Some Tamil Nadu government hospitals have been forcing transgender persons to undergo unnecessary medical examinations in the process of getting their transgender identity cards, according to activists. In at least one district government hospital, trans women who’ve sought medical certificates in order to apply for their transgender identity cards, were made to undergo a lower abdominal scan to ‘ascertain’ their gender — a procedure that is unscientific, unnecessary, and humiliating.
Janani (name changed) from Tamil Nadu, is among 45 trans women who had recently applied for the state government’s transgender identity card. As part of the procedure, Janani was asked to come to the district medical college hospital in October-November 2020 where a team of doctors signed off on her gender identification statement. However, Janani was surprised when she received a call in January from one of the local community leaders. “They said that we have been asked to come to our district medical college for a scan and told us that the procedure for issuing identity cards has changed since the last time. She said that only if the scan report is attached to our application, we will get our cards,” Janani told TNM. She was then made to undergo a lower abdomen ultrasound, she said.
“We were scanned in the presence of so many strangers,” Janani said, “All I am asking is where is it mentioned that a scan is mandatory? Nobody else in our community who got their identity cards earlier were asked to sit for a scan. This is the first time I am even hearing of this 'rule',” she said. (The name of the district and the hospital is being withheld as the beneficiaries fear they may face retaliation from the authorities.)
According to the Transgender Persons (Protection of Rights) Rules 2020, a trans person seeking gender change certification and identity card needs to provide reports of medical interventions for gender affirmation, if they have undergone any such procedures. “The District Magistrate shall, on receipt of an application referred to in sub-rule (1) shall verify the genuineness of the said medical certificate, which shall not include any physical examination,” the rules state. The NALSA vs Union of India judgment of 2014 from the Supreme Court says that there is no need for any medical examination for gender identification, and that trans persons can self identify their gender.
Shalini Muthukumar, a trans woman who is in the know about the incident, said that when the members from the community questioned the staff at the hospital about the need to conduct lower abdominal scan, they were told that it was the District Social Welfare Officer (DWSO) who had mandated this. “The DSWO told us that the Dean (of the college) wanted us to go through the scan as part of the procedure. There is no such procedure and nothing that specifies this is mentioned in any government order. It is merely for his own curiosity,” Shalini alleged.
According to lawyer Sathyashri Sharmila, the Tamil Nadu government has been following the old procedure for gender identification even after the NALSA judgment by the Supreme Court. Sathyashri is India’s first out-transgender woman to be enrolled in a state bar council.
“As per NALSA (National Legal Services Authority Vs Union of India) judgment, it is very clear that there should not be any physical examination and that it should be certified only based on self-identification. In Tamil Nadu, the Tamil Nadu Third Gender Welfare Board has been following the procedure including a sonogram and a physical examination since beginning. This has been followed from before NALSA judgment. Now after NALSA judgment, this should have been changed, but I am not sure if a Government Order has been issued in this regard,” she said.
Adding that even under the Transgender Persons (Protection of Rights) Act 2019, self-identification is cited to be enough to certify a person as transgender, she said, “In Tamil Nadu, they are still following the old procedures only. And these are human rights violations as per NALSA judgment and Trans Act.”
As per NALSA judgment of 2014, “Transgender persons’ right to decide their self-identified gender is also upheld and the Centre and State governments are directed to grant legal recognition of their gender identity such as male, female or as third gender.”
Alleging human rights violation, Shalini said that the transgender identity card is an entry point to receive basic benefits like pension from the government. “Among those identifying as trans persons, many might not have undergone gender affirmation surgery due to multiple reasons. Many choose to remain in a male's clothes even if they identify as a trans woman. So basically, this card helps us assert our identity in case of issues like getting harassed and going to the police, apart from getting social benefits,” she explained.
Drawing a comparison with the legal system which accepts the word of a man and a woman regarding their gender identity without the need to subject them to a physical exam or a scan, Shalini questioned why transgender persons are subjected to this humiliation. “The NALSA judgment clearly says that there is no need for a physical examination in these issues. Importance goes to self-identification. We are taking the words of a man and a woman when they say they are a man and a woman. So why can't they accept us as trans women when we say so? Why do we have to undergo so many procedures? Are you going to give us thousands and crores of rupees every month?” she asked.
Writer and a sexual minorities activist A Revathi told TNM that the motive behind such illegal determination of gender must be questioned. “They (the government) are not asking a man or a woman to reveal their private parts to certify their gender. In such a case, why should a trans person alone be subjected to this? I find this really ridiculous and is a gross human rights violation,” she told TNM. Adding that the country and the state governments must provide absolute respect to the NALSA judgment of 2014, Revathi said that the motive behind the government officials carrying out such illegal procedure is unclear.
Activists also highlighted how the procedures have been made difficult for transgender persons to obtain the identity cards issued by the government. “Currently, if I want to change my gender in my certificates after I have obtained by transgender ID card, I am asked to go to my school where I studied and start the process from there. Practically, many people who come out as transgender are disowned by their families and societies and several people even have death threats against them. How does the government expect us to go back to where we spent our childhood and get these things done?” Grace Banu, a Dalit and a transgender activist pointed out.
The district social welfare officer from Tamil Nadu where the said issue happened told TNM that her duty ends with submitting a list of people who have applied for transgender identity cards to the district government hospital authorities. “My duty ends with giving the Dean the list. Beyond that, they (medical officers and screening committee) determine the process to be followed,” she said.
The Dean of the government medical college which has been accused of scanning transgender persons denied having issued any such orders. “I have not met any transgender (person) in the past 10 months i have been officiating. I haven't met anybody nor have I insisted any such thing. Because we have only been COVID busy and now students have come and we are trying to restore the college. We have not given any such instruction,” he told TNM.
TNM tried contacting the District Collector for his comment on the issue. The story will be updated as and when he responds.
(*Name changed to protect identity of the person)