Dr Aqsa currently works as an associate professor of community medicine at the Hamdard Institute of Medical Sciences. Besides giving voice to concerns of the trans community, she is also the fouder of Human Solidarity Foundation which works towards eradicating hunger and securing health for the most marginalised communities in India. Speaking to Patriot, she sheds light on the issues trans community tackles on a daily basis – right from realising their identity to establishing a safe space in the society.
Could you please tell us about your decision to transition?
Ever since childhood, I identified myself as someone different. I don’t know what that was. My behaviour had feminine traits, which my family saw, and for which I was bullied and trolled a lot. At that time, I couldn’t speak about it to anyone even when I knew that there was some sort of turmoil there. Only when I entered medical college, did I talk with a doctor and told him how I felt. After months of counselling, I finally came to terms with my gender identity and I identified myself as a transwoman. That’s when I decided to have a transition. My family didn’t agree to this decision though. Much later, I shifted to Delhi. I was dealing with depression at that time. I was having suicidal thoughts. That was the time I realised that I need to be who I feel I am inside. This was around five years ago. And once I started my hormone therapy, I started to feel the sense of relief and comfort that you have in your skin.
Speaking of school days, how hard was that phase for you?
My elder brothers and I were in an all-boys school in Mumbai. Since I didn’t behave in a masculine manner, I was bullied a lot. They used derogatory terms for me. It was a difficult phase. The problem was that I couldn’t speak about it to anyone. I could not complain to my parents because they used to ask me to change my behaviour. I could not talk about it to the teachers because we didn’t have that close relationship. So, you start internalising the guilt that maybe there is some problem with me and that’s why people are bullying me. I started to think that there is something wrong with me rather than the bullies.
It must have taken a toll on your mental and physical health…
When I first talked about my sexual orientation and gender identity, I was diagnosed with hypertension. I had a high BP, a lot of anxiety and depression at that point. When you have a lot of stress and you can’t vent it out, when you’re not able to talk about it, it manifests in a physical illness also. It was hypertension in my case.
I started my hormone balance treatment five years ago. I started my transition late in life due to lack of support. It is riskier for people who have some disease to take hormones, but we also need to understand that ultimately the hormones will make you feel so better that your stress goes away eventually. When I decided to transition, it was a matter of life and death for me. I didn’t think much of the side effects of hormones or anything.
What role did the support from your family and friends play during the transition?
I came out to my family when I was 20 when I realised that I was a trans person. At that time, my family could not understand my situation. They were kind of avoiding the situation saying I was overthinking. After that, I stopped discussing my identity with them for almost 10 years. They insisted I get married to a girl because, in an Indian setting, marriage is the solution for everything — including gender identity. When I joined the medical college as a teacher, I finally had some support from the students. I have a lot of friends among the students who understood my situation. Another four years later, I started my transition and I had a few friends who helped me during the process. From my family, a lot of people had stopped talking to me because of it, including my mother. But over the last five years, she has come around and become a very good support system now. She lives with me in Delhi now. Acceptance from the family has been increasing gradually. And when it comes to friends, I have a great network of friends who accept me as I am.
Since you transitioned relatively late in life, how has life been different for you as a woman than it was as a man?
I hadn’t come out during my college days or discussed my gender. So, I felt like I was living a lie acting like a heterosexual man so that no one knows that there’s a woman inside me. It was very difficult, especially when you are in a religious setting. As someone who was acting like a man, I had to go to the mosque and pray and stand beside the men. But ever since I came out, started transitioning and living socially as a woman, the women have started understanding me better than before. I’ve got a lot of female friends now. There’s this feeling of sisterhood, and I realised that this is what I had always wanted – to be accepted as a woman and to feel comfortable and happy with what I am doing.
Moreover, I think when we live in a metro, it becomes difficult for a single woman to live alone. I would say that after some time, you adapt. It’s been five years now and I don’t find it an issue I am not travelling for work. I have my car. I can completely understand how other women feel when they’re using the metro or rickshaws to travel to work.
One thing I noticed when I transitioned is that suddenly the perception of people around me has changed. They see me as a woman now. So, all the stereotypes associated with women are associated with me.
I’ve also seen how the perception of men around me has changed. Now I can appreciate all the problems that women have talked of. I always share this joke with my female friends. After I transitioned, men have stopped looking me in the eye and instead look one foot below.
How has the transition empowered you?
