What Transgender Men Face When They Access Healthcare

0.1 Introduction

0.1.1 This article is based on a report published in The Hindu on 2 January 2026.
0.1.2 It examines the systemic barriers faced by transgender men and gender-diverse people in accessing healthcare in India.
0.1.3 Using lived experiences, expert opinions, medical perspectives, and legal developments, the article shows how gaps in medical knowledge, training, research, and institutional protocols lead to discrimination, unsafe treatment, and denial of care.
0.1.4 Special focus is placed on transgender men and gender-diverse persons assigned female at birth, whose healthcare needs remain poorly understood

0.2 Lived experience highlighting the problem

0.2.1 Manohar, a transgender man, approached a tertiary government hospital in Tamil Nadu seeking gender-affirming care.
0.2.2 He faced judgmental behaviour, comments on his clothing and appearance, and was told that if he identified as a trans man, he should dress “like a woman”.
0.2.3 Medical care was provided only after he produced a Transgender Person Identity Card under the Transgender Persons (Protection of Rights) Act, 2019.
0.2.4 This shows how identity documentation becomes a gatekeeping tool rather than a means of inclusion.

0.3 Unequal experiences within the transgender community

0.3.1 While transgender women face discrimination, transgender men and gender-diverse people assigned female at birth face distinct and less visible challenges.
0.3.2 Their issues are often overlooked in healthcare policy, medical education, and research priorities.

0.4 Lack of awareness among healthcare professionals

0.4.1 Activists point out that even treatment for minor illnesses such as fever or cold can become difficult.
0.4.2 Many doctors lack basic awareness of transgender identities.
0.4.3 Patients therefore rely on a small informal network of “recommended doctors” who provide dignified and respectful care.

0.5 Historical reasons for poor understanding

0.5.1 Public health experts explain that transgender healthcare in India has historically focused on transgender women.
0.5.2 Greater social and cultural visibility of trans women shaped public health priorities.
0.5.3 As a result, transgender men and gender-diverse people remain poorly understood, even by trained professionals.

0.6 Problems in primary healthcare delivery

0.6.1 For transmasculine people, primary care is often routed through gynaecology departments.
0.6.2 Many specialists operate within binary gender frameworks.
0.6.3 This leads to ridicule, hostility, and inappropriate medical responses.

0.7 Gender-affirming care and hormone therapy

0.7.1 Gender-affirming care for transgender men often includes hormone replacement therapy (HRT).
0.7.2 Testosterone is used to promote masculinisation and suppress female secondary sex characteristics.

0.8 Lack of clarity on hormone dosage

0.8.1 There are no uniform dosage guidelines for testosterone.
0.8.2 Prescriptions range widely from 100 mg to 1,000 mg.
0.8.3 Dosage may depend on body weight, desired speed of masculinisation, or goals such as beard growth.

0.9 Easy availability of hormones and unsafe access

0.9.1 Testosterone is easily available through private pharmacies and online platforms.
0.9.2 Minimal medical oversight increases self-medication and unsafe hormone use.

0.10 Health risks of unsupervised hormone use

0.10.1 Hormones are steroids with serious long-term health risks.
0.10.2 Risks include kidney problems, heart attack, stroke, and diabetes.
0.10.3 For those with underlying conditions, hormone therapy may have immunosuppressive effects.
0.10.4 These risks are often poorly communicated and monitored.

0.11 Shortage of trained specialists

0.11.1 Affordable endocrinologists trained in transgender care are scarce.
0.11.2 Many lack training in transgender-specific hormone management, pushing patients toward unsafe practices.

0.12 Ethical concerns in medical practice

0.12.1 Gender-affirming care often lacks ethical grounding.
0.12.2 Some doctors view transgender men through patriarchal, heteronormative, and reproductive-centric lenses.
0.12.3 Reported practices include invasive fertility questions, pressure regarding childbirth, and unnecessary vaginal examinations.

0.13 Gatekeeping through psychiatric diagnosis

0.13.1 Healthcare providers often act as gatekeepers.
0.13.2 Access is allowed only after psychiatric diagnosis of gender dysphoria.
0.13.3 Experts argue care should be based on gender incongruence and informed consent.

0.14 Limited research and training ecosystem

0.14.1 Research on transgender healthcare in India is extremely limited.
0.14.2 Most advances have occurred in Western countries.
0.14.3 Indian doctors lack context-specific evidence and structured training modules.

0.15 Signs of gradual improvement

0.15.1 Some discriminatory practices, such as dress-based restrictions, have been discontinued.
0.15.2 Government hospitals have begun gender-sensitisation training and NGO collaboration.

0.16 Legal developments

0.16.1 In 2024, a petition was filed in the Madras High Court seeking improved healthcare protocols.
0.16.2 The Court allowed a rejoinder affidavit and suggested improvements to Standard Operating Procedures (SOPs).

0.17 Conclusion

0.17.1 Legal recognition alone is insufficient to ensure healthcare access.
0.17.2 Meaningful inclusion requires research, training, ethical medical practice, and respect for gender identity.
0.17.3 Without systemic reform, transgender men and gender-diverse people will continue to face exclusion from safe and dignified healthcare.