Dr. Anirudhha Hazra, Health News, ET HealthWorld

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Shahid Akhter, Editor-in-Chief, ETHealthworld, spoke with Dr Anirudhha HazraAssistant Professor of Medicine, University of Chicago, Illinois, to learn more about the challenges of accessing transgender health care and the way forward to mitigate social determinants.

Transgender Healthcare: Scenario
Thinking about the transgender population from a global perspective, I think we didn’t have a lot of data on the health outcomes and health of this population until relatively recently. And I think that’s because nobody really cared to look at that population well until a few years ago. What we do know is that there are certain communicable diseases that disproportionately affect transgender men and women and other people of diverse gender identities around the world. Not just in certain countries, but really globally who care about global health equity, health care and health outcomes. Specifically, transgender women account for 19% of new HIV infections worldwide, compared to less than 1% of the general population. We are again seeing these communicable diseases follow racial and socio-economic fault lines and transgender people are no different.

Transgender health care: challenges
There are several challenges and barriers when it comes to caring for or finding access to care for transgender people. I think the biggest problems come from the structural level of marginalization of a population that has really not been served by the general population.

And the biggest structural challenges arise in how people can’t access the care they need, whether because of the inability to access funds or the privilege of doing so. But then, if they even have the privilege and the funds to access care, the care is often violent towards them, does not benefit them disproportionately and brings no affirmation to their identity.

There are many layers when we think about barriers to accessing health care for transgender people. I think we can examine it with an individual on a systematic level himself. The individual transgender population often lacks the resources to access health care, health insurance, or even find a primary care physician. But structurally, we see issues that doctors are only able to take care of in transgender populations. Physicians who feel ill-equipped lack the training to understand the health care needs of this particular population itself. All the more reason that medical education needs to become more knowledgeable and inclusive of these populations in order to truly address inequities. experienced by transgender people in India.

Transgender Healthcare: Medical Curriculum
I think medical education is pretty dynamic right now. In 2022, countries around the world are reassessing how we teach our doctors and future doctors what healthcare really means. Understanding adopting a less paternalistic approach and understanding the importance of assertive decision-making are important aspects of health care for all populations, not just transgender people. No country is perfect and when it comes to this respect, not at all.

Some countries have had more work and the ability to do more research around this type of work, the United States being one. But even in the United States, there is a huge amount of inequality in different parts of the country who are able to provide access to this care. But yes, it is a very exciting time. When we think about medical education globally, we can truly embrace changes that can have a real impact on transgender or heterogeneous people. These draft skills are phenomenal. It is a combination of over a year of work in multiple disciplines across India. I think these offer us a blueprint of how we can begin to embrace these types of changes in the medical curriculum. The work done by Transcare India and MedEd has really developed a link between higher level institutions like the Indian National Medical Commission to determine how can we advocate for these skills to now be implemented in the medical curriculum that will be compliant with the Act on 2019 Transgender in India.

Transgender Healthcare: Improving the Doctor-Patient Relationship
I think raising awareness among professionals is extremely important, not just for the care of transgender people but for all marginalized people. I think we now understand the importance of medical providers to not only provide good medical care, but also to provide empathetic care that can really help strengthen the doctor-patient relationship. So the work that has been done by Transcare India is doing exactly that for a specific population that needs it the most here in India, which is so important.

Transgender Healthcare: Global Collaboration
Collaborations are so important. I think what really makes this team so unique are the multinational collaborations with the University of Chicago, Chicago center Delhi. We are able to learn from each other and see different forms and models of health care that have worked and have not worked when we think about medical education specifically. I think this kind of shared learning is so important and has really enriched me personally over the past 12 months, so I really hope we can continue this with further funding for future projects through Transcare India.


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