The Transgender Issues in India
The Transgender Issues in
India
R.RAJASUTHIR
Secondary
Grade Teacher
Thiruppathur
Panchayat Union Primary School
Keelakavanipatti
Introduction to language
In India there exists a marginalized population that identifies as a
transgender. The term transgender is generally used to describe those who
transgress social gender norms. The people that were assigned male at birth but
have strongly feminine gender expression and identity. In parts of India,
Transgender face sexual assault and physical violence by police and public.
These people also face discrimination and harassment in health care facilities.
A report exploring that HIV prevalence is between 17.5 to 41 percent
transgender a population which is more than fifty times higher than the gender
Indian adult population. Furthermore, India has no medical guidelines for
gender reassignment surgery, so many transgender resorts to back array
procedures that leave them with dangerous complications. The pressure need to
address the transgender health issues and rights exists in almost realm in
Indian society.
Issues Affecting
Transgender health
According to the Gay and Lesbian medical association (GLMA) Besides
HIV/AIDS, issues related to transgender health include breast, cervical cancer,
hepatitis, mental health, substance abuse, Tobacco use, depression, access to
care for transgender persons issues surrounding marriage and family recognition
conversion therapy and refusal clause legislation and laws that are intended to
immunize health care professionals from liability for discriminating against
persons of whom they disapprove. These people experience health issues and
barriers related to their sexual orientation and gender identity and
expression.
Review of literature
Bilodeau
(2005) gives a sample of terms that describe transgender identities:
Transsexuals (Properative, postoperative), transvestites, drag queens, drag
kings, male to female (MTF),female to male (FTM), cross dressers and gender
benders. Transgender is an umbrella term that encompasses all these gender
variant identities. The medical profession dominates the body of research
regarding transgender people. This review outlines some research of
transgendered people from both a medical and psychosocial perspective.
Transgender people face unique challenges based solely on their gender
identity. Seil (2004) found that a disturbingly large number of transgender
people have other mental health diagnoses; 37.2% of all transgender patients in
his study had secondary diagnoses other than substance abuse and GID. Also
32.1% of this study had a positive history for drug and alcohol abuse (seil,
2004). There are many reasons that account for these high numbers. One reason
could be the isolation many transgender people experience in relation to their
gender identity. Another explanation could be the guilt that typically
accompanies their cross-gender identification.
Lev (2004) wrote a book to help practitioners work with transgender
people and their families. There are four parts of a person’s sexual identity;
biological sex, gender identity, gender role, and sexual orientation (Lev,
2004). These aspects of sexual identity “interact with one another in complex
ways and develop and integrate in various patterns” (Lev, 2004, p-87) to create
a unique sense of identity for each person. Each aspect exists on a continuum.
A Person can identify anywhere on that continuum and can exist in more than one
place at the same time (Lev, 2004, p-97).
Research objectives
The study aimed to examine forms, determinants and
outcomes of transgender social social-economic status, issues affecting the
health and discrimination in health care settings
Ø To
analyse the socio-economic condition the transgender.
Ø To
explore the discrimination faced by transgender in health care setting.
Ø To examine
the issue affecting the transgender health.
Research site
An explorative study was adopted to select the study the problem of
transgender from the area of villupuram of Tamilnadu.
This district was more
identical culture and traditions but here show an increasing numbers of
transgender. The district was famous for pilgrimage like kuvakam temple.
Therefore, there were purposively selected for this study.
Research design
Identification, selection and conducting of interviews among transgender
is not an easy task since not all transgender would accept their identity
especially in strictly culture bound rural communities. The study consisted of
transgender (n=50) and that had been selected for the study by using purposive
sampling technique because it was a challenge to collect data from the
population given their obscurity. Perhaps the researcher made an approach on
nongovernmental organisations which works among transgender an in depth
interview guide was prepared and carried out in order to understand the
practical difficulties faced by transgender community.
TamilNadu Aravanigal
welfare board
A Land mark initiative
In a pioneering effort to address the issues faced by transgender
people, the government of Tamilnadu (A State in south India) established a
transgender welfare board in April 2008. The board would potentially address a
variety of concerns of transgender people that includes education, income
generation and other social security measures.
