Kiran Nayak. B (he/him) is a trans disabled person and an award winning social activist with varied experience working on transgender and disability issues across states. 34-year-old Kiran hails from a tribal agricultural background in rural Telangana. Kiran, who has an orthopaedic disability, focuses on building networks for trans persons and on improving their access to mental health and sexual and reproductive health services and with a crisis intervention approach towards violence towards trans and queer people with disabilities in India. In 2020, Kiran founded two groups: Karnataka Vikalachetanara Sanghatane (a network of people living with physical, virtual and all other forms of disabilities across Karnataka) and Society for Transmen Action and Rights group (a network for trans persons in Andhra Pradesh and Telangana).
Please describe your disability and sogie*.
Kiran Nayak: My disability is the orthopedic disability (polio). After 3 years of my birth, my disability affected me and I identify as a transman.
Are you able to leave the house on your own or do you require help?
Kiran Nayak: I can leave the house on my own. I am a wheelchair user.
How often do you have to access healthcare for your disability? Is the health service affordable? Are medications and follow-up interventions affordable?
Kiran Nayak: Both in terms of my physical disability and transness, I face a lot of issues that require medical care. I can talk about my disability rather easily to the healthcare professionals but talking about transness is very, very difficult, which leads to even more (psychological and physical) health issues. Although there are a few government hospitals nearby, there are no private hospitals. Although they are very expensive and are accessible to very few of us, it is a bit easier to navigate in private hospitals. Medicines that are needed for trans people (for example, testosterone) aren’t available locally. You have to go out of your place to cities to get this. The government is also mostly never supporting trans people, which creates a lot of problems.
Are you currently covered by any of the health insurance or health coverage plans?
Kiran Nayak: No. There are not even any specific policies for trans people, except for LIC but nobody at the administrative, district, and state level is supporting trans people access it. Everybody talks about us but nobody supports us.
Would you consider going to or suggest going to a government hospital?
Kiran Nayak: I’d have to suggest private hospitals only because even if you go to a government hospital, nobody will understand you. Most of them will not even ensure you are being taken care of. They don’t even touch you or ask you about your complaints and concerns. They decide that we are mentally ill and don’t care about us. You wish you had not gone to them, even for small issues. Since government hospitals are terrible and so many of us cannot afford private hospitals is another reason why we have lots of health issues. The very first question they ask, “Are you male or female?”. That’s how it starts.
Is the hospital/clinic entrance and the toilets accessible? Are the reception desk, waiting area and health care workers equipped to communicate in accessible formats?
Kiran Nayak: Some private hospitals have good accessibility. But in a lot of government hospitals, you do not have a ramp if you have a wheelchair or vice-versa. Accessibility to the toilets is another big issue. Holding in the urine since we do not have access to toilets causes kidney problems to so many trans men. Due to the same reason, I often need to have my kidney treatment every year compulsorily.
Have you accessed gender-affirming healthcare services? (Including mental health)
Kiran Nayak: No accessibility at all. We do not get any access. The hospitals in cities, which are often corporate hospitals, are a bit better than the local/government ones. Even when there are guidelines, they often do not treat us well. You have to be very vocal about it in order to be heard by the health professionals. I had to fight for almost 1.5 years to get my dysphoria certifications.
If you are a menstruator, were you advised suppression of menstruation? If so, were you satisfied with the advice?
Kiran Nayak: Gynaecologists mostly do not understand. Sometimes, they even ask very personal and intimate questions that are irrelevant to the issue. We have no other option but to answer these questions.
Are the healthcare workers equipped to communicate in accessible formats?
Kiran Nayak: From laboratory technicians to doctors to non-teaching staff, nobody shows any awareness or empathy. Even if you tell them, they do not understand. They just want to know whether you are a “body” or a “girl”.
Even for issues that are unrelated to my transness and disability, I had to talk about both of them to receive good care, that too in a private hospital.
Have you had difficulty in gaining access to affirming healthcare services? What changes do you think are necessary to make the process safer and easier for everyone?
Kiran Nayak: As far as my experience goes, government hospitals definitely have to change. They should be provided with awareness sessions on trans men and trans women and all other marginalised genders and sexualities.
Is there anything else you would want to add?
Kiran Nayak: Finally, I only have one thing to say. The problems that trans people and disabled people, especially trans disabled people face are not understood well by the doctors who are indifferent to the intersectionalities of the marginalised identities we come from. They just give you a pill and that’s it. They do not get to the root of the problem. I remember the government of Kerala giving an order for hospitals, especially for trans people. These small changes are not being implemented anywhere else in the country. Even when we have the NLSA judgment, the doctors just try to experiment with us, not give us the care we need. The governments must ensure that the healthcare professionals are properly trained before they are allowed to treat us. Our bodies have become their experiment sites. The COVID-19 pandemic has only increased our problems. For instance, nobody is taking care or working on the implications of COVID-19 vaccinations on trans* people who are on hormones. I just finally want to say that we, trans-disabled people, also have our bodily autonomy and doctors should be patient enough to listen to us.
This interview with Kiran Nayak aims to highlight the lack of accessibility for queer disabled people within the healthcare system.
Sogie* is a acronym of Sexual Orientation and Gender Identity Expression.
The current interview is a part of Nazariya QFRG’s fellowship “Exploring Self Through the Lens of Gender and Sexuality” and the questionnaire for the interview was prepared by Vasavi and Nishika.
Kalluru Vasavi is a dalit, queer, neurodivergent student of psychology. They hail from a small coastal town in Andhra Pradesh. They are a first generation student whose research interests lie in the areas of anti-caste work, mental health, gender and sexuality, and power dynamics. They are currently a fellow at Nazariya- A Queer Feminist Resource Group (Nazariya-QFRG) and The Unsound Project and working as a research intern at Indian Mental Health Observatory- Centre for Mental Health Law and Policy. Vasavi is someone who would know all the basic details about everyone and everything but denies to call themselves a “stalker” on a daily basis. You can follow them on Twitter, Instagram and Facebook.
Nishika is a 2nd year MBBS student at HBT Medical College and Dr. RN Cooper Hospital. They were a fellow at Nazariya QFRG. They are the co-founder of QAHAANI, a collective that advocates for queer affirmative healthcare. They are a research fellow at MAHAC.
Featured image source: Instagram