That day was Honey’s birthday. The young Indian woman, dressed in a royal blue kurta – a traditional garment – blew out her 31 candles. Her gift, she had offered it to herself a few weeks earlier: after a lifetime of feeling like a woman in a man’s body, she was finally able to have her gender confirmation surgery.
However, the atmosphere is not festive. Honey lives in a small dilapidated house in a slum in the city of Salem in the state of Tamil Nadu. Even though this state in southeastern India is theoretically the most progressive when it comes to the rights of transgender people, they remain extremely stigmatized.
“From a young age, I was drawn to all things feminine. I wanted long hair, wear makeup and dress like girls. When I told my family about it, I got beaten up. They told me I had to stop talking about it,” says Honey, who today let her thick black hair grow out, which she wears in a ponytail.
After doing their coming out, transgender women are almost automatically disinherited by their families and excluded from society. Like Honey, they often join a “jamaat”, a system of cohabitation that allows them to live in community and find a semblance of family. Here, these women have become true sisters. As they come from different regions of the country, they communicate in Tamil – the local language –, in Kannada and in Hindi.
The interior of the house is dark, even in broad daylight. The main room is empty except for an old fabric sofa. This is the only place where they can live, because no landlord agrees to rent them accommodation. Outside, the narrow houses overlook dirt roads.
By doing their coming out, they also renounce their profession. Without the possibility of employment and therefore income, Honey and her sisters have no choice but to turn, reluctantly, to sex work. Some of them, however, could have made a career in their respective fields, such as Poorvi who holds a baccalaureate in history, Nayanika a baccalaureate in botany or Bindu, a baccalaureate in physics.
In addition to the social stigma they face, women in the community regularly face discrimination within the health system. For Honey, it’s not uncommon to be the butt of teasing during her visits to an establishment.
Although she always managed to get the care she needed, she often had to face “disapproving” looks and comments from the medical staff. “If I arrived on the scene and there were already people waiting, I was made to feel guilty for having come at a busy time of the day or told to come back later,” says- she. She doubts that the same thing was asked of the other patients.
feel accepted
To prevent them from being reproved when they need healing, a solution is now available to them. In June, a medical helpline was established for Salem’s LGBTQ+ community. Call4Svasth, which can be translated from Hindi as ‘Call for your health’, is a new initiative to provide them with unbiased care and advice over the phone.
At the end of the day, Nischal Anand and his colleague Simran Singh traveled the 200 kilometers from Bangalore — India’s Silicon Valley — to the city of Salem, in preparation for their visit to the community the next day. Both are coordinators at Swasti, a non-profit organization whose goal is to improve the health and well-being of marginalized communities in India.
Their goal: to connect face-to-face with the community to introduce them to the new hotline. The service is completely free — the project is funded in particular by philanthropy.
Why a telephone line and not a mobile application? Not least because people in marginalized communities like this don’t really use smartphones, says Simran. Most have “old” cell phones that cost between 2000 and 3000 rupees (between 30 and 50 Canadian dollars) that do not support these applications. “The telephone line system is the most accessible for them. […] It’s already integrated into their daily life and it doesn’t require additional steps to access services,” she reports.
When they arrive, they seem wary and skeptical. Sitting on the floor sipping chai tea, Nischal and Simran chat with the six women for more than an hour to explain how it works.
Bindu is the first guinea pig of the group. Suffering from itching, she is desperately looking for a cream to relieve her skin. She steps back from the group and dials the number. After going through an initial triage, she is finally put in touch with a nurse, with whom she discusses her medical history. To fully understand what it is, the nurse asks him to send her photos of the irritations on his skin.
There is no acceptance for these transgender women.
After discussion with a doctor, she finally gets her prescription after an hour. “The people on the phone were very nice. I felt accepted,” she says after the call.
” [Dans les établissements de santé], there is no acceptance for these transgender women. They feel alienated and excluded. By dint of being treated and looked at differently, it also has psychological impacts, ”deplores Nischal, after having spoken at length with some of them.
Postoperative follow-ups
The phone line will also allow them to ask all their questions about their hormonal treatments, gender confirmation surgeries, follow-ups and complications. Until now, members of the community generally relied on word of mouth to learn about postoperative issues.
“After the surgery [de confirmation de genre], they have a lot of health problems. This involves physical changes, gastritis, heartburn, nausea… They have no support after the operation,” summarizes Nischal. Several women have also tried to treat urinary tract infections themselves after their operation, for lack of follow-up.
India is struggling with a shortage of doctors, the Call4Svasth project deals in particular with doctors who do not practice in hospitals, such as the wives of soldiers called to travel frequently. The team is also considering recruiting retired doctors.
While the helpline provides non-judgmental first contact for communities, it remains limited, admits Nischal, program coordinator at Swasti. As only primary care services are available there, community members still have to go to a facility to see a specialist. But for many women who fear medical visits, the new helpline helps avoid bad experiences.
When The duty leaves the scene, Honey and her sisters are all smiles. They are much more confident than at the start of the meeting. Despite the language barrier, they insist on getting their message across through Nischal: “They don’t often have the opportunity to speak with outsiders. They are very grateful that people from so far are interested in their reality. »
This report was financed thanks to the support of the Transat International Journalism Fund.The duty.