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Prejudice and Healthcare Access for Trans Men in India

Last updated on January 2nd, 2026 Posted on by NEXT IAS Current Affairs Team  14

Syllabus: GS1/Society, GS2/Governance

Context

  • Despite legal recognition and welfare initiatives, transgender men and gender-diverse persons assigned female at birth (AFAB) continue to face systemic discrimination, and inadequate access to inclusive healthcare in India.

Key Issues Faced in Healthcare Access

  • Structural and Institutional Barriers: Persistent misgendering, judgemental attitudes, and denial of care in public healthcare institutions.
    • Healthcare access is linked to gender recognition certificates under the Transgender Persons (Protection of Rights) Act, 2019, creating administrative gatekeeping.
    • A binary understanding of gender among medical professionals excludes transmasculine and non-binary identities.
  • Knowledge and Research Gaps: Limited Indian research on gender-affirming care for trans men and AFAB individuals.
    • Medical curricula and clinical practice are largely shaped by the experiences of trans women, causing unequal attention to trans men.
    • Absence of ICMR-backed, India-specific ethical and affirmative medical protocols for diverse gender identities and sex characteristics (GIESC).
  • Unethical Practices: Refusal of medically indicated procedures such as hysterectomy due to patriarchal and reproductive biases.
    • Reports of unnecessary invasive examinations, violating bodily autonomy and medical ethics.
  • Challenges in Hormone Replacement Therapy (HRT): Inadequate counselling on dosage, risks, and long-term side effects of testosterone therapy.
    • Lack of standardised dosing guidelines linked to body weight or health conditions.
  • High incidence of self-medication due to limited access to trans-affirming endocrinologists and administrative hurdles in public insurance schemes.

What are the Implications?

  • Ethical Implications: It reflects weak integration of ethics, empathy, and lived experiences into public service delivery.
    • Denial of dignified healthcare violates Article 21 (Right to Life and Dignity).
    • Highlights a gap between formal equality (laws) and substantive equality (outcomes).
  • Health Implications: It increases self-medication and unsafe hormone use, raising long-term health risks.
    • It leads to poor mental health outcomes, including anxiety, depression, and distress.
  • Economic Implications: Loss of productive workforce participation due to poor health outcomes.

Initiatives taken by government

  • Transgender Persons (Protection of Rights) Act, 2019: The law passed by the Parliament aims to end discrimination against transgender persons in accessing education, employment and healthcare and recognise the right to self-perceived gender identity.
  • National Council for Transgender Persons: In pursuance of the Transgender Persons (Protection of Rights) Act, 2019, the National Council for Transgender Persons has been constituted to advise the Central Government on the formulation and evaluation of policies, programmes, legislation and projects for the welfare of the transgender community.
  • National Portal for Transgender Persons: It was launched by the  Ministry of Social Justice and Empowerment in 2020. 
    • Any Transgender applicant can obtain a certificate of identity and identity card without any physical interface with the office of issue. 
  • Mitr Clinic: India’s first transgender-led healthcare centre, established in Hyderabad, Telangana. It is entirely staffed and managed by members of the trans community.
    • It faced closure in January 2025 due to funding cuts but reopened as Sabrang Clinic with support from Tata Trusts.
    • Services offered are: General health services; clinical consultation on Hormone Replacement Therapy, Treatment for Human Immunodeficiency Virus (HIV)/Sexually Transmitted Infection (STI) etc.

Judicial Measure

  • The ruling in National Legal Services Authority (NLSA) v. Union Of India (2014) famously known as the NALSA Case, has following implications;
    • The Court directed Centre and State Governments to grant legal recognition of gender identity whether it be male, female or third-gender.
    • Recognising third gender persons as a “socially and educationally backward class of citizens”, entitled to reservations in educational institutions and public employment.

Way Ahead

  • Policy and Institutional Reforms: Develop ICMR-led, India-specific, evidence-based protocols for gender-affirming care.
  • Capacity Building: Mandatory gender-affirmative training in medical education and in-service programmes.
  • There is a need for adoption of World Professional Association for Transgender Health (WPATH) aligned protocols, adapted to Indian socio-economic realities.
  • Community-Centric Approach: Inclusion of community health workers with lived experience in public healthcare delivery.
  • Regulation and Safety: Standardised guidelines for HRT dosage, monitoring, and follow-up.

Concluding remarks

  • The challenges faced by trans men and gender-diverse persons in healthcare reflect deeper systemic issues of knowledge deficits, patriarchal norms, and weak implementation of rights-based laws. 
  • Addressing these gaps is essential not only for inclusive healthcare but also for advancing constitutional morality, social justice, and ethical governance in India.

Source: TH

 
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