Progressive policies, regressive practices: Kerala transwoman denied essential medication

The incident has cast a shadow over the efficacy of Kerala's transgender policy, raising questions about their ground-level execution and the systemic challenges faced by transgender individuals.

ByDileep V Kumar

Published May 15, 2024 | 10:00 AMUpdatedMay 15, 2024 | 10:00 AM

Ahana has been jailed for possessing a narcotic substance. (Kerala prisons website)

Kerala’s claim as a progressive state on transgender rights took a backseat when an imprisoned transwoman approached the Kerala High Court, alleging denial of essential medication to undergo gender affirmation surgery.

Kerala, lauded for being the first Indian state to formulate a transgender policy in 2015, had garnered acclaim for its progressive stance towards transgender rights.

However, the latest incident has cast a shadow over the efficacy of such policies, raising questions about their ground-level execution and the systemic challenges faced by transgender individuals.

The petitioner, Ahana, a native of Ernakulam, highlighted before the court the grave health risks posed by the denial of medication by jail authorities.

The medication in question, gender-affirming hormone therapy (feminising hormone therapy) is imperative for gender-affirmation surgery and is vital for the petitioner’s well-being and health maintenance.

Also read : Interview: Meet transwoman Padma Lakshmi, the 1st transgender lawyer of Kerala

Shocking, says lawyer

Talking to the South First, her advocate Padma Lakshmi said, “It was by chance that I came to know about Ahana who is lodged at the Kakkanad Sub-Jail.”

She added, “It was for another client that I arrived at the sub-jail. There I came to know about Ahana. I met her and took note of her plight.”

According to Padma, who is the state’s first transgender lawyer, Ahana is physically and mentally weak and is showing suicidal tendencies as she couldn’t take medication for the past 170 days.

“What is shocking is that the jail authorities completely ignored her demand for medication. They told her that the medicines were expensive and it is beyond their budget. This is a violation of the fundamental rights as well as a violation of directives and laws related to transgender welfare,” added Padma.

Padma along with advocates CK Athira and Radhika Krishna had approached the court on behalf of Ahana.

It is alleged that the jail authorities were ignorant of the fact that there is a multi-disciplinary transgender clinic in Kottayam Government Medical College Hospital.

“I am skeptical of their claim. What they told me is they couldn’t afford her to take to a private hospital. I asked them are they ignorant of a clinic at Kottayam GMCH. They have no answers,” said Padma.

Also read : In a first, Kerala announces reservation for transgender students in nursing colleges

Interim order

Meanwhile, Justice Johnson John who considered the plea directed the registry to number the petition.

Also, the public prosecutor sought time for instructions on behalf of the respondents – the State Government, Law Secretary, Director General of Prisons and Correctional Services, and Prison Welfare Officer.

The case might again be heard a week later, said Padma.

Ahana, a sex worker, was arrested for allegedly possessing contraband substances and has been charged under the Narcotic Drugs and Psychotropic Substances Act, 1985.

Also read : Kerala government launches ‘Pride’ project to provide jobs for transgender persons

₹10 lakh compensation sought

Padma said the arrest itself was unjustified as the said contraband substance was seized from a customer who visited Ahana.

“How could she know what a customer is carrying with him? But that’s another matter. Our primary concern is denial of treatment,” said Padma.

Ahana has been undergoing feminising hormone therapy to undergo gender reaffirmation surgery for the past three years and thanks to the apathy of the jail authorities, the surgery will now get delayed, the advocate said.

“It is the responsibility of the state to ensure the welfare of the prisoners. But they had failed in it. Hence we sought a compensation of ₹10 lakh against this dereliction,” said Padma.

At the same time, the public prosecutor informed the court that proper directions would be given to the superintendent of the sub-jail to provide proper medical care to Ahana.

Challenges for transgender people

A study, ‘Equity Issues in Gender-affirming Medical Care in Kerala: A Reflective Commentary‘ published in the International Journal for Equity in Health on September 2023, highlighted that, “In Kerala, despite proactive policy and positive legal support, transgender individuals face many challenges in gender-affirming medical care which include lack of family support and equity-related issues concerning several social support institutions including health services.”

Government hospitals are still lacking in facilities for gender-affirmative healthcare.

“In the past, transgender individuals used to go to neighbouring states and undergo surgeries and some ended up with lifelong complications. From the survey and the available literature, it can be surmised that the gender transitioning process is a difficult phase due to a lack of family support and equity-related issues concerning several social support institutions including health services. This is despite a proactive policy framework in the state,” the study noted.

On the condition of anonymity, a member of the State Transgender Welfare Board told South First, “The petitioner’s plea before the High Court not only seeks immediate redressal of her medical needs but also draws attention to the larger systemic issues plaguing transgender welfare in Kerala. The court’s intervention is eagerly awaited to ensure that the rights and dignity of transgender individuals are upheld, and systemic barriers are dismantled to foster genuine inclusivity and equality.”

(Edited by Majnu Babu).