In the crowded neighborhoods of Rawalpindi, Pakistan’s transgender community faces a health crisis compounded by societal neglect. For Honey, a transgender woman, the persistent cough she experienced two years ago was not just a health scare—it was a reminder of the discrimination embedded in Pakistan’s healthcare system. Fear of being ridiculed or ignored prevented her from seeking timely medical help. When she was eventually diagnosed with tuberculosis at a screening camp organized by the Dopasi Foundation, it marked the beginning of a journey marred by rejection at multiple clinics.
Pakistan bears one of the highest tuberculosis burdens globally, with 686,000 new cases reported in 2022. Within this staggering statistic lies a grim reality: the transgender community is disproportionately affected due to systemic barriers. Many transgender individuals are forced into sex work, living in overcrowded conditions, which increases their vulnerability to infections like TB and HIV. Moreover, healthcare providers often refuse to offer adequate treatment, and societal stigma further isolates those affected.
Community Initiatives Offering a Lifeline
Initiatives like Dopasi Foundation and Dareecha Male Health Society have stepped in to fill the gap left by public healthcare services. Portable X-ray machines and AI-driven diagnostics have allowed screening programs to reach the most vulnerable. Honey’s apartment has become a sanctuary, hosting TB screening camps to ensure others don’t endure the suffering she faced. “I just didn’t want anyone to go through the pain that I went through,” she says.
These community-led efforts not only provide medical care but also challenge societal norms. Dareecha’s center serves as a safe space where transgender individuals are treated with dignity. “Nobody is stigmatised, nobody is discriminated [against] here. We’re all equal,” says Muhammad Usman, the organization’s executive director. Yet, the challenges persist, and more systemic reforms are needed to address the root causes of this inequality.
Structural Change and a Long Road Ahead
While Pakistan passed progressive legislation in 2018 to protect transgender rights, including healthcare access, enforcement remains inconsistent. Programs like Tahafuz Markaz, a police unit designed to support transgender individuals, offer some hope. However, systemic discrimination within healthcare facilities continues to undermine these initiatives.
For individuals like Rania, a transgender outreach worker, the fight against tuberculosis is personal. After witnessing a flatmate succumb to TB due to delayed treatment, she became an advocate for healthcare accessibility. “I am stigmatised and isolated and not responded to – what can I expect for any other transgender person?” she asks.
The battle against tuberculosis in Pakistan’s transgender community is not just a health issue—it’s a human rights issue. Addressing it requires not only medical intervention but also societal change, where transgender individuals are treated with the dignity and respect they deserve.