'Hum Bhi Hai Insaan':
The Transgender Humanitarian Crisis during the Covid-19 Pandemic in India
Debapriya Ganguly and Rajni Singh
Kabhi mazdoor bhai, Kabhi doctors ke liye paani aaya
Hamara naam bhi mooh pe na aaya
Aise hum abhagye
Bhookh hume bhi lagti hai, Hum bhi hai Insaan
Marr hum bhi rahe hai, Ab to lo hume pehchan.
Amit Sharma, Hamari Bhi Karlo Insaano Me Ginti
Transgender or the third gender refers to people who transgress the rigid gender dichotomy. It is a political term encompassing a spectrum of atypical gender identities. In India, Hijra is the standard label used by the mass to refer to people who are seemingly 'born this way' and are categorised as the ‘other.’ This catch-all term, however, hides the 'complexity and diversity of the various subgroups of gender-variant people in India.' Transgender, in common parlance, is often synonymous with pre-, post-, and non-operative transexual people. However, it is incorrect to make this link as the transgender community in India is heterogeneous with its own complexity and cultural diversity. As Venkatesan Chakrapani explains, there are Aravanis, Kothis, Jogatas/Jogappas and Shiv-Shaktis in India. In exclusively heteronormative societies such as India, where heterosexual integrity (the sex of the body aligning with the gender identity) is essential, individuals who do not conform to this straitjacket-like societal order are deprived of agency and empowerment.
Stigma, on the basis of identity and its manifestation in exclusion and denial of basic human privileges is the everyday reality of the transgender community. Exclusion of members of the transgender community at social, political and economic levels and the interconnected issues of transphobia, internalised shame, abuse and neglect at state and community levels are contributing factors for the marginalization of transgender people. A study conducted by Deepika Ganju and Niranjana Saggurti, formulate a tripartite structure of stigma: 'felt stigma (shame/fear of rejection), internalised stigma (acceptance of negative feelings) and symbolic stigma (othering, blaming and shaming of marginalised groups/associated people).' This framework helps provide a deeper understanding of the systematic oppression that leads to transgender communities' hardships.
A report by the National Human Rights Commission, highlights that '92% of transgenders are highly deprived of the right to participate in any form of economic activities in India.' The study further highlights that '96% of transgender people are forced to take low paying work' such as begging or sex work (23 per cent) or the traditional badhaai which is demeaning and exploitative in nature. In addition, 29 per cent of transgender people have never attended school while 33 per cent have graduated with a degree. Furthermore, 1 per cent of the monthly income of transgender people is above Rs 25,000 while 26.35 per cent earn around Rs 15000.
Since the community largely exists in socioeconomically fragile settings and has low literacy levels, they are largely unaware of their healthcare entitlements. Studies suggest that members of the community suffer from chronic illnesses and are highly susceptible to HIV (17.5 per cent–41 per cent). Furthermore owing to the discrimination and psychological harassment at the healthcare sites and low priority status in healthcare regimes, members of transgender communities are unable to access life and health insurance schemes and are hence deprived of the privilege of living a life of quality.
Biological disasters such as the present Covid-19 pandemic redefine vulnerability and those who could be so defined. The transgender community in the present situation is extremely vulnerable owing to their gender and socio-economic margins: they experience a double burden. The present article attempts to throw a light on the crisis that the said community is facing owing to a lack of dialogue and inclusion in policy making.
As of 22 February 2021, the spread of the novel coronavirus (COVID 19) has taken 2.46 million lives globally, brought the world to a grinding halt, toppled the economy with a global recession around the corner, and has brought out glaring flaws in existing socio-political orders. The pandemic has laid bare the inequalities existing in the world. Rebecca Solnit comments that, theoretically, all of us are vulnerable to the virus, yet there exist specific sections of society who have been rendered even more vulnerable. In India, as of 22 February 2021, 156,000 deaths have resulted from this corona virus. The above lines from Amit Sharma’s short film Hamari Bhi Kar Lo Insaano Me Ginti (2020) (Count us as human beings too) attempts to start a dialogue on the misery that the transgender community is experiencing amidst the unprecedented lockdown in India. The word abhagye (unfortunate) highlights that while the world stands together in solidarity, the transgender communities are left to fight alone. The pandemic has forced the citizens of the world to ponder over what they have to do to deal with the crisis, and what others do not, and it is this difference which is important during the Covid-19 pandemic. Every person is dealing with the virus and its aftermath according to our socio-economic position in society. However, those who already live in the margins and have been systematically excluded and discriminated against in the socio-political, economic, healthcare and education frameworks are hanging by a thread.
