Does The Health And Wellbeing Of Trans Youth Matter To India?

I was 17 and I was depressed. The contradiction between my body and my real gender identity was tormenting me. I wanted help, I wanted counseling, I wanted advice, I wanted guidance, I wanted hope, I wanted a life. I had nowhere to go, no one to talk.

That was me two decades ago, as a gender non-conforming youth, confused, afraid and completely suicidal. The situation hasn’t changed much for today’s teenagers who are gender non-conforming. They need to talk and they are afraid, because the support system for them is missing in our country.

I am one of those estimated 25 million people, or one in a global population of 0.5%, who are transgender. India has one of the largest population of transgender people in the world, with an estimated population of 4.88 lakhs. That is 3/4th of the population of the state of Sikkim.

Trans activist Kalki Subramaniam.

Unlike me in my teenage years, today’s educated trans teens have the technology and ability to access information in their hands instantly. Yet, can they access health services? It is a big question, and the answer is a big “No”.

On April 14, 2015 the Supreme court of India legally recognized the transgender community, and directed both Centre and State government to do the needful to uplift the community which is one of the most marginalised, misunderstood and underprivileged in the country.

But, apart from a few states, many still continue to ignore the well being of transgender people. The Centre, through its Ministry of Social Justice and Empowerment, seems to still work on ways to reaching out to the community. However, there is too little done when it comes to physical and mental health services for transgender people.

In India, Gender Dysphoria Clinics are still a distant dream. Do our health care professionals have enough knowledge to offer supportive health care services for transgender people? Only a few. In a study published recently in The Lancet Psychiatry in Mexico, researchers found that being transgender is not a mental illness. But in India, little medical research has been conducted on the issues of transgender people.

For representation only.

Trans youth in India are vulnerable to sexual abuse and violence. The stigma and discrimination against them right in their own homes drives them to the streets. Being rejected by your own father, mother, or siblings is terrible, and it leads to depression and suicidal tendencies. Where do these young people go for survival? To other transgender people  who are like them. What do they do for a living? Begging and sex work.

Presently our government does not have a support system to embrace trans youth and provide them the psychological and medical support they desperately need. God knows how many years it is going to take us activists to sensitize them and make them implement healthcare measures.

In a book by A. Revathi named ‘A Life in Trans Activism’, transgender actor and writer Gee Iman Semmalar shares his terrible experience with a doctor.

“For accessing hormone treatment, they require your mental health to be ‘assessed’ and for two psychiatrists to certify you as having gender identity dysphoria (a lot of psychiatrists still write ‘gender identity disorder’). Depending on your psychiatrist, this could take any amount of time, in some cases, even years. We are left at the mercy of doctors who know very little about us.

In most cases, they try to convince us that we should continue to live in the same bodies, they warn us about the consequences of ‘sex change’. Among trans friends, I have heard of instances of electro shock therapies, house arrests, being chained to their bed posts, trans men being forcefully administered female hormones and marriage being prescribed as a ‘cure’. With no way to opt out of this oppressive medical system, I let them certify me as having a disorder. In fact, I pleaded with them to certify me, in order to become who I am today.

During my teen years, I (and other transgender youths like me) desperately wanted help, support and counselling. No one was there to help and guide us. We used to take estrogen pills and injections without prescriptions from a doctor, and we used to change it often until we had satisfactory results. Word of mouth recommendations for growing breasts and feminisation made us try several different types of pills. We were risking our health.

Though today transgender people can access information easily, many uneducated trans youth in India continue to risk their health due lack of  proper medical support.

Sex-reassignment surgeries are expensive in India, there are very few doctors who do it with the best results, so many transgender women opt for penectomy the not-so-expensive surgery process of removing the genitals. How about post surgery care? Do trans women take post surgery hormone therapy? No one knows about it.

In India, HIV prevalence is among the general public is 0.31%, but HIV prevalence among the transgender community is 8.2%.  Almost 9 people in 100 are vulnerable to HIV. Fortunately many NGOs have given sexual health education for the community. That is about it, no other services or support they could give. We need gender dysphioria clinics and counseling centres. We need understanding trans friends, doctors ,and medical professionals.

Members of the trans community protesting in Mumbai (2005). Source: REUTERS/Stringer AD/JJ – RTRKQGM

It is both our Centre and state governments that have a huge role to play in this. It has been three years since the judgement from the Supreme Court of India legalized transgender identities, directing the Centre and the state governments to take proactive measures for the welfare of the transgender communities. But the governments are doing it at a snail’s pace. I hope, wish, and pray they they act fast to reach out to the desperate transgender community.

India needs its trans youth. We hold lots of creative power and can contribute to the growth of our country, and that cannot be wasted.



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