- Amnesty International’s latest report highlights the need to address structural barriers undermining transgender people’s rights
By Shailendree Wickrama Adittiya
Communities across the globe were faced with uncertainties, difficulties, challenges, and risks due to the outbreak of the Covid-19 pandemic, but it is fair to say that the pandemic affected some groups differently, and in ways that were usually overlooked. Transgender people make up one such group, and Amnesty International recently released a report titled “Pandemic or not, we have the right to live”, which looked at the urgent need to address structural barriers undermining transgender people’s rights across Asia and the Pacific.
Issuing the report, Amnesty stated that “transgender people – who were already subject to deep-rooted and persistent structural inequalities – found their pre-existing marginalisation exacerbated by the pandemic and related public health measures, and suffered disproportionately”. The report documented the experiences of transgender people in 15 countries, including Sri Lanka, between March 2020 and August 2022.
Gender-affirming care
One of the key topics discussed in the report was regarding gender-affirming care and the reduced access to such due to the Covid-19 pandemic. Amnesty International quoted a transgender man living in Sri Lanka as saying: “The main difficulty transgender men have faced is getting hormone medicines. When their hormone stocks finished, they couldn’t go to the hospital to get medicines because of the curfews. At times, they also couldn’t complete the process to get their gender officially recognised, because clinics were closed, and surgeries got delayed.”
The report states that a range of gender-affirming services, including surgery and hormone therapy, were significantly disrupted alongside other types of healthcare during the pandemic.
“In Sri Lanka, for example, a 2020 Asia Pacific Transgender Network (APTN) report highlights that gender-affirming surgeries were postponed and cancelled, with no information provided about when they might resume.”
This disruption of treatment could lead to a return of features associated with the sex assigned at birth and/or trigger symptoms of depression and anxiety, particularly when experienced alongside social isolation and a lack of support networks, high levels of societal discrimination and harassment, and possibly existing mental health issues, Amnesty highlighted.
Eligibility for relief
Relief measures played a crucial role in keeping communities alive during the pandemic. With many facing a loss of income as well as a restriction of access to essential items, relief aid and Government support helped vulnerable communities. However, the Amnesty report highlighted that in some cases, the eligibility criteria for these relief measures were unclear and/or discriminatory.
“Transgender men in India, Pakistan, and Sri Lanka, for example, told Amnesty that transgender men were not explicitly recognised in Government support schemes for daily wage workers,” the report states.
Identity document requirements were seen as a key barrier, with many Covid-19 relief measures in the region linked to official ID documents. This posed challenges to transgender people without such documents. Transgender people, along with others working in the informal sector, were often also unable to provide documented proof of income.
The publication adds that APTN’s partners in Sri Lanka, as well as India, Indonesia, Nepal, and the Philippines, reported that many transgender people were unable to register for relief support because of the difference between their identity documents and the way they physically presented.
Housing
Transgender individuals who found themselves unable to afford rent and could not access shelters often had to return to their birth families, many of whom were not supportive of their gender identity. Those who were in the process of transitioning, but had yet to disclose this to their families, found themselves at particular risk of harassment and abuse by their families, the report stated.
“Those trans men who were working in the urban areas had to return to their homes to their parents. It was a problem because some of them hadn’t told their parents they were going through the (physical transition) process. It was very difficult for them to go back home with their new appearance. Some of them were scolded and treated very badly. They called me and repeatedly told me, ‘I don’t want to stay with my parents. I would rather kill myself’,” the Amnesty report quoted a transgender activist in Sri Lanka as saying.
Impact on mental health
The report also looked at the impact the Covid-19 pandemic had on the mental health of transgender people, stating that the impact of discrimination and stigma on the mental health of these communities was a concern long before the pandemic. However, the deepening of structural vulnerabilities during the pandemic have likely also acted as additional stressors.
“Interruptions in gender-affirming treatments also had detrimental effects on transgender people’s mental health,” the report stated, adding that a 2021 study of 63 countries found that since the beginning of the pandemic just over 35% of transgender respondents had had suicidal thoughts, and 3.2% had attempted suicide.
LGBTI and trans-specific organisations have also recorded further increases in individuals reporting suicidal thoughts, depression, anxiety, and other mental health issues since the start of the pandemic.
“Representatives of LGBTI and transgender rights organisations in Bangladesh, China, India, Indonesia, Malaysia, Pakistan, Singapore, and Sri Lanka told Amnesty in interviews that they received a higher volume of calls to their helplines about anxiety and depression amongst transgender people during the pandemic,” the report went on to state.
Amnesty International highlighted that key sources of wellbeing and resilience for transgender people are members of their own communities, but that there is evidence that shows that the loss of social support resulting from lockdown and social distancing measures deprived transgender people of a critical source of support in the face of discrimination.