In my previous blog posts, I’ve written about my initial impressions in India. I’ve discussed my fascination with the concept of borders—physical as well as psychological ones—and the ways in which our minds often construct faulty comparisons as a means of overcoming the discomfort of difference. Since my previous posts, I have started my work with Swasti, a public health resource centre in my host city of Bangalore, and learned even more; this time, not about erratic driving habits, but about public service, passion and an indisputable vision.
Established in 2002, Swasti is driven by a dream of achieving public health outcomes for those who are socially excluded and poor. Through the implementation of different community engagement modules and field research programs, and by adopting an interdisciplinary approach that addresses three core components of positive community wellness—behaviours, systems and social determinants—Swasti seeks to empower groups that are often excluded by the government and policy sectors in India, namely female sex workers and sexual minorities. Swasti’s three-pronged approach was informed by extensive research, which demonstrated that there is a fundamental gap between the theoretical framework of policies designed to serve these communities and the realities faced by members of these communities (I will discuss this further in a little bit).
At Swasti, I am assisting staff members in the creation of a business proposal for the Generation Youth (GenY) Initiative, a program that, unlike those catered towards adults, is specifically designed to serve transgender and gender nonconforming youth. It is based on a truth that has been demonstrated time and time again by educators, psychologists, clinical social workers and health care professionals all over the world—that is, that childhood and adolescence mark a critical period during which an individual acquires values, beliefs and skills that shape the rest of their lives. In recognizing that the social marginalization of transgender people begins early in one’s life and contributes to high rates of poverty and illnesses such as HIV/AIDS later in life, the GenY Initiative hopes to introduce young people to various support systems that, when accessed, will decrease the likelihood of acquiring these negative health outcomes.
The transgender community is among the most vulnerable in India, and throughout history has endured intense discrimination, prejudice and violence, not only from healthcare professionals and law enforcement, but from family and community members as well. Transgender youth, in particular, face immense challenges. In a disturbingly high proportion of cases, families and communities disown these children and refuse to provide social, emotional and financial support. Educational institutions and employers routinely discriminate against—and in some instances, even deny admission to—young people who are transgender and gender non-conforming. These prejudices accumulate and leave these youth with little option but to flee from home into a world of uncertainty, where social resources are incredibly difficult to access.
While it is true that social protection programs do exist, an overwhelming proportion of these services are inaccessible to an overwhelming proportion of the transgender community. Many social service programs require that individuals obtain legal documents such as a proof of residence and voter’s identification card—documents that are incredibly difficult to acquire if the person is estranged from their home. Laws that require transgender people to verify their gender identity before a government-sponsored medical committee only exacerbate the difficulties. To understand how problematic this mandate is, imagine having to consult with a psychiatrist and government official in order to have your preferred gender identity included on your driver’s license. Policies are only effective when they consciously consider the unique needs of those they are supposed to theoretically assist.
In addition, many of the policies currently in place fail to consider that the bodily autonomy of transgender individuals in India often lies with somebody else, such as a partner, family member or community leader. The inability to make independent choices about one’s reproductive health presents a particular nuance that has to be considered by any intervention service. For instance, how can policy makers expect members from this community to routinely use government-sponsored contraceptives when doing so leads to violence or neglect from a romantic partner?
These disparities in policy are numerous, but can all be attributed to one fundamental error: the lack of inclusion of marginalized communities in the sociopolitical landscape. When we ignore this error, we contribute to the preposterous belief that marginalized populations are simply not standing up for themselves, or are doing so in a socially divisive manner. But the problem, as I have seen through my work at Swasti, lies not in the refusal of the oppressed to voice their concerns, but in the reluctance of those in privilege to listen, empathize and act.
This concept has without a doubt been the source of much debate throughout history and time, and is elaborated further by Gayatri Spivak, an Indian scholar whose groundbreaking essay, “Can the Subaltern Speak?” dynamically challenges the colonial mindsets that are often employed in the analysis of marginalized groups. In the case of the transgender community in southern India, the current situation is that the toxins of disease, poverty and ignorant policy are preventing this Subaltern from speaking. Swasti is founded on a dream of changing this narrative, and is in many ways a response to Spivak’s piece. I am incredibly grateful to learn from this movement and from the people whose souls refuse to rest.