There are no authentic data about the prevalence of diabetes among the transgender community. The fact casts doubt on claims of extending comprehensive health coverage to members of this community.

“Talking about rights of the transgender community is a social taboo in our society. Organising awareness campaigns directly addressing their health issues is difficult,” says Dr Muhammad Arshad Siddiqui, in charge of Diabetes and Foot-care Clinic at Mayo Hospital, Lahore, and chairman of Sehat Foundation, Pakistan. Dr Siddiqi was addressing a diabetes awareness seminar and foot-care camp organized exclusively for transgender people at Kot Radha Kishan.

A large number of members of the local transgender community participated in the awareness session arranged to promote awareness and sensitise the transgender community about diabetes, its causes, complications and prevention.

The seminar was part of a general campaign about diabetes awareness among the public in connection with the World Diabetes Day which is observed on November 14.

“Every 20 seconds a limb is lost somewhere because of diabetes,” Dr Siddiqui told the audience. This year’s theme is Family and Diabetes.

The purpose of selecting the theme is to spread awareness of how diabetes causes emotional distress for families. The session, organised in collaboration with Go Green Society and Pakistan Islamic Medical Association, was part of the Blue Ribbon campaign aimed at dissemination of information about various risk factors around diabetes.

Transgender people were formally declared the third sex in Pakistan in 2012. However, the legal acceptance of their status did not result in equal access to the healthcare system. They regularly complain about the denial of basic health facilities in public sector hospitals.

According to 2017 census data, the population of transgender people in Pakistan is 10,418. As many as 64.4 per cent of the country’s transgender people i.e. 6,709 people live in the Punjab, most of them in Lahore.

Transgender rights campaigners claim a much bigger population. Mona, a leader of a Lahore-based transgender rights group known as the Khwaja Sira Society, says there are between 400,000 and 500,000 transgender people in the Punjab. “The sex of most transgender people is not disclosed on their national identity cards. This helps them avoid discrimination,” she says.

Transgender people have sometimes been denied treatment at public hospitals because managements could not decide whether to treat them in a male or female ward. “The government’s claims of setting up separate wards for transgender patients in hospitals is an eyewash,” says Neeli Rana, a transgender candidate in the 2018 general elections.

Transgender people were declared the third sex in Pakistan in 2012. However, the legal acceptance of their status did not result in equal access to the healthcare system.

Dr Siddiqui tells TNS that Sehat Foundation organizes campaigns and workshops to raise awareness of health issues. It also contributes in literature development and by holding talks by health experts for the media, celebrities and policy makers. “The Diabetes and Foot-care campaign is one of these,” he says. He says such awareness sessions are known as Sughar Baithak.

Speaking at the seminar, Dr Siddiqui said that according to the second National Diabetes Survey of Pakistan, the prevalence of diabetes in Pakistan was 26 percent. “Only about 20 percent of the patients know that they have diabetes; the rest are still unaware about their condition and what they need to do about it,” he said.

Talking about the devastating complications of diabetes, he said, the diabetic foot disease was preventable and yet grossly neglected. He said the ignorance resulted in greater morbidity and mortality.

This seminar was followed by a foot-care demonstration for diabetic patients. Literature containing educational material about foot-care was distributed among the participants.

At the end, Muskan, a member of the local transgender community, thanked the Sehat Foundation for holding the awareness session for the transgender community.

“The session provided important awareness about diabetes and boosted our confidence in the society although transgender people are socially, economically and politically marginalised and often discriminated against,” she said. She said there had been incidents of violence against transgender people in several parts of the country.

Dr Salman Haseeb, president of the Young Doctors’ Association, Punjab, said that as responsible health care professionals, doctors must ensure that transgender people receive the same quality of healthcare as others do. He called for greater sensitivity towards the needs of the transgender community, so that they can receive quality care at the primary level.

“The standards of care for diabetes and other health issues should not discriminate between genders,” he said. He also called for creating a database of diseases among the transgender community, with proper documentation of diagnosis and referral.

He mentioned that the government has announced plans to issue Health Cards for transgender people as a way to end discrimination in healthcare.

The author is a health reporter for The News International