Zanaya Chaudhary, a transgender person (middle with yellow dress), speaks at a press conference at Lahore Press Club on March 4. (Photo: Kamran Chaudhry/UCA News)
Chandni, a Lahore-based transgender person, appealed to her sisters for help after the pandemic shuttered the wedding halls. She died last July battling Covid-19.
“She suffered alone without visiting the hospital. There is deep mistrust of the healthcare system within our community due to mistreatment, leading to a general reluctance to being open about sexually transmitted diseases,” said Zanaya Chaudhary, a board member of Khwaja Sira (transgender) Society.
“The discrimination starts at the gates of government-run health facilities. The employees at registration desks as well as doctors harass our community members. The male and female wards are reluctant to admit injured transgender people. Most of us resort to self-medication and dangerous back-alley operations to avoid confusion and depression.
“Three transgender people, including Chandni, died in Lahore last year due to coronavirus. We demand an end to discrimination and misgendering by medical professionals and an equitable access to health services.”
Chaudhary was speaking at the Aurat (Women) March press conference on March 4. The speakers announced women’s health and issues faced by gender minorities, especially during the pandemic, as the theme for this year’s rally scheduled for International Women's Day on March 8.
“We are painfully aware that healthcare settings become a primary site of violence themselves, especially for transgender people and differently abled women. Unnecessary medicalization of bodies not considered ‘normal’ and gate keeping lay bare the rotting ambitions of a failing system that seeks to dehumanize what it does not understand,” states the Feminist Manifesto on Healthcare by Aurat March Lahore.
“Ninety-two percent of transgender people report facing discrimination or harassment in healthcare settings in Khyber Pakhtunkhwa. Another study in Punjab reported that 74 percent of transgender persons prefer not to go public hospitals.
“Healthcare practitioners completely lack knowledge of any ethical guidelines when dealing with transgender patients. 46 percent said they were unprepared while 34 percent said they were only partially prepare when asked if their medical education adequately prepared them to provide care for transgender patients.”
Transgender people in the Islamic republic continue to suffer human rights abuses and growing incidents of violence. Often shunned by mainstream society, transgender citizens find themselves vulnerable to being forced into begging, sex work or dancing in a country where it is considered un-Islamic for a woman to dance in front of men.
In 2018, parliament approved the Transgender Persons (Protection of Rights) Act which prohibits “the denial or discontinuation of, or unfair treatment in, healthcare services.” However, the Code of Ethics of Practice for Medical and Dental Practitioners of the Medical and Dental Council includes no specific guidelines for providing care to transgender patients.
Last December Prime Minister Imran Khan launched the Sehat Insaf (Health Justice) card facility for the transgender community, the first in the country’s history.
“The present government has taken the responsibility of the transgender community and would give them a sense of ownership. We shall provide them full protection in society by removing negative perceptions about them,” stated Khan before distributing the cards among members of the transgender community in Islamabad.
The Sehat Sahulat Program provides initial coverage of 300,000 rupees (US$1,900) per family per year and additional coverage of 300,000 rupees per family.
A prerequisite to enroll in the program is possession of a valid transgender national identity card where the gender section is marked with an X rather than the male or female option.
According to Dr. Zafar Mirza, former special adviser to the prime minister on health, only 900 transgender persons have enrolled for this program.
“Currently, only 1,600 transgender persons out of the country’s entire population are registered with the National Database and Registration Authority, which is an alarming figure,” he stated in a discussion held on March 4 to review accessible healthcare for the transgender community in Pakistan.
Many transgender persons were declared ineligible for the service due to incorrect gender registration, with many members of the transgender community being registered in either the male or female category, rather than the X category, added Mirza.
Aurat March volunteers in Lahore also highlighted the financial challenges of transgender persons amid the pandemic.
“The community has been pushed into a dire hunger crisis during the pandemic with the usual sources of earning a livelihood having dried up. Transgender and non-binary persons living with hostile families under Covid lockdown have to deal with added stress and trauma,” said Nayab, a woman activist.
“Policymakers must ensure equitable and meaningful representation of transgender individuals in designing interventions for Covid-19. The National Command and Operations Centre must ensure that data on Covid-19 is segregated to identify transgender persons and it is publicly available.”