Gender-Affirming Care (GAC)

10.10.2025

Gender-Affirming Care (GAC)

Context:
 A recent article underscores the urgent need for Gender-Affirming Care (GAC) in India, highlighting its role in ensuring dignity, equality, and mental health for transgender and gender-diverse individuals.

What is Gender-Affirming Care?

GAC comprises medical, psychological, social, and legal interventions that help individuals align their gender identity with their bodies and societal recognition.

• Social Interventions: Correct names, pronouns, and institutional recognition.
   
• Psychological Support: Counselling and peer networks to manage gender dysphoria.
   
• Medical Care: Hormone therapy and surgeries to affirm desired gender characteristics.
   
• Legal Support: Institutional inclusion within healthcare and education systems.
   

WHO recognizes GAC as medically necessary, not elective, due to its direct impact on wellbeing.

Need for GAC in India

• Mental Health Crisis: Over 31% of trans persons have attempted suicide, many before age 20.
   
• Health Benefits: Access to GAC reduces depression and suicidal ideation (JAMA, 2023).
   
• Constitutional Right: Article 21 ensures dignity and access to healthcare.
   
• Social Inclusion: Enables acceptance, employment, and equality.
   
• Public Health Priority: Mandated under Transgender Persons (Protection of Rights) Act, 2019.
   

Barriers to GAC

• Poor Medical Infrastructure: Few trained professionals, no national protocols.
   
• High Costs: Surgeries (₹2–8 lakh); Hormone therapy (₹50,000–70,000 annually).
   
• Weak Policy Implementation: Ayushman Bharat TG Plus remains underused.
   
• Stigma and Discrimination: Fear of mistreatment deters care-seeking.
   
• Unsafe Alternatives: Self-medication leads to severe health risks.
   

Consequences of Neglect

• Worsened mental health and suicide risk.
   
• Social and economic marginalization.
   
• Physical harm from unregulated treatments.
   
• Policy invisibility due to data gaps.
   
• Violation of human and constitutional rights.
   

Way Forward

• Integrate GAC into Ayushman Bharat and government hospitals.
   
• Train medical staff in gender sensitivity.
   
• Partner with trans-led NGOs for outreach.
   
• Reform insurance and create national GAC guidelines.
   
• Collect data for evidence-based policy.
   
• Awareness drives to combat stigma.
   

Examples: Tamil Nadu’s gender clinics and Kerala’s Transgender Cell serve as best practices.

Conclusion:

Gender-affirming care is a human right, essential for dignity, health, and equality. Ensuring its availability and affordability will move India closer to true social and mental health equity.