Ciara Dempsey
Country: Ireland
Background - International Geography and Psychological Studies
Research Project: Access and Barriers to Health Services Experienced by the Hijra in Dhaka, Bangladesh
ABSTRACT:
The hijra community are ostracised within Bangladesh society, do not have access to health services like their fellow non-hijra citizens and have specific health needs. This study examined where the hijra access health services and highlighted the barriers they experience. It explored whether health organisations catered for hijra and what services they provided. It also looked at unmet health needs experienced by this community. This research took place with the hijra community in Dhaka, Bangladesh.
Methods:
In-depth interviews, key-informant interviews and focus group discussions were the methods used to gather data while the sampling technique was heterogeneity sampling. Ten participants took part in in-depth interviews for investigating the access and barriers hijra experience. Key informant interviews were used with five organisations that provide health services. Two focus groups took place with five chelas (junior member of hijra community) and five gurus who had undergone castration or urethral reconstruction (senior members of hijra community). Conventional content analysis was used to analyse the data.
Results:
The hijra community have access to very good STI/HIV health services, although this does not include treatment for Hepatitis. The main barriers they experience relate to general and transitioning health services. These barriers include geographical proximity, discrimination, financial constraints and community politics. They choose different healthcare providers on these bases. This can result in the hijra not receiving proper treatment and taking part in risky procedures or treatments for transitioning. There is also room for improvement in relation to the area of mental healthcare provision.
Conclusions:
Like transgender communities across the world, the hijra experience discrimination which has a ripple effect on their access to healthcare. However, the hijra also have a very specific culture, hierarchy and community system which needs to be taken into account by those who are working with them. Regardless of the global or local context, the hijra’s right to health is currently being violated.
Word Count: 14990
Key Words: Hijra, transgender, Bangladesh, health services, transitioning