Before the transition, I was very afraid that people will know there is something abnormal with me. I wanted my feminine features to come out, but I hadn’t come out back then. I tried to speak less in social gatherings and I didn’t express myself freely.
Now, I am proud as a woman. Especially after transition, I don’t give a damn about what anyone thinks or feels. You are only answerable to your conscience. And that has made me feel very empowered. When I talk about the rights of trans people or the rights of women, I don’t give a damn about who feels what.
Even before the transition, you must have faced a lot of discrimination. How did such instances affect you?
Once, I went in for a name change for my documents in my medical college. It was a very tough time – to the extent that I had to threaten them with litigation because they said they’ll set up a medical board, which shall examine me. They kept sitting on that file for days. It was much easier for me to change my name in Aadhaar card and PAN card than to get it changed in my office, where I have been working for several years. That was a painful incident. However, I am happy that I have paved the path for any other trans person who comes to work. So, I guess that won’t be a challenge that they will have to face.
When you joined as the head of the vaccination centre, you became the first transwoman to do so. How was the work environment for you?
It’s been two and a half years since I joined the centre. The initial curiosity around me has now settled. But these medical colleges send a new batch every year. For them, it’s a new experience because they had never imagined that their teacher could be a trans person. So, there are a lot of those ‘hush-hush’ talks when someone new joins our college. But I must say that I have been very blessed. I have received a lot of love and affection from my students and newly joined colleagues. After the media coverage following my appointment at the vaccination centre too, I remember that people specifically came there to see me and click selfies with me. It felt good to be appreciated. There was a lot of curiosity about a trans person heading the centre, but it only made me feel very proud.
What do you think we need to change in our education system to familiarise children with the transpeople community?
We need to begin the familiarisation very early because children’s identity with their age starts right at the age of three or four years when they start knowing who is a boy or girl. This is the time when they enter a school where they have gender segregation like different uniforms and washrooms for boys and girls. And during this segregation, if you are a trans person, the experience can become very harrowing and brutally difficult. The sensitisation has to start right then in terms that people can be different for me and it’s alright, and that I should not be teasing them for it. A lot of work needs to be done by the parents, teachers and the school administration including the bus drivers, security personnel, caretakers because they are the ones who also maintain close contact with the children. There was an incident where a queer child died by suicide in DPS Faridabad because the child was abused and bullied. This is just the tip of the iceberg. But if you look at the queer community, almost everyone has had such experiences. We’re just fortunate we didn’t die by suicide. So, the schools must become more gender-inclusive.
What do you think about cis men and women representing trans people in the media?
This is one of my areas of research for a project that I am currently working on. There is a problem with the trans representation in media. One, cis people are pushing trans people, and the excuse that’s often used is that they don’t have enough actors from our community. But in today’s time, there are several trans models and trans actors available, so this excuse can’t be used anymore. The recent Gangubai movie also has a cis man playing the role of a transwoman. The consequence is that people start thinking this is how transpeople behave. When you see Vani Kapoor as a transwoman in Chandigarh Kare Aashiqui, it implies that you won’t be able to identify transwomen if you come across them, and therefore you can be fooled by a girl that she is a woman when she is a transwoman. When you use men to portray transpeople or members of the hijra community, it evokes a lot of disgust at times because the notion that follows is that these transwomen are so violent, muscular and powerful. They are not feminine enough.
This stereotype had made my mother very anxious. She used to say I would look like those men or someone from the hijra community. There’s also a problem with portraying trans characters for comic roles, or as people who abduct children, or as women who fool men for money.
While I appreciate that filmmakers are highlighting our issue and struggle by using cis people to portray us, I hope they remain receptive to the feedback criticism that comes from the community. I had tweeted about how I liked the movie but was unhappy with the representation of trans people through cis people, and Ayushman Khurana had retweeted it.
How has the healthcare system received trans people so far?
I have been a passionate advocate of how our current healthcare system is transphobic whether it’s about general healthcare or other services. One important point we talk of is how we can change the medical curriculum, and how the new doctors should be trained and be competent enough to provide medical care to a trans person. Now, there is a legal mandate in the form of the Trans Act that mentions there’s a need for curriculum reform and that facilities should be provided for trans people for counselling, surgeries, trans affirmative care and so on. It’s time we put this into action.
Also, I want to highlight that across India, there are only 17 medicos from the transgender community. The number might seem less and show how the community is marginalised, but for us, it is a really big number.
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