Highlight the welfare
schemes formulated by the government of Tamilnadu.
1.
The government has created a data base
on transgender that would help to deal their problems and demands such as
housing, ration cards, voter identity patta and health facility etc.
2.
The government has also issued a
government order for admission of transgender in government schools and
colleges
3.
Furthermore, Tamilnadu is only state in
collaboration with Tamilnadu Aravanigal welfare board, free sex reassignment
surgery is performed for transgender.
Major findings
Ø The participants reported very high levels of
postponing medical care when sick or injured due to discrimination (32%) or
inability to afford it (58%)
Ø A
Staggering 80% of respondents reported attempting suicide compared to 2% of the
Arising the risk factors significantly
Ø Majority
of the respondents 78% misused drugs or alcohol specifically to cope with the
discrimination they faced due to their gender identity or expression
Ø Respondents
reported over four times the national average of HIV infection, compared to
general population
Ø Respondents
faced significant hurdles to accessing health care, including
1.
Refusal of care: 70% of our respondents
reported being refused care due to their transgender or gender identity
expression.
2.
Harassment and violence in medical
setting: Majority 78% of respondents were subjected to harassment in doctor
offices:
3.
Despite the barriers the majority of
respondent have accessed some form of transition related to medical
care; the majority reported wanting to have a surgery but have not had any
surgeries yet.
Ø From
the in-depth interviews it is inferred that the socio-economic status of
transgender is very poor they feel inferior to others and are constantly
humiliated and ill-treated by the society at large.
Recommendations
ü The
transgender persons must be properly documented in census
ü They
need to be empowered with high degree of education and vocational training to
upgrade their earning and status in the society.
ü Since
they are prone to health setbacks, they need proper medical facilities including
insurance in the health sector
ü Public
and private insurance systems must cover transgender related care and is
essential to basic health care for transgender people
ü Medical
providers and policy makers should never base equal and respectful treatment
and attainment of government issued identity documentation
ü Whether an individual has obtained surgery,
given that surgeries are financially in accessible for large majorities of
transgender people because they are rarely covered by the insurances
ü Whether
an individual is able to afford to attain proof of citizenship or legal
residency.
ü Rates
of HIV infection attempted suicide, drug and alcohol abuse and smoking among
transgender to over whelming need for:
Ø Transgender
sensitive health education, health care and resettlement programs
Ø Early
diagnosis and specific prevention programmes.
ü Health
outcomes of transgender is urgently needed:
Ø Health
studies and other survey especially for transgender
Ø Information
about health risks, outcomes and needs must be sought specially about
transgender population.
Ø Separate
categories for transgender men and transgender women so HIV rates and other
sexual health issues can be accurately tracked and researched
Ø The
state and the central law ministries, health and social welfare ministries need
to recognize transgender people rights and the states should set up gender
dysphonic clines where treatment for transgender people should be free. Only
then transsexual people will not be victims of wrong medical treatment.
Case study
We have been born like this: People don’t understand why we area like
this we force ourselves to live with no other go. A few case studies collected
in this regard reveals the existing miserable condition of transgender
community.
Case study – 1
Transgender person reside in the interior parts of villupuram. People
generally do not prefer to have transgender persons as tenants and so rental
accommodation is hard to get. The infrastructure in their house is very poor
and the persons living in a house is more than the capacity of the house. The
45 years old women identity as female by the age of 13 this was the beginning
of my double life beneath men’s cloths, I started to wear women’s
undergarments. I spent time with mother doing chores that young boys are not supposed
to do; this was end of her dual identity. Family and teachers tried to talk
he’s out of her weird behaviour. Soon her siblings and relatives could not bear
the stigma of being related to a transgender. They turned against her and
started abusing and insulting her. She buried her social identity took on a new
name and turned to the streets to be seen as “Q queer, an aberration and a
object; In 1998, she underwent an illegal sexexchange operation just for Rs
5000. In those days sex change operation were illegal in india. During the year
2001 she joined in NGO and started working as a field worker, spreading
awareness on STDs and HIV, and distributing condoms along with the message of
protection.
