Bhopal- "I reside in a Kinnar camp in Bhopal. At the tender age of 15, my family members cast me out of our home, subjecting me to mental anguish fueled by their taunts. Seeking refuge, I found solace in the camp. However, after some time, I began experiencing health issues. Upon getting tested, the devastating news came to light: I was infected with AIDS. The fear of ostracization looms over me - if my condition is discovered, I know others will distance themselves from me. Unfortunately, repeated visits to hospitals for treatment often invite discrimination against individuals like me."

During her visit to the Transgender Clinic at AIIMS Hospital in Bhopal, a 30-year-old transgender shared her distressing story with the attending doctors. She revealed her reluctance to disclose her pain, fearing the discrimination that often accompanies revealing her AIDS diagnosis. Consequently, she undergoes treatment in secrecy, without confiding in anyone. Doctors speculate that her HIV infection may have stemmed from unprotected sexual encounters between the ages of 15 and 25.

AIIMS Bhopal commenced operating weekly OPDs specifically for transgender individuals on Thursdays, starting from February 15, 2024. Over a span of five OPDs, from February 15 to April 18, a total of 17 transgender individuals sought medical assistance at AIIMS. Alarmingly, among these patients, four were diagnosed with HIV.

According to doctors, the fact that only 4 out of 17 transgender patients are affected by AIDS is alarming. They emphasize that shame and discrimination often prevent AIDS patients from seeking proper treatment. Dr. Roshan Sutar, in-charge of the Transgender Clinic, explained to The Mooknayak that they prioritize treating transgender individuals while safeguarding their identity. Additionally, they meticulously review each patient's history to gain insight into their mental well-being.

The doctors note that, based on the history of the four HIV-positive transgender patients, the infection likely spread through unprotected sexual encounters.

They express concern that, due to a lack of awareness, many may unknowingly contract AIDS through unprotected sex with multiple partners. Furthermore, they suggest that the actual number of cases may be higher, but social stigma and fear prevent transgender individuals from seeking medical assistance.

In a conversation with The Mooknayak, Bhopal's transgender activist, Sanjana Singh, affirmed that fear often deters transgender individuals from seeking healthcare services. " "It's true that transgender individuals avoid hospitals out of fear. If AIDS infections are spreading within the transgender community, then the Health Department and AIDS Control Committee should intensify awareness campaigns. We urge everyone in society to seek medical care without fear or hiding, to prevent diseases like AIDS from spreading," Sanjana said.

Gender Affirmation Surgery

According to the in-charge of the Transgender Clinic, 90 percent of individuals from the transgender community have sought assistance at the clinic for various issues.

Among them, 10 percent are transwomen who have consulted regarding surgery. Doctors explained that some individuals are dissatisfied with their bodies and seek assistance at the clinic for potential surgical interventions. Dr. Sutar emphasized that undergoing surgery to alter one's body requires adherence to a legal procedure. Without completing this process, surgery cannot be performed.

The decision to proceed with surgery depends on the individual's role within the transgender community. Doctors clarified that any trans male or female seeking changes to their body must live in their desired role for a year, demonstrating their contentment in that role. Following this, the process continues with the submission of a declaration and consent letter from a certified NGO.

Surgery for body modifications can only be conducted after completing the entire legal procedure. Currently, AIIMS has not performed any such surgeries.

The Role of AIIMS Bhopal's Transgender Clinic

The objective behind establishing the Transgender Clinic is to provide a safe space where transgender individuals can seek medical treatment without fear or hesitation. Regardless of age, children, adults, and elders can all find solutions to their health concerns in a confidential and supportive environment. The clinic operates with sensitivity towards the needs of the transgender community and their families, striving to provide inclusive healthcare services.

Statistics show that 2-8 percent of transgender individuals face difficulties in accessing healthcare facilities, highlighting the importance of mental health care in addition to physical care. Dr. Roshan Sutar, the in-charge of the Transgender Clinic, emphasized that AIIMS Bhopal is the only institute among all AIIMS in the country to establish such a clinic, following the directives of Director Professor (Dr.) Ajay Singh. The primary aim of the clinic is to address the needs of individuals experiencing gender identity disorder and dissatisfaction with their bodies.

It is estimated that there are around 35 thousand transgender individuals in Madhya Pradesh. However, according to the voter list released by the Madhya Pradesh State Election Commission in October 2023, there are only one thousand 373 registered as "other" voters (third gender).

-English Translation by Geetha Sunil Pillai