Analyzing access to healthcare among gender diverse communities using a critical accessibility framework

Keywords: community engagement, transgender, health access, India
Session Type: Virtual Paper Abstract
Day: Friday
Session Start / End Time: 2/25/2022 09:40 AM (Eastern Time (US & Canada)) - 2/25/2022 11:00 AM (Eastern Time (US & Canada))
Room: Virtual 35

Abstract

Our community-engaged study examined multidimensional factors impacting access to healthcare among gender-diverse individuals including Hijra, Kothi, or transgender (HKT) people after the legal and healthcare policy changes that took place in India during 2018-19. We analyzed data collected from two focus groups with 15 participants in Kolkata, India. Penchansky and Thomas’s taxonomy of access to care and critical accessibility theory, emphasizing the intersections of place, class, and gender, are used as the guiding frameworks. We identified barriers to access such as stigma, lack of services for the unmet healthcare needs of the HKT people, missing gender-neutral facilities in healthcare settings, fear of safety from violence, and unawareness among both the providers and the patients. The critical accessibility lens indicated that HKT people living in places with a history of discrimination, stricter heteronormative attitudes, low-income neighborhoods, and with family members involved in sex work, experienced more barriers and challenges. The coupling of a critical lens with existing healthcare accessibility frameworks provided a deeper understanding of access and its intersectionality with issues of substantive access to rights, class, gender, discrimination, and neighborhood inequality; more than just geographic access. Study findings informed that health access interventions should be multidimensional and inclusive of rights, and economic and social diversity of people on a spectrum of gender identity. We continued our community-engaged approach and disseminated our findings and relevant information of the existing healthcare settings with the gender-diverse community members at a feedback session using visuals and maps on a story map.