Mumbai: India has laws and support systems for both transgender persons and people with disabilities, but none for those who are both identities – trans persons with disabilities. This shortcoming is felt most acutely in healthcare.
Kiran Nayak, a trans and disability rights activist, decided at age 31 to undergo gender affirmation surgery. Born with female organs, he said he grew up “with feelings of disgust about my own body”. But when he approached a hospital for the surgery, the medical staff questioned him about his choice – why would he want surgery when he was living with a disability? Nayak, whose mobility was impaired by early childhood polio, is a wheelchair user.
He recalled being hurt by the response, unable to see any link between his gender identity and his disability. “Medical systems complicate things for trans and disabled persons,” said Nayak, a trans man.
The activist runs two groups focused on trans and disability issues – the Karnataka Vikalachetanara Sanghatane and the Society for Transmen Action and Rights group (STAR) based in Andhra Pradesh and Telangana. His own research has brought him in touch with at least 17 persons with disabilities who identify as transgender persons in India. But this number could be a significant underestimation because of the challenges of coming out, he pointed out. Further, the government of India only identifies two genders — cis male and cis female — for the disability census.
In interviews with Behanbox, trans persons who live with disabilities complained that the medical fraternity is patronising and insensitive towards their healthcare needs. It does not help that families, already struggling to cope with their disability, find it hard to come to terms with their gender identity.
Lakshmikant, a 30-year-old from Telangana, has not been able to tell his parents that he has been living as a transman for the past several years. Speaking to them about gender affirmation surgery is unthinkable for him at the moment. “Because of my disability, they never considered that I had any feelings or felt any desires about living in and with my body,” he said.
Laws to protect the rights of the LGBTQI community and disabled persons, both fall under the ambit of the Ministry of Social Empowerment and Justice, but they are never seen together on an integrated platform. “In India, while we continue to witness significant mobilisations by the LGBTQI+ & disability rights movement, we have rarely seen these working closely with each other,” said Shampa Sengupta, an activist working on gender and disability issues, writing for Feminism in India.
As we reported earlier (here, here and here) transpersons have to constantly deal with discrimination, harassment and denial of care. But those who are also disabled end up being pushed even further into the margins, and struggle with anxieties and challenges on many more fronts – healthcare, social, familial and economic, among others.
“Across states, there are a significant number of trans persons with disabilities who are living in government facilities and have been beneficiaries of disability-related schemes. They feel if they reveal their trans identity, the staff will be un-accepting and they may be deprived of the basic facilities,” said Vyjayanti Vasanta Mogli, a transwoman and a Right to Information (RTI) activist.
An equitable model of public service distribution cannot leave anyone behind and the rights of trans persons, who now have legal recognition, should have equal access to health services, said Aqsa Shaikh, a trans woman and an associate professor of community medicine at Hamdard Institute of Medical Science and Research.