The government of Bangladesh recognized the transgender community as “Third Gender” in 2014. It is 2018, and the official documentation and implication of the declaration are still pending. Socially speaking, the third gender community is still fighting the age-old stigma that permeates the culture. It is due to the stigma that most of them are still bound to earn their livelihoods by collecting tolls from shops and offering often forced blessings to newborn babies. Living the inhuman lives in slums outside Dhaka is the reality for most of these people.
The transgender community in Bangladesh faces many difficulties at every step of their lives; one of the biggest among those is the lack of healthcare facilities. While the transgender community in Bangladesh has about half a million members, there’s only a couple of organizations who provide sexual health-related information and treatment facilities. This inadequate arrangement propagates dire conditions for the community when it comes to availing the basic healthcare facilities. Thanks to the socially constructed stigma that they cannot go to private or public doctors like regular citizens which force them to go to quacks risking their lives.
Being a medical student and working in a few health-screening programs aimed at the marginalized community, my association with the transgender community has enabled me to know their day to day suffering while at the same time inspired me to look for opportunities to make a difference. The huge community that is the victim of the health service of inequality in Bangladesh deserves better; they deserve the access to basic health care which is a constitutional right for any Bangladeshi citizen.
The dearth of correct information about health screening is alarming across people from all social classes. The fear of being ridiculed by the society restricts even the affluent upper middle class and upper-class people of sexual diversity to seek information and ask for help. Many a time, programs designed for regular citizens do not suffice to provide the relevant information or ensure secrecy of that community members. In addition, almost no literature about health and treatment facility seeking behavior of the transgender population is available for distribution.
There are several communities based non-government organizations working to establish the rights of the transgender people. Bandhu Social Welfare is one of those. In its two-decade-long journey since 1996, the organization has grown from strength to strength. The organization was responsible for the inclusion of MSM in the first ever-Strategic Plan of the National AIDS/STD Programme, Bangladesh in 1997. Since then, it has played a pivotal role in enhancing the sensitivity of the government, different ministries, and national institutions like the National Human Rights Commission (NHRC). The NHRC included sexual minorities as a group needing attention in its 2nd Strategic Plan (2016-20). Over the time, it has expanded its work in 50% of the 64 districts of the country reaching out to more than 20,000 MSM and Hijras who have accessed SRHR services and received more than 5 million condoms and lubricants through
Bandhu outreach work and through the drop-in-centers, as per the claim of the organization’s special publication. More than 7600 episodes of STIs have been diagnosed and treated at the drop in centers directly managed by Bandhu. More than 7000 sexual minorities have received
HIV testing and counseling services. Bandhu has trained more than 15,000 service providers to reach and provided services to the hijra and MSM population, the publication “A Tale of Two Decade” postulates. However, the demand of providing general and surgical healthcare is so vast that now the time has come to think of bigger settlements to bring the transgender community under the healthcare umbrella.
Against this background, it’s a matter of cry to take up research initiatives that identify the health and treatment seeking behavior of the transgender community Bangladesh. Usually more concentrated in the slums, these people live inhuman lives. If a study can identify the health and treatment seeking behavior comprising of information about the dietary habits, sexual health, general health problems faced by the population, healthcare services sought for, direct and indirect expenditure due to illness of any kind in last 3 to 6 months and methods of payment of for treatment–then it can measure the extent of required health services for the transgender community and how the existing system can help create solutions to meet the requirements. The study can also work as a tool to provide information in creating awareness of basic health and healthcare rights among the transgender people. This kind of research initiatives can also open windows of possibilities to measure the feasibility of opening special clinics in public/or private hospitals that can render regular outpatient services for them. One example of this kind of outpatient service clinic is the headache clinic that deals with patients with neurological complaints. Conducting such special clinics will measure the burden of that particular health problem and at the same time can provide specialized treatments in a faster way.
The research initiative will be stepping stones to create a plethora of changes to be ushered in the realm of health-based rights for transgender community people. NGOs which are already working with the community can start advocating the public policymakers to make provisions for “Trans Clinic” in public hospitals where the transgender population can receive treatments on a weekly basis and get all sorts of healthcare related information like regular citizens. The “Trans Clinic” can also train up transgender men and women on basic health care issues that are important to them and thus can create employment opportunities for them. Last but not least, the clinic will be first of its kind platform to give the community a positive exposure in the society. In the long run, this kind of initiative can work as a medium to develop sensitization about the people of sexual minority groups, which is very much needed in this society where tolerance and love for them is a scarcity. At the same time, this kind of research can also provide understanding about the willingness to attain micro health insurance the marginalized community people might be interested in avail, which will provide ensure their well being during the old age when many of them become disable to do their usual chores.
The transgender community, if empowered with rights and opportunities can achieve feats just like other citizens of the country. There are examples of the transgender member of the parliament in India. Pakistan too recently passed a landmark law that outlaws the discrimination by private employers and business owners towards the transgender community. Bangladesh should not be left behind in its journey to open up and embrace the transgender community with more rights and respect.
The writer is the Managing Editor of ICE Business Times & ICE Today and health and human rights enthusiast.