The guidelines provided by the World Health Organization (2020) are simple and basic enough. The instructions urge people to wash hands frequently, practice good hygiene habits, clean objects and surfaces thoroughly, and, most importantly, to avoid in-person contact. However, in light of the critical situation and the past research on pandemics, there is a need to accept the truth that these guidelines can be followed successfully when we come from a place of privilege. The mandatory lockdowns in hopes of containing the virus, though necessary, have also exposed and exacerbated social inequalities. While some are working while braving the virus, some shifted to work from home and while some suddenly lost jobs and livelihoods. Among the last category are those in the transgender community who are daily wage earners. They have been hit very hard financially, among other aspects.
During planning crisis management meetings, there has been a lack of empathy and consideration towards those who live at the periphery owing to their socio-economic status and/or their sexual identities. While the economically privileged spend their days in isolation scrolling through their social media handles, the lockdowns hits those who have unstable employment, who live in cheek by jowl spaces and those for whom health care is too expensive and not easily accessible. There have been numerous scholarly and non-scholarly debates, arguments, and discussions regarding the exodus of migrant workers and their hardships in India. Still, there has been an almost collective silence about the similar or even worse difficulties of the transgender community.
Figure 1. Left to fight alone. Some transgender people in India with Rajni Singh (one the authors of this paper)
Source. Photo Courtesy of Raina Roy (a veteran trans activist). Roy and Rajni Singh conducted a study on transgender inclusivity in India for the National Human Rights Commission. Used with permission.
Heteronormative societies institutionalise individuals into associating deviance with perversion and something against the 'natural' order. This has resulted in the cultivation of hostility or what Indian political leader Bhimrao Ramji Ambedkar (1893–1956) referred to as 'social nausea.'
In India, social distancing has always been a socio-cultural phenomenon. It has been normalised and is a part of our routine lives. The practice of maintaining distance physically and ideologically has been in nexus with caste, class, and deviant sexualities since ages past. 'Social nausea', as propounded by Ambedkar in his critique of the caste system, results from the 'social isolation' of those who are considered low in the social hierarchy chain and necessarily means the exploitation and the invisibility of those oppressed. Those who have been oppressed are routinely excluded from discourses and socio-political and economic institutions. As a result of the antagonism developed by the dominant heteronormative patriarchal culture, which is exclusivist in nature, the transgender community is forced to be at the receiving end of stigma, discrimination and a spectrum of violence. The exclusivist nature and lack of recognition of the personhood and rights of transgender people are responsible for forcing them to live a life robbed of dignity, physical, emotional, housing, and financial security, education and, in the present health crisis, the right to safe and accessible sanitation and hygiene. Because of these factors, the community is at the receiving end of stigma, discrimination, and a spectrum of violence. The virus has simply added salt to their wounds with little hope sight.
The phrase 'stay safe and stay home' does not fit with the abysmal everyday realities of transgender individuals. Having been forced to leave their homes and being banished from their families in their early adolescent years the idea of home and security do not go hand in hand. Geographical and psychological homes have often been synonymous with humiliation, anger, rejection of self, and trauma for transgender people. Most of them separate from their biological families to live within traditional hijra households under the systematically organised guru-chela system. The hijra households are alternate familial structures that provide security, acceptance, and recognition for those who do not conform to the dichotomous gender taxonomy.
