After seven decades of independence, health is still not a fundamental human right under the Pakistan constitution. Basic health is a ‘need’ not a ‘want’, that must be guaranteed to all, especially to those who can’t afford expensive private healthcare. It is an essential service, to prevent disease, maintain health, treat illness and provide access to essential medicines. Healthcare in Pakistan is mostly out-of-pocket expenditure and the poverty rate in Pakistan is 39%, which means 85.8 million the population lives below the poverty line making it difficult for them to afford healthcare services. The situation worsens for the transgenders who are already neglected by society.
According to 2017 Census of Pakistan, 10,418 transgender people were registered. Transgender community faces multiple issues in our society, for example, familial rejection, high levels of stigma, discrimination, gender-based violence, marginalization and social exclusion. Due to societal norms and behaviors they face discrimination in healthcare sector as well. It is difficult for them to get quality treatment in healthcare sectors in Pakistan as Pakistani citizens. These individuals are most vulnerable and are at high risk of emotional and psychological abuse, physical and sexual violence, sexually transmitted infections, viral hepatitis and HIV, substance abuse, use of intravenous injections, depression, anxiety and suicidal thoughts. There is a high prevalence of HIV/AIDS among transgender due to unsafe sexual practices.
Another issue transgenders face with getting medical treatment is expenses. It is difficult for transgender community to avail these services because it is strenuous for them to make ends meet.
A research conducted in Lahore in 2020 concluded that about 70% of the transgenders seek health care from government hospitals, but they believe that they receive poor quality care due to various reasons including unacceptable behavior of healthcare professionals, felling ashamed, unavailability of CNIC, unaffordability of treatment and the feeling of discrimination during treatment.
Alishba, a transgender activist, was shot seven times in Peshawar in 2016. She died due to delay in health care because the male and female wards were reluctant to admit a transgender. Trans Action KP Facebook page blamed the KP government for her death because she never received intensive medical attention. Despite the fact that Article 25 states that sex-based discrimination is prohibited.
It is important for law makers to keep every segment of society in mind while policy making and there should be the equal representation of transgender community.
Written by Maria Saif
Edited by Amna Sheikh