Access to health services: Barriers faced by the transgender population in India

Objective: To critically appraise the literature characterizing unique health needs, barriers to access healthcare services and propose research as well as programmatic priorities for interventions to overcome them. Method: Using scoping review, we appraised peer-reviewed published studies and gray literature from three databases, PubMed, PsycINFO, and Google Scholar. The literature included a total of 67 articles met the inclusion criteria for a review. Results: The review highlights that transgender individuals live on the margins of society, facing stigma, discrimination, socio-economic and educational exclusion, violence, and poor health including mental health. Transgender individuals experience difficulties accessing quality healthcare services, whether general health needs or specific to their gender needs. Key barriers to access health services reported were discrimination at healthcare facilities, lack of treatment protocols, low health literacy, and poor healthcare-seeking behaviors among the transgender individuals. Other barriers include: their education, gender-based violence, socio-economic barriers, lack of health insurance, exclusion from social protection schemes, and health systems barriers. Conclusion: Transgender individuals in India are deprived of right to healthcare. A rights-based approach for programming and research should be prioritized to address barriers to healthcare services.