In a study conducted by the Water Supply & Sanitation Collaborative Council (WSSCC) and Freshwater Action Network South Asia (FANSA) entitled Leave No One Behind: Voices of Women, Adolescent Girls, Elderly, Persons with Disabilities and Sanitation Workers, the researchers bring home the fact that owing to prejudice, the transgender community faces a Herculean task in finding decent living spaces. This is a classic reflection of the thought that in heteronormative societies, the fundamental right of housing is a privilege, and those who do not conform to a specific societal order are refrained from accessing this right. Hence, members of heteronormative communities are forced to accept accommodation in rented places, paying double the rent, located in highly congested areas with poor living conditions. Sanitation, which has been recognised as a global human right, is not easily accessible for the transgender community. Those living in shared shelter spaces with their guru or those who are living in huge numbers in single-room accommodation often share toilets. With numbers over thirty, people living in such accommodation often choose to defecate in the open.
Moreover, the lack of gender-neutral toilets and the harassment and violence that transgender people are subjected to when they approach either a toilet for males or one for females, restricts them from good hygiene practices. The simple relief that one experiences while going to the toilet has always been a cause of worry for transgender persons. In light of these arguments, existing conditions leave simply no room for maintaining social distance and hardly any conducive facilities in which to practice hygiene and sanitation.
According to the statistics provided by the National Sample Survey Office (NSSO) on housing and sanitation, a third of the rural population and half of the urban population live in housing spaces where isolation and self-quarantine is simply not possible. Thus, as has been highlighted, for those transgender people who are living in extremely congested areas, 'social distancing' seems a far-fetched idea. Furthermore, as the report highlights, the supply of water in places like slums comes from communal sources and, owing to long queues and people struggling to gain access, transgender people are further excluded. These conditions make it challenging to practice hand hygiene and get clean drinking water, among other factors. Owing to the inability to access safe hygiene spaces, transgender people are highly susceptible to urinary tract infections, and, considering this pandemic event, they face a double health crisis.
The need to practice social distancing has become a burden for those who earn a living through daily social interactions. The existing widespread transphobia and the corresponding lack of opportunities and discrimination keep transgender people out of jobs that come with financial security and they are forced to pick up professions that are devoid of respect, dignity and are mostly unacceptable in society. Most people from the transgender community earn a living through begging, sex work, and through the traditional methods of seeking alms in functions and ceremonies—that is, basti badhai. Anecdotal reports in newspapers, suggest that there has been a significant drop in the earnings of those who used to beg in the local train compartments in metropolitan cities like Mumbai and at traffic signals. Begging in public places allows them to earn a meagre income anything ranging from ? 500 to ? 1100 (US$ 6.90 to US$ 5.90) daily, which helps them buy food and puts a roof over their heads. Due to the complete Covid-19 shutdowns and the fear of police brutality, the community struggles to acquire basic amnesties like food and medicine. The privilege to work from home hence is not practically possible for these community members.
Financial insecurity has brought to the transgender community the impending threat of losing their homes and a hunger crisis. The transgender people have already been bearing the brunt of exploitation by property owners. The virus has served to exacerbate discrimination against them. Recently, posters put up in Hyderabad, warn citizens not to talk to transgender people as they might be potential carriers of the virus. This is an example of hatemongering, which is responsible for pushing the community even more to the margins. While some landlords have been understanding, some have demanded even higher rents or have ordered them to leave the houses. These events are not isolated. They have emerged from the general order of the workings of society. It has often been noted that homes are readily available to only those who have 'respectable' jobs, come from good families, and are dominantly heterosexual. It has always been challenging to access decent accommodation for those who do not conform to the acceptable, often heteronormative requirements of property owners. Thus, transgender people who have always been considered repulsive, face even more difficulties.
While there has been much discussion about the migrant labourers returning home and the hunger pangs they experience while walking home, there has been no talk about what the transgender people would do in pandemics. Unlike the migrant labourers who generally confirm to the heteronormative patriarchal order, the transgender people, as has been argued before, have no safe homes to return to. Where do they go? Moreover, with limited income and even more limited savings, the members of the community complain that their savings are being exhausted as they struggle to keep food on their plates. The situation has turned into a nightmare for those who are aged, disabled, or are not in condition to look for alternative ways to earn money. Transgender activist, Laxmi Narayan Tripathi, rightfully asserts that members of the transgender community are more likely to die from hunger than coronavirus. The haunting silence about the woes of transgender people is very disturbing.
