Pakistan expands health insurance for trans people

Colin Stewart is a 45-year journalism veteran living in Southern…

The government of Pakistan has added trans people to a health insurance program that previously covered only Pakistanis living below the poverty line.

Imran Khan, prime minister of Pakistan: Our government is “taking responsibility” for trans people. (Photo courtesy of Hindustan TImes)

The program is aimed at combating the social exclusion of transgender people in the deeply conservative Muslim-majority country, where homosexuality remains a crime.

Thomson Reuters Foundation reported:

All transgender people are now eligible for medical treatment including reconstructive surgery under the program, which originally was set up to enable poor and marginalised communities in Pakistan to access healthcare.

Prime Minister Imran Khan said his government was “taking responsibility” for trans people, who say they are routinely denied treatment and can face harassment or ridicule from hospital staff and patients.

Hospital staff often associate them with prostitution and HIV/AIDS, they say.

“It is part of a grand programme to provide health insurance not just to the poor but the vulnerable sections of society, including … transgender (people),” said Zafar Mirza, a special assistant to Khan.

The insurance provides 720,000 Pakistani rupees ($4,670) worth of coverage a year for treatment of all ailments, including cancer and heart disease, Mirza said. The existing program issues health insurance cards to anyone earning less than $2 a day, although transgender people will not face that test.

Transgender Pakistanis gained recognition in 2009 when the Supreme Court granted them equal rights, ruling that they could be categorised as a “third sex” on national identity cards.

They were counted for the first time in the 2017 national census, which recorded 10,418 in a population of about 207 million, though charities estimate there are at least 500,000.

Many live outside mainstream society, earning a living as dancers or forced into sex work or begging.

Zehrish Khan, project manager for transgender rights group Gender Interactive Alliance, welcomed the government’s move, but said more needed to be done to ensure equal access to care.

Only fraction of the trans population would get insurance as those who had not registered themselves as third gender on national identity cards for fear of being stigmatised would not be eligible, she said.

“The scheme is good but healthcare providers need to be sensitised,” said Khan. “Many of us resort to drugs and alcohol because we need psychiatric help and empathy to overcome the continuous harassment we face.”

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