♿Healthcare Discrimination

In healthcare settings, discrimination takes place due to a lack of affirming and non-discrimination policies, training of personnel, and monitoring and evaluation of the programmes and practices. Many LGBTQIA+ people report misgendering practices at healthcare facilities, including staff calling them by their IC name, being mocked and ridiculed by staff, or being advised by healthcare professionals to change their behaviour instead of treating their healthcare issues. They are also often asked probing and irrelevant questions regarding their sex life by healthcare professionals, or prescribed religious counselling or conversion practices to “cure” their SOGIESC identities.

These discriminatory attitudes create an environment of distrust towards the healthcare system and affects LGBTQIA+ people’s health seeking behaviour and access to healthcare. They may also be unable to disclose an accurate and honest description of their health history due to fear of discrimination. A study by CERIA confirmed that criminalisation, discriminatory laws and policies, and religious approaches contributed to poorer health-seeking behaviours. The respondents in the same study showed low knowledge of HIV and sexual health, shame and stigma with condom acquisition, and internalised self-blame due to societal pressure to ‘return to the right path’.

Besides general common health needs, such as treatment for physical and mental illness, pain, and disease, transgender and non-binary people may require specific healthcare treatment for gender dysphoria. Gender-affirming treatment includes gender affirmation surgery, access to counselling, and hormone replacement therapy (HRT). These options are inaccessible at most government health facilities, requiring trans people to seek them out from private facilities, at a much higher premium. Many choose to purchase hormones on the black market and self-administer them, a practice which comes with significant risks to their health.

Case Study: Misgendering During Hospital Admission

A trans woman was admitted to a government hospital ward due to dengue fever. She reported that hospital staff, patients, and even visitors looked down on her due to her gender identity. She became a topic of gossip among the hospital staff during her admission and even overheard the staff calling her “pondan” instead of referring to her as a woman. She requested an early discharge from the hospital due to discomfort.

Key Takeaways

• The patient’s SOGIESC drew the focus of medical staff even though she was admitted for an illness unrelated to it.

• She faced invasions of privacy from hospital staff, patients, and even patients’ visitors. Medical staff displayed discriminatory attitudes towards the patient and used slurs when discussing her.

• The patient was driven to pursue an early discharge, which could have negatively impacted her health outcomes from dengue fever.

What does this have to do with remedies?

The patient may not have been aware of her rights and the availability of a reporting mechanism.

In this case, oversight bodies can improve public awareness by advertising their complaint mechanism in hospitals (both public and private) and making it clear that their services extend to LGBTQIA+ people. This can be done by including examples. For example, trans and non-binary people who have faced slurs or verbal violence from hospital staff can lodge a complaint with the said oversight body.

Source

• SUHAKAM, Study on Discrimination Against Transgender Persons Based in Kuala Lumpur and Selangor, 2019