29 in PloS Global Public Health.

The results of the study highlight that the negative experiences, often experienced at the interpersonal level, are also because of a health system that is designed for cisgender persons in the binary of male and female. For instance, the need for legal documentation that ‘matches’ their gender identity forces individuals to come out in hostile settings. Other points of inaccessibility include binary-restricted (male-female) queues, washrooms, medical forms, and waiting rooms in healthcare settings. Participants reported denial of healthcare services even before reaching the practitioner.

Health professionals denied services, privacy provisions, and due consent when administering invasive procedures. Dr Harikeerthan Raghuram, lead researcher and associate director (Health Equity) at iHEAR said,`”Many doctors wonder why they do not get to see transgender patients in hospitals. Now we know that transgender patients delay or avoid accessing healthcare because of negative experiences they have had in hospitals in the past. We must urgently reform medical education to fix this situation.”

Dr Aqsa Shaikh, one of the senior authors of the study, said access to correct, caring, and compassionate healthcare is everyone’s need and a right. “Unfortunately, for marginalized groups like trans and gender-diverse individuals, this can mean navigating an endless quagmire that invisibilizes or excludes them. This needs to change and that change is possible by taking small steps in healthcare provisions to ensure everyone is included,” Dr Shaikh said.

“These insights from the study underscore the necessity of broadening conversations on trans-inclusivity in healthcare provision beyond HIV and gender-affirming services,” said Dr Anant Bhan, senior author of the study.