TW: Medical transphobia, Medical trauma

The TWEET Foundation (TWEET is short for Transgender Welfare Equity and Empowerment Trust) is an organisation formed of trans people, run by trans people and working for trans people.

The community-based organisation (CBO) was registered in 2015, with a mandate of working towards the welfare, equity and empowerment of trans people.

“It took us a couple of years to get the TWEET Foundation registered because of the red tape involved. A lot of us had our deadnames on our documents so that was another hurdle,” explained Abheena Aher, one of the founding members of the CBO and a trans rights activist.

They have had two co-chairs since the beginning, on principle. One of them is always a trans man and the other, a trans woman. In doing so, they aim to change the notion about trans men and women not coming together, by enabling them to work with each other on an equal footing.

Healthcare Is HIV-Centric, Other Needs Ignored

One of the CBO’s founding members and the current co-chair, Maya Awasthy, is a trans woman from the Hijra community.

“Most organisations working with Hijra and trans communities focus on HIV- and STI-centric healthcare. But, as trans people, we have needs and aspirations beyond that,” said Awasthy.

Given Aher and Awasthy’s prior experience of working in the advocacy space, the 45-year-olds joined hands with others from the community and formed the organisation with the aim of tending exclusively to the needs of trans people—be it accessing primary healthcare, educational and skill-building initiatives, or helping them update their legal documents.

The TWEET Foundation also aids the trans community’s access into gender-affirmative healthcare, like surgeries and hormones. “Most trans people haven’t had the opportunity to finish their education or find a well-paying job and yet, we are somehow supposed to amass lakhs of rupees for procedures which should be available free-of-cost,” rued Aher, an activist with 25 years of experience working with trans communities.

She also spoke about how trans surgeries are treated as a money-making business by private hospitals and the like. “There are so many genital complications, because to them we are guinea pigs, not human beings.”

Has Legal Recognition Changed Anything?

The Supreme Court reaffirmed trans people’s right to self-identification i.e., I am trans because I say I am trans, in a landmark judgment in 2014 (referred to as the NALSA judgment).

Although the judgment was progressive, it has since been superseded by a regressive Trans Act, which talks of a ‘screening committee’ who will certify and therefore, qualify trans people as being trans.

Not only this, the Act also compels trans* people to undergo surgical procedures if they want to identify within the binary.

“The NALSA judgment enabled trans people to be more vocal about our transness, but things on the ground haven’t changed much,” regretted Awasthy, an activist with over 15 years of experience.

She recounted an incident where cops accused her of soliciting as she was walking down the road, just because of her non-conformity to the gender binary; at the time of this incident she was wearing a tee shirt and pants, while her hands were decorated with mehendi.

They let her go after she told them about her background in the advocacy space and threatened to call other Hijra women, who would raise a hue and cry.

But not everyone has the privilege to fight back. Awasthy spoke of trans-women being denied treatment by doctors, just because they are trans. “Trans women, who go to hospitals seeking medicines
for common ailments like fever, are often rebuffed, for no fault of their own.”

Health Professionals Need to Be Sensitised

Gautam Ramchandra, a board member of the TWEET Foundation, had something similar to say. “When I was trying to onboard queer-affirmative doctors for a digital platform (SafeAccess) in 2019, I was shocked to see their dismal attitude towards, and awareness about, our healthcare needs.”

The 23-year-old program coordinator managed to onboard only three out of the 25 doctors he met with in Lucknow. “A couple of them just asked me to leave in a very rude manner, while some others spouted nonsense like gay men are responsible for spreading AIDS.”

Mental Health Needs To Be Addressed

Ramachandra was earlier managing a shelter home for trans-masculine people, run by the TWEET Foundation in Delhi. He lived there for about six months during the first lockdown.

It was in this period that he understood that merely providing a roof over the heads of trans people is not enough. One also needs to address their mental health issues, which are grave due to the persistent discrimination arising out of transmisia.

Dinner table conversations at the shelter would often take a dark turn, as the trans-masculine people living there opened up about their abusive families and the resulting isolation, one after another.

Considering that therapy is neither accessible to, nor affordable for, everyone, Ramachandragot trained as a peer support provider.

“I would feel helpless listening to some of the trans-men at the shelter. Most trans-men and non-binary folks I have spoken to, whether at the shelter or even otherwise, experience some form of suicidal ideation [at various points in their lifetime].”

Although he doesn’t want to diagnose anyone, he has also noticed anxious and depressive tendencies while interacting with the trans-masculine community.

Aher pointed out that even the Trans Act has no provisions addressing trans-people’s mental health. She is also of the opinion that those trans-people who curry favour with the government get appointed to welfare boards and trans-caucuses, but they are hardly ever successful in spotlighting the kind of support that trans people so desperately need.

What About SRHR?

Apart from mental health concerns, the sexual and reproductive health and rights of the trans community is rarely talked about. “For instance, if a trans-masculine person wanted to get pregnant, which gynecologist would understand this?” questioned Ramchandra.

Sensitive and non-judgmental health professionals are so hard to come by. Aher elaborated, “Some psychiatrists ask really personal questions about one’s sexual history, for no reason.” She also recounted a distressing experience when a doctor from a public hospital called 10-12 of his juniors to look at her genitals, without her prior consent.

Ramachndra opined that although there are international resources available, such as those by the WPATH (World Professional Association for Transgender Health), not everyone has the luxury to refer to them and figure out one’s sexual and reproductive needs by oneself. Trans-affirmative healthcare (be it physical, mental or sexual) providers go a long way in paving the way for trans people to be their truest selves.

The House Of Dignity

The TWEET Foundation has recently opened the doors of a second shelter home for the trans masculine community. Many trans people are forced to run away from home and so, they are left without a place to stay.

The shelter house is in Mumbai and is called Garima Greh (the house of dignity), and celebrated raksha bandhan with great fervour this year. Trans-women tied rakhis around the wrists of trans-men, who have probably never been respected as men at their birth-homes.

The caption on their Instagram post, to do with the festival, read: “The festival of raksha bandhan denotes the promise of togetherness… A promise to be with each other in giggles, in cry, in pain, in joy. To all the trans people out there, family isn’t by blood, it’s by bond…”