India's healthcare system has glaring irregularities that get exposed often. Years passed, it has been a work in progress to become inclusive and accessible to all communities residing in the country. However, despite numerous efforts, the goal seems to be a distant dream even when India is, slowly and steadily, becoming a developed nation.
For marginalised communities, accessing quality healthcare facilities is an uphill battle. People living in remote areas have to travel length and breadth for the tiniest of ailments with no establishment adequately equipped around them. Apart from accessibility, lack of inclusivity is a massive problem even today. Topics like mental health, women's issues, etc., are gaining prominence after decades of stigma around them.
Adding to this, India's healthcare infrastructure is not gender-inclusive. The country's transgender community suffers the most as medical professionals are not sensitised or equipped to handle their problems. As a result, they are deprived of essential treatments and are denied treatment altogether. It has not been an easy road for them from sexual health mental health to even availing COVID-19 vaccines.
Therefore, organisations around the country have stepped up to bridge the enormous gap. One of them is called 'Mitr Clinic', India's first-ever clinic that is exclusively for the transgender community and run by them.
Mitr Clinics- A Friend In Need
The name suggests a comprehensive system that solves the transgender community's basic healthcare needs. It was started by 'Safe Zindagi', an organisation raising awareness about HIV-AIDS. An integral part of it is working closely with the help of 'Program ACCELERATE' and the National AIDS Control Organisation of India.
In the project mentioned above, the initiative is the labour of love of an inclusive health advocate named Simran Bharucha, Director of Transgender Health. Speaking to The Logical Indian, she explains about the endeavour, "Mitr Clinics is my initiative, it is my baby. We brainstormed for several years about a platform that works for the transgender community. It was when I worked with Program ACCELERATE that I got the opportunity to come up with a comprehensive trans health clinic."
'Mitr Clinic' aims to bridge the gap in general healthcare services for the community. Along with that, it sensitises society about transgender-specific issues and handles them with utmost care and empathy.
Of, For And By The Transgenders
The initiative strikes a chord with the people for several reasons. One of which is the team that works in the Mitr Clinic. From doctors to mental health professionals, nurses, outreach and housekeeping, all belong to the transgender community. "This is a clinic run by the community, for the community. We are a part of the team because of our qualifications, not solely because of our identity. We have two MBBS doctors from the trans community, which is a big moment of pride for us," Bharucha adds.
The services are divided into three categories- general health services, gender affirmation, and legal and social protection. The first group treats both communicable and non-communicable diseases such as diabetes and many others. It also includes chronic and acute ailments of any kind, vaccinations such as Hepatitis A and B and Human Papillomavirus (HPV) vaccines to combat cervical cancer.
Also, Mitr Clinic ensures inclusive psycho-social support to the members. With the psychologists and psychiatrists belonging to the community, it becomes easier for them to open up and emphasise mental health problems. With the advent of COVID-19, it has become imperative to keep ourselves mentally healthy. In light of this, the initiative provided a toll-free number on which the community could call and speak to concerned professionals about their problems.
Further, the project assists the community while navigating through the healthcare system. Bharucha elaborates, "The transgender people have a lot of issues with the legal documents because it does not consist of their preferred name and gender, making it difficult for them. This is where we come in and help them in the best way possible."
Gender Affirmative Facilities
The second category consists of raising awareness about HIV/STI Issues and assisting them accordingly, gender-inclusive. "Gender Affirmative is the golden tool that we have. We provide good services in Hormone Replacement therapy. We provide sessions so that people, in the future, do not regret it when they are going for their surgery. We cater our services to both trans men and trans women," Simran Bharucha continues her conversation with The Logical Indian. The services also include Gender Dysphoria screening and counselling, Facial Feminisation and aesthetic surgeries such as breast implants and vaginoplasty.
The activist also points out that it is just a clinic and not a full-fledged medical facility that will perform surgeries. She explains, "One must know that a clinic is not an operation theatre (OT). Therefore, we have identified trans-friendly medical institutions that are familiar with performing perform gender affirmative surgeries. Further, we refer our clients over there. Mitr Clinic has tied up with leading private institutes and ensure that the procedures are performed at affordable and reasonable rates. It should be a win-win situation for both the entities, the client and the doctors involved."
Mitr Clinic's third and important ambit is giving Legal and Social Protection. The team helps the clients register to the Indian government's transgender portal, after which they receive a certificate, proving their true identity to the world. "When a client decides to go in for the gender affirmation surgery, we help them with two certificates. One is from the psychologist and the other from the psychiatrist, stating that they are mentally and physically fine to go ahead with the procedure," said Bharucha.
They also help the community members to avail the necessary insurance services. "Right now, all the gender affirmative surgeries come under cosmetic surgeries and do not fall under the health insurance bandwidth. Procedures like Dialysis, Chemotherapy, etc., are covered by them, but not the Gender affirmative ones," Bharucha talks about the efforts made in the sphere.
Acceptance,Towards Transgender Community
Unlike other unfortunate instances, the journey of Mitr Clinic has been positive. This is a breath of fresh air when the transgender community continues to be discriminated against. Bharucha proudly states, "Yes, we (transgenders) are being stigmatised based on our gender, but when we have a conversation around this with the mainstream society, the health ministry, for example, the Mitr Clinic has been getting tremendous support." Simran Bharucha also cited an example where the Maharashtra authorities promised to establish such clinics in each district of the state.
"I was in Ajmer attending a 'mela' where a few transgender members came up to me and asked if I could give them the number of the clinic for a teleconference. They wanted an organisation that could teleconsultation with the community across the country, considering it may not be possible to establish clinics everywhere. When I gave them the number, I could see the tears in their eyes," Bharucha narrates a touching anecdote.
Currently, the Mitr Clinic is established in Hyderabad, Thane and Pune. With their work, they hope to raise awareness about transgender health necessities and make the infrastructure inclusive in every way possible.