Govt hospitals set up transgender centers in push for equitable healthcare

Doctors hail move, activists suggest more needs to be done

Government hospitals in the capital are starting clinics for the transgender community to offer equitable access to healthcare. Rising demand for gender affirmation surgeries is perhaps a trigger behind these new clinics. While Ram Manohar Lohia Hospital has already begun an out-patient department (OPD) for the transgender community, the All India Institute of Medical Sciences (AIIMS), New Delhi is coming up with a centre of excellence for transgender healthcare soon.

A Centre of Excellence for transgender healthcare has been announced by none other than AIIMS, New Delhi. Born out of a collaboration between the Union Ministry of Health and Family Welfare, National AIDS Control Organisation (NACO) and Ministry of Social Justice and Empowerment, the centre will start functioning within AIIMS’s Burns and Plastic Surgery department in three to four months.

Speaking on the idea behind the creation of this centre, Manish Singhal, professor and head of department (HOD), Burns and Plastic Surgery Department, said that a need was felt to have a comprehensive facility for transgender medical care. “This centre is envisaged as a facility where all the care can be given together, rather than making people run around in different departments,” he said.

AIIMS’s centre of excellence comes after another centrally-funded hospital, Ram Manohar Lohia Hospital, started a special Out-patient Department (OPD) for transgender people. The department, which opened on Prime Minister Narendra Modi's birthday, provides OPD services for transgender people every Friday. It also has a separate registration counter of its own.

Speaking on the services provided at the special OPD, Shailesh Kumar, Professor, Department of Surgery, Ram Manohar Lohia Hospital, said the patients are seen by a group of ten to twelve medical professionals from several disciplines, such as urology, medicine, dermatology, burns, psychology, paediatrics, and endocrinology.

“The initial response to the centre has been very positive with high footfall being recorded since its inauguration in September,” he added.

Gender affirmation surgeries, a top priority

Singhal pointed out that gender affirmation surgeries need to be the top agenda, as far as transgender healthcare is concerned. “It is a step-by-step process, with clearances needed from administration and several departments such as endocrinology. A system will be created to ensure hassle-free admission for transgender people for these surgeries,” he said.

Speaking on the demand for gender affirmation surgeries, Richie Gupta, director and head of department (HOD), Plastic Surgery and Reconstructive Surgery Department, Fortis Hospital, said that because more individuals are now coming out of the closet, the demand for this surgery has risen by about ten times, compared to 30 years ago.

“Availability of more healthcare personnel and safer modes of surgeries have added to the rising demand,” he added.

Concurring with the rise in demand for gender affirmation surgeries, Anmol Chugh, consultant, Plastics and Aesthetics Centre, CK Birla Hospital, said that it’s one of the most sought-after surgeries, as it effectively sets the transgender community on the path of self-affirmation and acceptance.

Speaking on the cost of such surgeries, Gupta said that gender affirmation surgery can cost anywhere between Rs 5 lakh to Rs 7 lakh for male-to-female transition, whereas female-to-male transition can go upwards of Rs 5 lakhs.

“While transgender persons do get yearly health insurance of Rs 5 lakh each under the Ayushman Bharat scheme, private insurers still lag far behind in terms of providing coverage for such surgeries,” Chugh claimed.

Doctors, activists hail move, say more needs to be done

Hailing these projects, Chugh said that these centres will set an example of polyclinics for the transgender community, a sort of one-stop solution.

“There’s a need to add administrative components also to these centres so that right from consultation, financial and mental counselling, surgeries, post-surgery care, rehabilitation into society is smooth,” he added.

Giving an example, Chugh said that a gender affirmation surgery requires multiple specialities like psychiatry, endocrinology, plastic surgery, etc., along with contact with multiple authorities for surgical clearance who might not be sensitive to the needs of transgenders due to lack of awareness and education.

Calling it a positive move, a transgender rights activist said that while this is good to hear, there also needs to be a gender sensitisation session for doctors and healthcare personnel.
 

“Some doctors are very judgemental and look at us very strangely. This has resulted in a hesitation to consult,” the activist said.

Another activist said that the community needs a trans-friendly environment in order to feel safe and confident to share their concerns. “We need free and accessible treatment and consultation about HIV-AIDS, hormone therapy and more since everyone can't afford it at the current prices,” the activist added.

Agreeing that the community faces a stigma, Singhal said that AIIMS conducted a gender sensitisation programme for doctors and healthcare personnel who will be caring for people from the transgender community in the newly announced centre.