What are the barriers to receiving gender-affirming care in your country?

By March 27, 2024 March 29th, 2024 Learning, Regional

A major component of trans and gender diverse people’s health care is gender-affirming care, the medical aspect of gender transition, which is not being implemented as part of the comprehensive health service packages. 

We asked trans and gender diverse groups in five countries “What are the barriers to receiving gender-affirming care in your country?” in India, Nepal, Pakistan, Philippines and Sri Lanka, and here are there recommendations:

Sensitization in all healthcare systems is necessary, there have been several incidents regarding the stigma towards transgender people. We also need to make amendments to the existing medical curriculum and third and more importantly, we need to have several interventions supporting the enabling environment for gender affirmation services. We need to strengthen the services at the state level so at least one public healthcare system can avail the services. I also feel we need to provide the skills to the community members, because communities can serve the other communities on gender affirmation care would be the best methodology/ approach to work.” 

Trans activist India

“A major barrier is that [gender-affirming care] services are not available in many countries. That’s why people need to travel from one country to another…also the prices are not affordable for the trans people, and doctors may not be equipped for the good surgery services [in my country]. In countries like Nepal, we have reached out to some surgeons, they said they can do it, however, they need to have first the concrete policy from the government on this.”

Trans activist Nepal

“I want to emphasize the importance of sensitizing individuals about hormonal therapy for gender affirmation. Many Khawaja Siras (Pakistan’s transgender community) lack awareness about their own body type and the specific hormones that would best suit their needs. Instead of seeking professional guidance, they often rely on the choices made by their friends, leading to potential complications and side effects when their bodies reject the hormones.

To address this issue, it is crucial to have a law in place that specifically addresses the concerns and requirements of gender affirming hormonal therapy.”

Trans activist Pakistan 

“Discrimination is a factor that prevents us from seeking gender-affirming care services. A friend who went to a hospital was declined by an Endocrinologist because admitting trans people was against his religious belief.” 

“Lack of understanding about transgender people including their rights and health needs is the reason why they have challenges accessing gender-affirming care services.  While trans people are confused about the right way to take gender-affirming hormone therapy, health professionals are also clueless about it.”

“We can tap into private institutions to work with the government to further the gender affirmation care services in the country and organize some meetups for awareness campaigns led by trans organizations” 

Trans activists Philippines

“Lack of knowledge of the staff members at the service provision centres, hospitals and personal attitude of service providers towards the [trans] community are the main issues that we have seen as the barriers. Also, trans health care and services are not recognised as an important need in the medical platforms. 

Providing ongoing training to the service providers and including gender identities to the training curriculum would be a successful initiative which we can take and making non-discrimination policies within the service providing institutions would protect the rights and dignity of the community members.” 

Trans activist Sri Lanka 

What is it like in YOUR country? 

What are the barriers for trans and gender diverse people receiving gender-affirming care in your country?


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