Abstract
Kerala witnessed a transformation in recent times in the case of social acceptance of the transgender community. Participation in HIV/AIDS projects gave them some social recognition. There was a turning point in the situation when the Supreme Court judgement came in 2014 on National Legal Service Authority vs Government of India. It started to formulate policies and welfare schemes to support the transgender community. Following this, the Kerala government drafted the Transgender Policy in 2015. The present situation is much improved. Yet there is not much improvement in healthcare services. There is no protocol or guidelines for treatment, which may result in practice without quality assurance and high cost. This chapter is an attempt to review the situation of the transgender community in Kerala before and after the transgender policy to look into achievements and gaps in security measures, including healthcare access.
TopGlobal Context
Since the last two decades, there has been an increase in the awareness about the gender identity problems and health rights issues of transgender people all over the world. International agencies like WHO accept that every person should have the right to determine their gender identity in legal terms and to live without discrimination, harassment, injury, pathologization or criminalization (WHO, 2015). Transgender persons are identified as follows; someone born male, who identifies as female, may use the term “male-to-female”, (MtF), “trans woman”, “transgender woman”, “trans feminine”, or simply “woman”. Someone born female, who identifies as male, may use the term “female-to-male” (FtM), “trans man”, “transgender man”, “trans masculine”, or simply “man” (WHO, 2015).There are about estimated 25 million transgender people, living in the world (WHO, 2016).
In many countries, legal recognition does not exist for transgender people, whereas some countries have recognized their legal rights, enacted laws, and made policies supporting them. These are prerequisites for their daily life activities like accessing health services and applying for housing, travelling, employment, education etc. On the contrary, laws criminalizing same-sex sexual behavior and non-gender-conforming behavior created and sustained stigma, discrimination and violence. This favored regulations and surveillance systems akin to policing, to harass, arrest, torture and abuse people, leading to inaccessibility of health care. Stigma, discrimination and lack of legal recognition are significant barriers for transgender people to access the health services they need (WHO, 2015).
Key Terms in this Chapter
Intersex: In biology, an organism having physical characteristics intermediate between a true male and a true female of its species. It is a socially constructed category that reflects real biological variation, according to Intersex Society of North America.
Gender Dysphoria: Discomfort or distress related to the incongruence between an individual's gender identity and the gender assigned at birth.
Queer Pride March: Outdoor events celebrating lesbian, gay, bisexual, transgender, and queer (LGBTQ) social and self-acceptance, achievements, legal rights, and pride.
Sexual Diversity: It refers to all the diversities of sex characteristics, sexual orientations and gender identities, without the need to specify each of the identities, behaviors, or characteristics that form this plurality.
Heteronormativity: Denoting or relating to a world view that promotes heterosexuality as the normal or preferred sexual orientation.
Sex Reassignment Surgery: A surgical procedure by which a transgender person's physical appearance and function of their existing sexual characteristics are altered to resemble with their identified gender.
Transphobia: Irrational fear of, aversion to, or discrimination against transgender people.
Transgender: An umbrella term encompassing those, whose gender identities or gender roles differ from those typically associated with the sex they were assigned at birth. Many of them refer themselves as Trans woman (MtF-Male to Female) or Trans man (FtM-Female to Male) affirming chosen identities by themselves.
LGBTI: It is an acronym for lesbian, gay, bisexual, transgender, and intersex. These terms are used to describe a person’s sexual orientation or gender identity.
Queer: People who do not conform to traditional ideas about gender or sexuality, especially the idea that everyone is either male or female or that people should only have sexual relationships with the opposite sex.