Indian Journal of Endocrinology and Metabolism

: 2020  |  Volume : 24  |  Issue : 3  |  Page : 286-

Transgender health care status in Kerala

Suja Sukumar1, Vivek Ullatil2, Arjun Asokan3,  
1 Consultant Endocrinologist, Renai Medicity Hospital, Palarivattom, Cochin, Kerala, India
2 Consultant Psychiatrist, Renai Medicity Hospital, Palarivattom, Cochin, Kerala, India
3 Consultant Plastic Surgeon, Renai Medicity Hospital, Palarivattom, Cochin, Kerala, India

Correspondence Address:
Suja Sukumar
Consultant Endocrinologist, Renai Medicity Hospital, Palarivattom, Cochin - 682 025, Kerala

How to cite this article:
Sukumar S, Ullatil V, Asokan A. Transgender health care status in Kerala.Indian J Endocr Metab 2020;24:286-286

How to cite this URL:
Sukumar S, Ullatil V, Asokan A. Transgender health care status in Kerala. Indian J Endocr Metab [serial online] 2020 [cited 2020 Oct 26 ];24:286-286
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Full Text


The Transgender community face injustice at every turn: in their families, schools, workplaces, and even hospitals. Once their gender status is revealed, they are unable to live a dignified life due to social discrimination and stigma. To understand the issues faced by them, the Social Justice Department of Kerala conducted a statewide survey in 2014-15. Survey estimated the presence of more than 25000 transgender people. Although 52% felt a need to change their physical appearance through medical or surgical interventions, only 9% could do so. An overwhelming 32% attempted suicide at least once in their life. To rectify this situation, in 2015, Kerala became the first Indian state to implement a comprehensive policy to enforce the constitutional rights of transgender people following the directives from supreme court judgment of 2014.

The policy emphasizes the rights of transgender people to self-identify as male, female, or transgender, encourages educational institutions to have a transgender policy, and ensures to take legal action against parents who desert or abuse gender-nonconforming children and against doctors who practice “conversion therapy.” Social Justice Department of Kerala has implemented several provisions that can be accessed by anyone with the ID card issued by them, for example, the allotment of up to INR 2 lakhs for transgender persons who have undergone SRS, availing stay facility at shelter homes, and launch of 24 × 7 transgender helpline 1800 425 2147 to provide distress counselling. For the first time in the country, transgender individuals who have undergone sex change surgery could get married under Special Marriage Act.[1]

However, facilities for gender-affirmative health care are non-existent in government set up due to lack of facilities. In the past, transgender persons used to go to neighboring states and undergo botched up surgeries in small clinics with inadequate facilities and suffered lifelong complications.

Ours is the first multidisciplinary clinic for transgender health in the private sector in Kerala. We started the “Integrity clinic” in September 2017 involving various departments like endocrinology, plastic surgery, psychiatry, gynecology, legal cell, etc. Currently we have more than 300 patients under our regular follow up and have performed more than 100 surgeries, including genital surgeries, breast augmentation and reduction, facial feminization, voice change surgeries, and body contouring. Our hospital follows WPATH and Endocrine society guidelines [2] and has a trans-friendly policy where all staff have been trained to communicate in a respectful and sensitive manner. We have provided unisex toilet facilities and surgeries are being done at one-third cost as compared to other centers. There is now a move toward enabling the direct transfer of money for SRS to private sector hospitals by the government. Recently an Indian subsidiary of the WPATH, called the IPATH (Indian Professionals' Association for Transgender Health) has been formed with us being part of it, presents great potential for collaborative research and development in the area of gender-affirmative healthcare.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.


1Department of Social Justice, Government of Kerala. State policy for transgenders in Kerala. 2015.
2World Professional Association for Transgender Health. Standards of care for the health of transsexual, transgender, and gender-nonconforming people, version 7.