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Complex Registration, Limited Research: Why India's LGBTQ Feel Left Out from Vaccination Drive

Trans community and vaccination 
 Image credit: PTI (Representational)

Trans community and vaccination Image credit: PTI (Representational)

Adding to the struggles of not getting primary healthcare and vaccination, the impact of COVID induced confinement on LGBTQIA individuals has been excruciating and traumatic.

The COVID-19 pandemic has pushed back the LGBTQ rights movement by years and amplified the pre-existing discrimination against the community by a thousand-fold. Therefore, it should come as no surprise that the members of the LGBTQ community have faced several challenges in accessing treatment for the COVID-19 virus and are now struggling to get vaccinated too.

According to the Cowin dashboard, only about 35,000 people out of the 4,87,803 trans members of the community have received the vaccine so far. While the low numbers can be chalked up to vaccine hesitancy, we need to ask now: what has been done to include the LGBTQ community in the vaccination process?

The challenging registration

Many trans members are immunocompromised and therefore, at greater risk from the virus, despite that no efforts were made to make the process of registering for vaccination more inclusive for them, pointed out Koyel Ghosh, a managing trustee at Sappho for Equality, an organization that works to establish rights of sexually marginalized women and transmen.

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In an interview with News18, Ghosh explained that many LGBTQ members, especially from marginalized backgrounds, do not have a proper photo ID. In cases of trans members, it is often difficult for them to use documentation that takes their birth gender into account instead of the gender they have chosen and identify with. Therefore, they initiate change in documentation.

“However, these changes in the documentation might take long, due to which many of them may not have updated documents with them for vaccination at the moment.” She explained. “It also does not help that trans people do not have the option of choosing their gender during vaccination. The vaccination forms do not have the provision that allows anyone to choose the ‘transgender’ as an option and have a generic ‘other’ listed in the gender section instead,” she explained.

Limited Research on Trans Community

So far, little to no research has been done on the LGBTQ community as far as the COVID-19 vaccine is concerned, so there is a significant amount of scepticism regarding the efficacy and side effects of the vaccines among the members of the community. Even The Human Rights Commission has pointed out this underrepresentation of these marginalized groups in medical trials, including those for vaccines.

Dr Narendra Kaushik, a plastic surgeon, said that he had to delay the sex reassignment surgeries for many of his patients due to the spike in COVID-19 cases in the past year. “These delays are very undesirable for the individual and can be psychologically traumatic for them as their gender dysphoria can only be helped by performing these surgeries.”

Maya, a trans person who is a member of Vikalp’s Women’s Group, explained that during the pandemic, many trans individuals who are under hormone replacement therapy (HRT) also experienced extreme mood swings after their HRT was abruptly halted due to the pandemic.

Maithilee Sagara of Nazariya, a queer feminist resource group that works towards affirming the rights of queer women and trans persons, also added that there is growing misinformation about whether HRT can cause blood clots if taken with the vaccine. She said that this is not entirely true, but this has caused hesitancy in the community to take the vaccine.

“Such people should ideally consult their endocrinologist before going for the vaccine, instead of being hesitant. The media, too, should highlight the stories of trans rights activists who have shared their experiences of taking the vaccine. This will encourage more individuals to opt for vaccines,” she explained.

Access to Healthcare

During the pandemic, the members of the LGBTQ community also faced discrimination when they tried to access the most basic healthcare facilities.

The quarantine centres were exclusionary spaces, where people with non-normative gender and sexual expression faced backlash and challenges and did not feel safe to be open about their gender, which is why some non-profit organizations have demanded inclusive health care spaces.

Such spaces have, in fact, been opened in Manipur because of the initiative by All Manipur Nupi Maanbi Association (AMANA), founded by Manipuri trans activist Santa Khurai. As a result, the Manipur government opened two quarantine centres specifically for trans persons coming back to the state.

Ghosh, the trustee of Sappho for Equality, said her organization has also demanded special beds for the LGBTQ community. “They are often denied access to healthcare, so it is important to have special provisions for them,” she explained.

Returning to Unsafe homes, difficult places

Adding to the struggles of not getting primary healthcare and vaccination, the impact of COVID induced confinement on LGBTQIA individuals has been excruciating and traumatic.

Ghosh explained, “LGBTQ persons who are thrown out of their homes at an early age had to return to those unsafe, intolerant homes yet again as COVID cut their livelihood and their capacity to pay rent.” Those who choose not to return were left homeless. Therefore, during the pandemic, we saw a steady rise in homelessness among members of the LGBTQ communities.

Maithilee Sagara of Nazariya said that their helpline number has been addressing a significant increase in the number of calls. They have been receiving more requests for therapy from members of the LGBTQ community.

“The majority of the distress calls are about domestic violence from families. In addition, people are complaining of mental health problems arising out of endless questioning and scrutiny. To address the growing demand for therapy, we have hired one additional counsellor,” said Sagara.

Mental Health Woes

Sagara also said that domestic violence is not only physical but also psychological. “Domestic violence has increased dramatically as the community members cannot go outside because of the lockdown and accessing their safe spaces such as schools, colleges and community gatherings is no longer possible. There is a lot of everyday misgendering at home by insensitive relatives, which can also be traumatic. Therefore, for many LGBTQ members, it has been about a year that they have not been allowed to express themselves freely at home.”

For instance, Rach, a pansexual person from Delhi, said that he felt gender dysphoria when he was judged by his parents at home for wearing nail paint and doing anything feminine.

Tahoe, a bisexual individual from Mumbai, said that he faced mental health issues as all his safe spaces were ripped away, and as a closeted queer, there were limited people he could confide in. “Not being able to meet these people made me go towards a downward spiral,” said Tahoe.

Mansi, a 22-year-old queer woman from Delhi, said that gender and sexual minorities are at an increased risk for depression, anxiety and suicidal ideation. “The isolation and loneliness of physical distancing have made it worse for us,” she explained.

The Way Forward

Vasundharaa S. Nair, a social scientist and mental health clinician, said that since the lockdown happened in many states, members of the LGBTQ community could not meet one another. “Their entire linkage with their community was broken because of their confinement,” she explained.

Nair said that researchers are coming up with frameworks and trying to plan the set of guidelines required to support the community, but it is still in the ideating stage. “The judgement made by the Madras HC Justice N Anand Venkatesh by issuing guidelines to protect the LGBTQIA+ community is important and a way forward,” pointed out Nair.

She also added that in any health care policy, the community should be the primary stakeholders. Moreover, she said that clinicians who are not trained to deal with problems faced by LGBTQ persons should be given relevant training. “LGBTQ persons should not feel like a second priority. They should have established support groups and spaces to come out and express themselves irrespective of how big a crisis we are in,” she concluded.

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first published:June 15, 2021, 10:25 IST