Health Institutions role in care of Transgenders
MedPiper Technologies and JournoMed conducted a webinar series to improve healthcare access for Transgender and Sexual minorities- for the Doctors and by the doctors in association with IRIA Kerala- Raksha, Shakthi and Social Wings, IMA Kerala and CARB where the discussion is about the topic addressing Panel discussion on Healthcare Institutions’ role in the care of Transgenders and the event was held on 22nd July 2022.
Transgenders is an umbrella term and Transgenders face a lot of psychological, behavioural, physical, emotional and economic stress in society. Dr Praveen G Pai, a Geriatrician and a Technical Expert from Kerala State AIDS Control Society, Dr SK Hari Kumar, Chief Operative Officer, MGM Healthcare Pvt Ltd, and Mr Rajarajan S, COO of MGM Healthcare Pvt Ltd, Chennai were the speakers who are involved in this panel discussion. Dr SK Hari Kumar has a professional experience in Health Program Administration, capacity building and strategic planning. He handles the technical issues related to behaviour, sexuality, gender, mental health and partnership building.
Mr Rajarajan S, COO from MGM Healthcare Pvt Ltd, Chennai is seasoned management healthcare professional and a visionary leader with a global perspective. He dived into the topic of how healthcare is currently managed and the large inclusion aspects of the trans community and the barriers the trans people face in the healthcare system. It can be either the financial barriers concerning the discrimination or the socio-economic barriers they face, due to which they find it difficult to access healthcare.
Mr Rajarajan S spoke about the role of the learning and development team (L & D team) sensitizing the teams to the third gender. Inclusion that all gender forms are even showcased while filling up the consent forms. The consent forms don’t have a column for “third gender”. Trans individuals are not visible over there. This is something which hospitals can look out for to see how they become inclusive. It should start with HR and L & D sensitizing the teams. Timely support and care are provided for the trans community people. To take proper care of transgender people and LGBTQIA + people, a physician must know their requirements and a proper follow-up must be given. There should be at least a basic understanding of behaviour, sexuality and also the means of communication and the health-seeking perspective of this issue.
There is a challenge faced by private healthcare institutions even though if the institution is inclusive, a lot of guests are being treated who do accept the community and who might not be in acceptance to the community. Personal issues like the usage of restrooms and ethics must be taken into a consideration. One can observe a change that trans individuals participating in clinical research. As this population is an emerging population one need to acknowledge that. The healthcare institutions started catering for the needs of trans community people by allowing them to work among the medical professionals and the other professional staff. This can arise the employment opportunities and the behavioural aspects of trans community people can be acknowledged.
Trans community people working in healthcare institutions are utilized to spread social awareness against any type of cancer. In a few organizations, even transgender community people are chosen as short-term employees, and apprentices for a few works. However, still, some organizations have not yet included them as part of the pay role. The inclusivity and removal of disparities are going to be very vital things. In the future transgender community can work and opt for broader job opportunities and retain their importance in society.
Transgender people and LGBTQIA people face major discrimination either socially, economically, psychological or physiologically and in many ways. This might create attrition. It is not just companies that open the doors and create an inclusive policy. The champions are among even the transgender people and the people from LGBTQIA + community. Many top companies have taken a lead to employ the people of the LGBTQIA + community. Trans individuals have brought this cultural diversity to organizations. The companies have opened doors and invited the inclusive policy. Finally, the three major things that need to be transformed are the discerning looks, the harassment, and the disparity showcasing trans individuals.
Dr S Hari Kumar spoke about the healthcare of the transgender and LGBTQIA + community. He also said that many governments are coming forward to deal with the issues of the trans community people and LGBTQIA + people. There are many health-related issues that these people face, i.e. vulnerability to HIV infection and STIs; there are many dermatological issues they face, psychological illnesses, and mental health issues. He also spoke about the paradox issue while employing people from a trans community. Not employing these people can be a behavioural basis. Gender itself makes one comprehend, express and interact and for everything, gender plays a crucial role. But when taking into consideration the transgender and the people from the LGBTQIA + community. There may be some aberrations and the civil society is not mature enough to condemn them with compassion so that their maturity and productivity would be the best. A system for facilitating their well-being and comfortability makes the move and those things need to be addressed well. Trans community people are utilized to spread awareness of even the HIV program.
A participative need assessment with the community must be made and most of the pillars are built by the community themselves. First thing is that there is a need for an effective advocacy package which is led by the community. A community champion would be leading in the front end and at the back end and the organization would provide its support from the back end. The second one is the skill-building package which is complimentary to the advocacy package which is used in various sectors like hospitals, govt offices, civil societies and political parties. In all these places, there must be an effective package which is led by the community. But here the main topic is guiding them to win over each section like in educational institutions and govt organizations. Their primary goal is to interact with the existing systems and personalities. In the nutshell, all organizations i.e. hospitals and educational institutions need to be sensitized.
Dr Rajarajan S spoke that currently, any hospital should be a patient-friendly, gender-friendly hospital. A lot of aspects are considered when it comes to a patient-friendly hospital, based on the population dynamics. 99% of government or private organizations have not incorporated the place for the third gender in the HIS systems. Right from the beginning, going to implement the inclusive for the transgender community and the LGBTQIA + community is going to place a crucial role. This can be of greater help in continuing the treatment and stuff. Though the govt has governed the laws against the third gender, none are yet implemented. Though the inclusions against the trans community and the third gender have been implemented among the organizations. Healthcare organizations can bring inclusion into a perspective, an employee the third gender and can even sensitize the third gender and give a review that our organization is trans community friendly or LGBTQIA friendly. In western countries, the LGBTQIA + presence is designated with a rainbow. There is a need for our systems to acknowledge their presence and include them in our daily day-to-day activities. To create a space for them, there is still a stigma in the community. This is not to discriminate against them but to protect them. Even the medical community works for efficient treatment. It is the responsibility of the hospital and the healthcare staff to allow the trans community and the LGBTQIA + community and it needs maturity over some time.
One should make sure that the community should be engaged totally in whichever responsibility they enjoy. They have adequate skills to perform well. Gender-specific documentation has to be introduced, there are several areas such as emotional dimensions and biochemical dimensions, where specific differences have been documented for the transgender population and also other spectrums of the population. In the coming generations, there will be several investigations, where the healthcare records should have a special column for the trans community population and the LGBTQIA+ communities. There is also an issue of self-stigma among the population.
Dr S Hari Kumar also spoke about the legal perspectives of the transgender community. As per the HIV Act of 2017 and supreme court directives of 2014. The directives say that transgenders shouldn’t be discriminated against at any point of time either in employment while providing education or healthcare. Whichever the scenario, an equal opportunity must be given to them. In health and other social support initiatives, there are a lot of facilities for transgender community people.
Healthcare providers should have a basic understanding of sexuality and the healthcare dynamics. It should be practised well. Many healthcare practitioners feel gender is a physically visible and dimensional trait and one must take care of the third gender. The healthcare providers if initiated the importance of this gender can provide excellent support and care to the trans community system. There are issues where healthcare institutions need to sensitize and respect the trans individuals’ community. The universal design needs to be inclusive of all genders. The HIS system needs to be inclusive of trans community people. Even an awareness must be created against the non-discriminatory policy and the organizations can announce their friendly relationships with all genders. First, doctors must be educated to make realistic plans. Trans-cultural workshops must be conducted to spread awareness in society.