The COVID-19 pandemic has disrupted people’s lives around the world, including those of many marginalized people, who suddenly face additional burdens and vulnerabilities. The crisis of pandemic has impacts on all the sectors but the disparity in healthcare delivery and social security towards disadvantaged groups of the society has been reemerged at this critical time of Corona. The transgender community is one of the deprived communities of our society is being greatly threatened by this pandemic and its social consequences.
Early in the COVID-19 pandemic, it was common to hear, “the virus is the great equalizer.” However, this crisis quickly illuminated the deep inequities in obtaining access to the necessary building blocks of health. This is especially true for the Transgender community of Khyber Pakhtunkhwa, who being structurally discriminated group have been rendered more marginalized under the diseases’ double jolt and social distancing.
The transgender community has been uniquely affected by the pandemic in several ways, including the risk of exposure to the virus and its adverse outcomes, reluctance to disclose their health and socio-economic condition due to stigma and discrimination, delays in access to primary and transitional healthcare like gender-affirming care, and reduced access to social support, which is crucial to protecting against the effects of stigma and discrimination. Notably, these challenges are occurring alongside numerous legal and interpersonal challenges and attacks on transgender rights especially the right to health as provided under The Transgender Protection of Rights Act 2018.
COVID-19 and its emergency response have directly or indirectly disrupted the healthcare services in the majority of countries of the world. In a developing country like Pakistan, the outbreak of contagious disease has greatly challenged the healthcare system. Lack of basic health facilities, insufficient health policies, lack of gender-sensitive and inclusive healthcare structures, weak governance, and an indifferent attitude of the public towards general protective measures has further worsened the scenario. There is emerging evidence demonstrating that the aggravated crisis is adversely impacting the accessibility to healthcare facilities for the transgender community. Further, the economic instability (e.g., poverty, living in overcrowded conditions, reliance on informal economic settings like dancing or sex work, homelessness) shapes one’s risk for infection, and poor outcomes.
There are many challenges which community members are facing during the pandemic and few of them are very critical. Most of the measures introduced by the government, are focusing on women, senior citizens, and differently able and unable to address the needs of the transgender community. Due to a lack of strong and social support, the community members are more vulnerable to experience poor mental health issues as well. The mental health burden for being socially marginalized and psychologically stressed is already high among the transgender community. Socioeconomic constraints resulting from COVID-19, lockdown, meager access to health care, limited mobility, and unfavorable environment may further aggravate the psychological toll. Therefore, it is important to reach out to them and provide support.
Another key issue that needs to be addressed is the interrupted, restricted, or limited access to HIV healthcare services, for people living with HIV or are at risk of, who are facing a lack of access to health care services regarding their health complaints, and procurement regarding regular Anti-HIV medications (ART). Solutions and targeted programs are required from the community and governments to sustain prevention, testing, and treatment services during public health emergencies and to help the transgender community not only to survive but emerge from the crisis.
Although there is uncertainty over how long the current COVID-19 situation will last, the need will likely persist in the coming weeks and months. Measures must be put in place to ensure that marginalized populations have equal access to public health and safety services, and assistance to overcome the socio-economic impacts of the crisis. Government and other actors should consider the specific needs and vulnerabilities of sexual and gender minorities and ensure their voices are heard when creating responses to the COVID-19 outbreak, understanding that health is a universal right, and every person, without any discrimination of their sexual and gender identity, should be able to access healthcare services without any disruption.