Global transgender health and rights: Addressing inequality in Indonesia

Global transgender health and rights: Addressing inequality in Indonesia

In 2019, the World Health Organization incorporated transgender health in the form of new guidelines for “gender incongruence” within “conditions related to sexual health” in the International Classification of Diseases, 11^th edition. No longer included under “mental behaviors and disorders,” this change represents an opportunity to develop depathologised and destigmatised frameworks to fulfill the rights of transgender people to health globally.  In this presentation, we will introduce some lessons from our research in Indonesia to consider transgender health and rights from a global framework. We draw on insights developed through our collaboration at the intersection of research and advocacy related to transgender health and rights since 2020.  This period has coincided with increasing regulatory and political challenges for sexual and reproductive health and rights in Indonesia. With respect to gender affirming care, Indonesian transgender people face considerable challenges in accessing quality clinical services, meaning that they largely rely on access to DIY hormones, and face considerable health risks. Transgender people also face barriers in accessing forms of healthcare more generally, including due to discrimination from healthcare providers, difficulty in accessing health insurance schemes, and the availability of services. We argue that expanding access to quality healthcare for transgender people should include a significant component of trans advocacy that incorporates evidence produced through research, to support quality healthcare appropriate to its context. Global transgender health can incorporate evidence developed within the national settings it is intended to operate within, which will require material support to overcome structural barriers in access to healthcare.

About Benjamin Hegarty and Alegra Wolter

Dr Benjamin Hegarty is a medical anthropologist and Senior Research Associate in the Global Health Equity and Justice research group at the Kirby Institute at UNSW. His ethnographic research draws on queer theory and transgender studies to explain how gender and sexual subjectivity and embodiment shapes experiences of health and inequality. His research has largely concerned communities of transgender women and men who have sex with men in Indonesia, with whom he has conducted long-term, collaborative, and interdisciplinary projects related to gender, sexual, and reproductive health. In addition to ongoing research investigating HIV and transgender health in Indonesia, he is working with colleagues at the Institute for Medical Research in Papua New Guinea to understand the relationship between health and human rights. His first book, The Made-Up State: Technology, Trans Femininity, and Citizenship in Indonesia, was published by Cornell University Press in 2022.

Dr Alegra Wolter is a trans physician with diverse leadership roles in medicine, public health, community empowerment, health advocacy, technology, and research. Her work focuses on gender equality, health disparities, human rights, and social inclusion. She is a member of the Advisory Board Chair for Suara Kita, an NGO dedicated to promoting the rights of LGBTIQ+ individuals in Indonesia. The organization currently advocates for access to national ID cards, health insurance, and social security for trans and vulnerable communities. She is also a part-time general practitioner at Angsamerah Clinic, providing clinical and psychosocial support to gender-diverse individuals and their families. As Indonesia’s first openly trans doctor, she gained public recognition through her campaigns, notably within the spectrum of gender, sexual and reproductive health and rights, SOGIESC diversity, and HIV and STIs.