Another crucial aspect that needs serious discussion and immediate consideration in the Indian public health system is the treatment of corona positive transgender patients. Past studies have highlighted that those who have low socio-economic status are more prone to lower immunity and poor physical and mental health as proper healthcare is not easily within their reach. An already overburdened public health management system, during a global pandemic system has proved to be even more problematic for transgender people.
As Dr. Aqsa Shaikh, an assistant professor in Hamdad Hospital, New Delhi, asserts, transgender persons are already at risk of Covid-19 in terms of their physical and mental health owing to low levels of immunity. Due to discrimination and transphobic healthcare systems, many transgender persons refrain from approaching systematic healthcare, and the pandemic has further put them in anxiety-producing situations. Rudrani Chhetri, a transgender activist, recalls an incident where, a friend, who approached a shopkeeper to buy sanitisers, was the victim of transphobia. The response that the friend and other transgender people receive from those who are supposed to help is highly insulting. The friend was asked: 'How can you people also get the virus?' This, and other similar responses and attitudes are a reflection of the historical association of impurity with those who are in the position of the marginalised, thus the 'social nausea.' Moreover, Dr. Shaikh remarks that a crumbling and over-pressured health system is accessible to select, privileged people. Those who have always been ostracised, marginalised and shunned will eventually be neglected even further.
Recent reports throw light on incidents where the transgender corona positive patient suffers as healthcare practitioners are unable to decide which quarantine ward should they be placed in. The system of gender-binary wards has the potential to be traumatic for transgender positive persons. The general apathy resulting from a lack of transgender sensitisation regarding the humiliation that individuals face in gender-binary isolation wards needs to be investigated. Furthermore, the inability to access antiretroviral therapy and the delay in sex reassignment surgeries has added further causes of woe.
Those living in hostile homes during the lockdown are dealing with dysphoria, confusion and anger. Lack of communication channels in families has taken a toll on the mental health of transgender people as their needs and interests are not taken care of. Those who had had their gender conformation surgeries done immediately prior to or during the pandemic crisis were unable to go for reviews as there were no doctors available in outpatient departments (OPDs).
With the social media timelines flooded with posts of citizens clapping and banging plates, in messages of gratitude for our healthcare workers, to posts of sympathy towards the migrant labourers, to celebrities becoming heroes for sending home the daily wage labourers, we are yet to see similar posts which discuss the plight of members of the transgender community. The relief measures, the Pradhan Mantri Garib Kalyan Yojna, offered by the Indian Government makes no attempt to address the transgender community. There are 488,000 transgenders in India according the 2011 Census. The grant of ?1500 provided by National Institute of Social Defence (NISD) proves to be a drop in the ocean as most people do not have the necessary documents and bank accounts to avail themselves of the benefits. At the time of writing, Kerala has been the first state to provide relief kits to the transgender community, and Manipur has established the first transgender isolation ward. Earmarked beds for transgender people in the M.R. Bhangur hospital in Kolkata has come as a relief to the community. Activists like Grace Bhanu and organisations like Milaap and Mist have begun crowdfunding campaigns to reach out to the communities to help them survive the pandemic. Yet a lot more needs to be done.
Pandemics are interconnected directly with social inequality. The mass spread of the virus, despite strict lockdowns, is because of those who lie in the lower sections of society being unable to deal with the pandemic. The pandemic has worsened conditions for transgender people. It is crucial for the government to bring in schemes that recognise the various transgender communities' individual needs and rights. It is only when each section of the society is safe that the pandemic can be controlled. There is a need for greater representation in government policies, schemes and decision making, which gives transgender people the security that is much required lest another pandemic should strike. The post-pandemic world has to be based on equity and inclusivity so that every one of us stands together, and no one is left alone to fight their own wars.
 English translation of the above-mentioned quote from the short film, Hamari Bhi Karlo Insaano Me Ginti by Amit Sharma:
You shed tears for labourers, and even for doctors,
Our names did not come upon anyone’s lips, that's how ill-fated we are,
We feel hunger too, even we are humans,
We are dying too.
At least now count us among human beings.
Amit Sharma is an Indian Bollywood film director who is best known for his 2018 film, Badhaai Ho.
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