Self-medication common among trans people

Among the many problems confronting the transgender community, the most pertinent and urgent is lack of access to quality healthcare. 

While the government’s free antiretroviral therapy (ART) addresses HIV, which the community is prone to, other conditions like diabetes and hypertension go unchecked.

Members of the community share that they feel discouraged to seek medical attention due to the stigma surrounding their gender. 

Self medication common

Uma, a transgender rights activist, estimates that Bengaluru is home to about 25,000 transgender people. Most of them self-medicate when they fall ill, she says. “We avoid going to doctors or hospitals because people look at us like we are animals in a zoo,” she shares. Though some doctors treat them as they would any other patient, a large number of them do not want to touch or treat them, she adds. She also cites doctors’ lack of awareness as a reason for their reluctance to get a health check-up. “Even if they want to treat us, they do not know how to go about it. Our anatomy is different and so our needs are different,” she explains. 

Priyanka, a radio jockey, recalls an incident where she was given the wrong medication when she had a stomach ache. “They thought I was on my period and gave me the wrong treatment. I then had to tell them my gender. It is not always easy to be upfront and reveal your gender to the doctors,” she tells Metrolife. A number of them follow the suggestions of medical shop owners, while another section of them go to local clinics, braving the unwanted attention of other patients. Some doctors and clinics hike up their consultation fees for trans people, says Priya, another member of the community. “In such situations, we can’t do anything but pay up. Because our options are limited,” she says.

Under the Karnataka State Transgender Policy (2017), they can avail healthcare without any discrimination from all hospitals, but it is not implemented, says Uma.

Sensitisation required

In the case of Rakshitha, another trans rights activist, her local clinic in Basaveshwaranagar was initially ‘uncomfortable’ during her visits. “But I explained my situation to them and now they do not have any problems when I drop in for a consultation,” she shares. 

Sex reassignment surgery (SRS) is common but it comes with numerous complications, which doctors are ill-equipped to treat, says Uma. “Many small clinics do it illegally. A common problem that crops up is blockage of the urinary tract, which they do not always know how to address,” she adds. Currently, M S Ramaiah Hospital offers legal SRS treatments.

She reveals that when a friend decided to undergo an SRS at a clinic, the instructions they gave her were questionable. “They told her she had to come to the clinic after midnight and leave before 9 am. She also could not take anyone with her to the clinic,” she shares.

Reference range issues

At a recently-held health camp by Bridge Builders Bangalore, an NGO, and Care on Call, a healthcare service, 66 transgender individuals were tested. Physician Nithyashree Koratagere, co-founder of Care on Call, shares that 70 percent of those tested “have clinical derangements and need follow-up care”. “Another problem we had while looking at their results is the reference range. There is no standardised range for them so it presents difficulties when it comes to treatment,” she says.

Uma believes that including transgender health in the curriculum of medical students will be of great help to her community.

“But, today you are asking me about our health. This is improvement. It would not have been a topic of conversation even five years ago,” she concludes.