Case study -2
Another transgender 30 yrs. She discloses his feelings as follows; I was
diagnosed as having gender identity disorder. In my case I had feeling of being
female as age of 14. Every time the feelings came up but it was forced to
repress it (Mostly by my parents). I realize that I am in depressed even after
years of talking anti depressants, it only got worse. Eventually, my mind
basically rejected my body I often
looked in the mirror and actually felt like I was in someone else’s body. I
tried to repress it but once this cat is out of bag, there is no putting it
back. As much as I dreaded it, I had joined in the Aravani community. The
community takes responsibility of sex reassignment surgery. Most of them live
as a group with a strong bonding. This facilities them to have the ‘we-
feeling’ and recognition to share their families and hence they often associate
among themselves even if living indifferent places.
Case Study -3 (A Transgender, 20 years)
A Lay mans perception of transgender person is very inferior, the
community has low economic status due to social stigma, they not offered even
though they are qualified. Most of them are beggars and or sex workers. I have
studied up to 12th standard and I am willing to do only work that
suits me. The society looks down upon us as sex workers and cheaters, for both
physical and mental health workers, understanding transgender persons has been
difficult, When I went to a government hospital for my illness, the workers
there including doctor looked at me as on animal. There is no one in this
society to care for us really. But what mistake did I make in my life? Is
having been born as transgender my fault? Only in sex work and begging they
don’t ask any qualifications. It is obvious from the case studies that most
families refuse to accept a transgender persons dilemma and do not discuss the
issue openly. The person leaves the family and ends up in a community of their
own.
Conclusion
Respondents in our study reported significant barriers to health care
and outrageous frequencies of anti transgender bias in care, from disrespect to
refusal of care, from verbal harassment to physical and sexual abuse.
Transgender people face violence in daily life, compounded by the high rates of
physical and sexual assault that transgender people face while accessing
medical care, which leads to additional health care costs, both to treat the
immediate trauma as well as ongoing physical and psychological issues that may
be created. The data gathered examine that there is an connection between
multiple incidences of discrimination, harassment, and abuse faced by our
respondents in health care system and the high risk for poor health our comes.
Additionally, our data suggest that discriminations events are commonplace in
the daily lives of transgender people and that is has a cumulative impact from
losing a job because of bias to losing health insurance due to long term
unemployment turning to work on the streets. The collective impact of these
events exposed our respondent to increased risk for HIV infection, smoking,
drug alcohol use and suicide attempts. In particular, those who have been fired
due to anti-transgender bias and those who have engaged in sex work, drug
sales, or other underground economics for income are much more likely to
experience health risks that are show to lead to poorer health outcomes.
References:
2.
Benjamin, Harry (1966), The Transsexual
phenomenon, The Julian press, inc. Publisher.
3.
Allen LB, Glicken AD, Beach RK, etal.
Adolescent health care experience of gay, lesbian and bisexual young adults. J.
Adolescent Health 1998:2:212-220.
4.
Fen way health. Glossary of gender and
transgender terms. Botson (MA): Fenway health; 2010. Available at; http://www.fenway
health.org/site/doc. server/handout-7-c-gender and transgender-term-fi.pdf
5.
American Psychiatric Association. Gender
identity disorder in Diagnostic and Statistical Manual of Mental Disorder 1th
ed. Text revision. Washington, Dc:AM,2000.P.576-82
6.
World professional Association for
transgender Health. The Hurry Benjamin International gender Dysphonic 6th
version. Minneapolis (MN): WPATH; 2001. Available at:
http://www.wpath.org/documants2/socv6.pdf.
7.
Ferdman J, Goldberg J. Transgender
primary medical care; Transgender health program;2006.Available at:
http;//transhealth.vch.ca/resources
8.
Savin - williams RC. Verbal and Physical
abuse as stressors in lives of lesbian, gay, male and bisexual youth;
associations with school problems, running away, substance abuse, prostitution
and suicide. J. Consult clinical psychology 1994;62:261-269.
Posts
No comments: