“I am happy, at least something has been done,” said Muskan, one of the transgender persons visiting Delhi’s Ram Manohar Lohia Hospital on the inaugural day of its OPD facility for the transgender community. 

Amid little awareness around gender sensitivity and no dedicated ward for medical services for transgender persons at the central government-funded hospital, its newly-launched ‘Special Out-patient Department’ is a long-overdue step towards inclusivity.    

The department, which was inaugurated on prime minister Narendra Modi’s birthday on September 17, will offer OPD facility for transgender persons for two hours every Friday, from 2 pm to 4 pm. It will also have a dedicated registration counter. A panel of 10–12 doctors from across departments, including medicine, urology, psychiatry, dermatology, burns, paediatrics, and endocrinology, will attend to the patients.

An official at RML Hospital told Newslaundry that at least 24 transgender individuals availed the OPD services on the inaugural day, September 22. However, one of these patients said they were denied consultation at the psychiatry department.

Notably, transgender persons are often denied healthcare access due to discrimination and stigmatisation.

Patient told ‘we don’t treat transgenders’

Several transgender patients at RML Hospital who spoke to Newslaundry raised concerns about the lack of gender sensitivity among hospital staff.

Veronica Ratra, a transgender person who was at the hospital for consultation at the psychiatry department during the stipulated special OPD hours, said she was still denied services on the grounds of her transgender identity. 

“I went to the psychiatry department but an official out there simply denied, saying ‘we don’t treat transgenders’,” she said.  

“Underlying issue is not just about receiving treatment but also about gender sensitisation within the healthcare system. You respected male and females, but why did you leave us unattended? Had the NGO Sewa Bharti people not been helping us, nobody would attend to us,” she told Newslaundry.  

The proposal to start an OPD for transgender persons was originally put forth by NGO Sewa Bharti to RML administration. The organisation is also assisting the hospital in coordinating with the patients.

Anamika Biswas, in-charge of Sewa Bharati’s Transgender project, acknowledged the mismanagement and lack of coordination in the initiative at present.

She said there is “some hesitancy” among doctors regarding treatment of transgender persons. “There are challenges, but we must recognise that not everyone is familiar with the needs of this community. For doctors, this is an entirely new experience. So, both doctors and transgender individuals need to work in coordination. Today was the first day, but I believe things will improve with time.” 

No dedicated ward

Despite the special registration counter, currently there is no dedicated ward or chamber for transgender patients. After receiving their department assignments for consultation, transgender patients are required to join the regular queues for the check-up. However, outside the hospital’s endocrinology department, Newslaundry found two queues, one for transgender individuals and the other for everyone else. 

“Currently, there is no dedicated ward or department for us. This can overwhelm the doctors. I hope there will be a dedicated department, doctor, and ward for us in the near future," said Muskan, one of the patients at the hospital’s endocrinology department. 

She, however, expressed optimism about the initiative. “It has just started so there are some issues but I believe things will be streamlined soon. It will take some time to streamline the whole process.” 

Stressing on the need for dedicated medical infrastructure for transgender patients, Sewa Bharati’s Biswas said, “The hospital needs to give the special OPD department a dedicated room for treatment unlike the usual process of sending patients from one room to another. I hope by next week, we will be able to streamline these issues as well.”

Meanwhile, on the queries about the shortcomings of the initiative, RML’s media cell coordinator Shailesh Kumar told Newslaundry that the confusions arising on the first day would be addressed. “Transgenders are our priority, and there will be a dedicated OPD facility for them. We will assign a doctor every Friday, and there will be a dedicated room for their consultations. If they require special consultation, the doctor will attend to them there.” 

Another hospital official said they would streamline facilities as a higher turnout of transgender patients is expected. “Today is the first day, so many might not have been aware of the initiative. Come next Friday, there will likely be a higher turnout from the transgender community.” 

‘Should be able to access services at all times’ 

Pointing to the restrictive access to OPD services, available only on Fridays for transgender persons, transgender rights activist Dr Aqsa Sheikh said the initiative is “too little and too late”.  

“Transgender people also have healthcare needs like any other gender and they should be able to access the services at all times and in all situations. If they need any such service, they should not have to wait for a separate day or a separate counter to avail those services,” said Sheikh, adding that all the departments in the hospital need to be sensitised to cater to the needs of transgender individuals. 

Sheikh noted that specialised services are only required for gender affirmation treatments and at least one government hospital in each state is mandated to provide the facility at a subsidised rate. She alleged that till now, most of the states and UTs, including Delhi, have failed to do so. 

“When transgender persons opt for gender affirmation treatment, there is a crucial need for the services of gynaecologist, psychologist, endocrinologist and plastic surgeon. This is where the need for a special gender clinic comes into picture,” Sheikh said.

“The government’s own laws state that every state needs to have at least one government hospital that provides gender affirmation treatment and surgeries. So far Delhi has failed in doing so and even the OPD in RML is not providing the surgical services.”