Transforming a Community’s Future

Simran Shaikh Bharucha (left) at the Mitr clinic in Hyderabad, during a visit by Ambassador Eric Garcetti (center) in June 2023. (Photograph courtesy USAID/India)

In 2007, Simran Shaikh Bharucha, who identifies as transgender (she/her), decided to undergo a sex change operation. A financially independent trans woman, Bharucha lacked for little to keep her from getting the body she identified herself with. Except for one crucial element—a trained and trusted medical professional who could offer her space and guidance before a life-altering surgical procedure. “I had to go to a non-medical person, a quack, for my surgery,” she reveals. Her story is similar to thousands of other trans people across India who struggle to find the resources, health care and education to live in a body of their choice.

In India, the rate of suicide among transgender individuals is about 31 percent, with half of them attempting suicide at least once before turning 20, according to a study published in the Indian Journal of Psychological Medicine. There is a high prevalence of depression and suicidal tendencies among transgender individuals, who face social stigma, a lack of social support, HIV status and violence-related issues. Mental health counseling, community support and providing livelihood opportunities are integral to Bharucha’s advocacy and community work.

Bharucha is an International Visitor Leadership Program (IVLP) alumna and the former director of transgender health at the ACCELERATE program, which is supported by USAID/India and implemented by Johns Hopkins University under the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). Under Bharucha’s leadership, the program opened India’s first comprehensive clinic for the transgender community in Hyderabad in January 2021. Two more health clinics were started in July 2021, in Maharashtra.

The Mitr clinics

Called Mitr Clinics, these health facilities serve as a one-stop center providing comprehensive services for the transgender community. They offer general health services, guidance and medication for hormone therapy and gender affirmation procedures, mental health counseling, HIV/STI counseling, prevention and treatment services, and legal aid and social protection services, all in a stigma-free environment.

“Although the clinics primarily offer HIV-related services, they also serve as entry points for non-HIV services,” explains Bharucha. “This was a crucial yet previously unmet need within the community.”

Mitr clinics are a dream come true for Bharucha. “For the first time, I realized my dream of implementing a clinic that is holistic, inclusive and community driven,” she says with pride. The goals and purpose of establishing these clinics were decided by the community through a series of engagements and conversations. A priority for most, says Bharucha, was health care, driven by a lack of sensitivity, awareness and resources among government and affordable private medical institutions. “If they go to a government hospital, for example, they will not find a doctor who could communicate with them in a dignified manner,” explains Bharucha. Additionally, sourcing sex-change surgeries and related services were also challenging. “There’s simply no space in my community where people can openly discuss these matters,” she says.

Simran Shaikh Bharucha (right) at a World AIDS Day event at the American Center New Delhi. (Photograph by Rakesh Malhotra)

However, establishing these clinics was not an easy feat for the transgender community. Bharucha says that while the concept of a transgender community-centric health care establishment was introduced more than a decade ago, it required the intervention of agencies to help set them up. “We were fortunate because after I joined ACCELERATE, we were given the go-ahead to address transgender health,” she explains.

Bharucha was deeply involved in setting up the clinics. “I joined ACCELERATE in October 2020, and within a week’s time I had my first community consultation,” she explains. “We did approximately 15 to 16 community consultations before the launch in 2021. These consultations served as a continuous check-in with the community about their needs.”

For example, says Bharucha, “we had to ensure that the doctor working at the clinic was from the community. I was worried about how to find a transgender doctor, but guess what? Our first doctor was identified from the crowd at the launch of the clinic in Hyderabad.”

The exchange experience

In June 2023, Bharucha participated in the IVLP, the U.S. Department of State’s premier professional exchange program. Through short-term visits to the United States, the program helps current and emerging leaders in various fields build lasting relationships with their American, and international, counterparts.

Bharucha says that the IVLP on Human and Civil Rights for Marginalized Communities was a “vibrant experience.” She traveled to multiple cities and explored innovative methods to celebrate diversity, foster inclusive public attitudes, tackle sensitive issues through cross-institutional collaboration, and expand networks of cooperation. “There were around 23 or 24 of us from different regions,” she says. Bharucha says she experienced not just the beauty of the country but also “the hard reality of America.”

“We learned about homelessness and the framework of shelter homes,” she explains. “We analyzed both perspectives. I realized that there is no country on this globe that does not face challenges. But what you show to the world is what you stand for. And that is the reality of our community too. While we do have our challenges, our strengths often go unrecognized.”

“We have a handful of transgender doctors, police personnel, judges and lawyers in this country, but what often get noticed is their perceived ‘stylishness,’ ‘effeminate’ demeanor or their presence begging at traffic signals, perceived as ‘loud.’”

The perspective of highlighting the positive to counter a negative narrative was her biggest takeaway from the IVLP, she says. To achieve this, says Bharucha, the community and social workers engage with the public through social media and traditional public outreach methods. “We are constantly advocating with the government to ensure there are shelter homes for the transgender community,” she says. “We are also involved in consistent advocacy aimed at mainstream society–by telling our stories, encouraging positive testimonials and sharing anecdotes through radio, TV, print and digital media.”

For Bharucha, the journey is far from over. “The change we seek is not a one-day effort,” she says. “But at least now, we have our foot in the door.”

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