While participants relied on private facilities for most health concerns—including minor ailments (45.2 percent), major illnesses (61.3 percent), and chronic conditions (66.7 percent)—government hospitals were more commonly used for STI screening (55.4 percent).
Published Oct 25, 2025 | 9:00 AM ⚊ Updated Oct 25, 2025 | 9:00 AM
For gender-affirming care, preferences leaned heavily towards private hospitals.
Synopsis: Most transgender adults in Chennai continue to rely on private healthcare for routine, mental health and gender-affirming care, while government hospitals remain underused due to discrimination, poor service quality and a lack of specialised services, a new study has found. Researchers from Madras Medical College surveyed 104 participants and identified systemic barriers, including inadequate counselling, long delays, and low awareness of trans-specific services.
Despite growing discussions about inclusivity in hospitals, most transgender adults in Chennai continue to rely on private healthcare for both general and gender-affirming needs. Government hospitals remain largely inaccessible due to discrimination, poor service quality, and limited specialised care, according to a recent study.
Published in the BMC International Journal for Equity in Health, the cross-sectional study by researchers at Madras Medical College examined how transgender adults in Chennai access and use healthcare services.
The study, conducted among 104 participants—including transgender women, transgender men, and one gender-fluid person—analysed patterns of healthcare use, preventive care, mental health, and gender-affirming services.
Findings show a consistent dependence on private healthcare providers for most medical needs, from routine check-ups to hormone therapy and gender-affirming surgeries.
Government facilities, though more affordable, were often avoided due to perceived discrimination, lack of specialised services, and delays in treatment.
“A lot of the doctors are at least bothered; they sit as though they don’t know why the patient is there. There isn’t that real enthusiasm to work with the transgender community” – Rose Venkatesan, a celebrity LGBTQ activist.
While participants relied on private facilities for most health concerns—including minor ailments (45.2 percent), major illnesses (61.3 percent), and chronic conditions (66.7 percent)—government hospitals were more commonly used for STI screening (55.4 percent).
Mental health needs were widespread but rarely addressed. Nearly 68 percent of respondents reported experiencing mental health symptoms in the past year, yet only 18 percent sought therapy, highlighting the shortage of accessible and trusted counselling options.
For gender-affirming care, preferences leaned heavily towards private hospitals. Around 87 percent of trans men used hormone replacement therapy (HRT), with 48 percent preferring private clinics for HRT and nearly 76 percent for gender-affirming surgeries.
Government facilities were avoided due to distrust, poor service quality, long delays, and lack of awareness about available options.
Overall, the findings point to a clear pattern: while private facilities provide more specialised and trusted care, government hospitals remain underutilised despite being more affordable.
The researchers recommend targeted gender-sensitisation training for medical staff, stronger public–private collaborations, and awareness campaigns to rebuild trust and increase the use of public health services.
The study notes that transgender people in Chennai face layered barriers—structural, social, and emotional—when seeking healthcare. It calls for gender-sensitisation programmes in hospitals, clearer referral pathways for gender-affirming care, and closer collaboration between NGOs and government health departments.
The researchers stress that improving trust in public healthcare and creating visibly trans-friendly spaces are essential steps towards equitable access for the community.
Rose Venkatesan, a celebrity LGBTQ activist, says that while government hospitals such as the transgender clinic at RGG Hospital exist, their services often lack the compassion and attentiveness transgender patients need.
“A lot of the doctors are at least bothered; they sit as though they don’t know why the patient is there. There isn’t that real enthusiasm to work with the transgender community,” she told South First.
For many transgender individuals, visiting a hospital is more than a medical appointment – it is a moment of vulnerability, as navigating one’s gender identity already demands immense personal courage and mental strength. Disappointment can set in quickly if patients sense a lack of care or understanding from medical staff.
Financial considerations also weigh heavily. Government hospitals provide free services, while private hospitals, though often offering more specialised care, can be expensive and sometimes push unnecessary treatments.
“You have to be very careful in the private sector; it’s important to go to a qualified doctor who is well known among the community,” Rose adds.
Reflecting on her own experience, Rose says she underwent gender-affirming surgery in Thailand in 2010, as expertise in India was limited at the time.
Today, she observes a shift among transgender patients in India, with many saving up to access private hospitals offering more specialised surgeries, while government facilities remain a preferred option mainly for prescriptions and hormone therapy.
The choice, she emphasises, is a balance between quality, accessibility, and affordability – highlighting the complex realities transgender individuals face even before receiving care.
Being transgender comes with unique mental health challenges rooted in social exclusion and family rejection. Rose explains that many trans individuals face abandonment, forcing them to find shelter and support among peers in the community.
“Families most likely will not accept you wholeheartedly, trans people end up living with other trans people initially and also for the long term,” she says.
Exploitation within the transgender community itself adds to emotional stress. Rose notes that some trans individuals experience mistreatment from others in their own network, creating a constant need for vigilance and resilience. These internal pressures, coupled with external societal stigma, can significantly affect mental well-being.
The lack of adequate mental health support compounds these challenges. Rose highlights that while counselling services exist in Chennai, their availability falls short of demand.
She calls for greater attention to mental health initiatives, pointing out that sustained support can help transgender individuals navigate the multiple layers of social and emotional pressure.
Romantic relationships often carry additional risks for transgender individuals, especially trans women. Rose explains that some partners may exploit trans women for sexual or material gain, leaving deep emotional scars.
“Often many trans women, they have suicidal tendencies when they feel that they’re used and dumped,” she shares, emphasising the severity of this vulnerability.
This exploitation is not limited to romantic contexts. Trans individuals may face abuse from acquaintances or others within the community, making trust and intimacy particularly complicated. Rose underlines that such experiences heighten the need for both emotional support and safe social networks.
Navigating personal relationships while managing societal pressures can be overwhelming. Rose stresses that robust mental health resources and peer support groups are essential to help transgender individuals build resilience against betrayal, exploitation, and emotional trauma.
Improving healthcare for the transgender community requires more than just facilities – it needs trained, empathetic professionals. Rose praises NGOs in Chennai for educating hospital staff about transgender issues but notes that gaps remain.
“NGOs are doing a decent job, educating the doctors and service providers on the issues that the trans community have in accessing their services,” she says.
Government initiatives are starting to address these gaps. Rose welcomes Tamil Nadu’s plan to include transgender health in medical curricula, believing it will equip future doctors with knowledge and sensitivity. She emphasises that hospitals must provide care without discrimination and respect each patient’s gender identity.
For specialised care such as surgery, Rose stresses that doctors must be actively willing to learn and ensure trans-friendly services. “Doctors, especially surgeons, should all be willing to take a chance into education and ensure that they are transfriendly,” she notes.
In her view, systemic education, combined with community-driven awareness, can significantly improve healthcare experiences for transgender individuals.
(Edited by Dese Gowda)
