Four transgender people sit together, one looks as though they may be pleading for money. They are all four wearing facemasks.

Asia and the Pacific Islands: Pandemic’s disproportionate impact on transgender people should be “wake-up call” to governments

The dire state of transgender people’s rights to healthcare, housing, and employment in Asia and the Pacific Islands worsened at the height of the Covid-19 pandemic, Amnesty International said today. The organization is calling for governments in the region – and world over – to ensure lessons are learned so transgender people are not left behind in future health emergencies and natural disasters.

In a report, Pandemic or not, we have the right to live, Amnesty International documented discrimination, violence and marginalization of transgender people in 15 countries – Bangladesh, India, Indonesia, Japan, Mainland China, Malaysia, Pakistan, Philippines, Singapore, South Korea, Sri Lanka, Taiwan, Thailand, Tonga and Viet Nam. It reveals that transgender people suffered disproportionately under restrictions to curb the spread of the virus, at the same time that they were excluded from receiving government assistance to help people cope with the impact of the pandemic.

The pandemic and governments’ responses to it have laid bare the many barriers that transgender and gender diverse people in Asia and the Pacific Islands must navigate every day to meet their basic needs.

Nadia Rahman, Amnesty International’s Researcher and Policy Advisor on Gender

“The pandemic should be a wake-up call to governments to build more inclusive and sustainable economies and societies for trans and gender diverse people, especially in the face of future health and climate crises. The first step is to ensure individuals can easily and quickly change their legal name and gender on official ID documents, which is crucial to accessing their rights to essential services on an everyday basis.”

As lockdowns were introduced at the height of the pandemic, transgender people faced numerous challenges including a loss of income, food insecurity, safe housing, problems in accessing gender-affirming treatment, increased domestic violence and a notable absence of social protection support. These are all part of systemic issues states in the region need to address urgently, to comply with their human rights obligations.

‘No money and starving’

Discrimination and stigma mean that the overwhelming majority of transgender people in the region work in the informal sector without any job security, labour protections or welfare benefits. For example, in the Philippines, South Korea and Viet Nam, trans women told Amnesty International that performing at entertainment venues, working in the hospitality industry, engaging in sex work, and taking part in beauty pageants, were often the only ways they could earn a living.

In Bangladesh, India and Pakistan, many transgender women earn money performing ceremonial functions at weddings and births, engaging in sex work or begging on the streets. When lockdowns were imposed, many of them lost their only form of income.

A trans woman in Bangladesh told Amnesty International: “No mainstream companies hire us. We are seen as ‘cursed’ and ‘taboo’. There is no data from the government about trans people. NGOs and activists talked to about 1,500 trans women [during Covid-19] and they [mostly all] told us that they are living a very miserable life, have no money and are starving”.

Obstacles to accessing healthcare

Transgender people in Asia and the Pacific Islands reported that they are routinely subjected to disrespect, lack of privacy and confidentiality, and in many cases, outright refusal of care, when they seek medical assistance.

There is also a lack of health professionals trained in the specific health requirements of trans people, including the regulation of hormones and other gender-affirming treatment. As a result, many transgender people rely on the internet or clandestine market sellers for advice about medication and its side effects.

Accessing hormones was even harder for trans people during the pandemic, with many trans people claiming that interruptions to their gender-affirming treatment was causing them symptoms of anxiety and depression.

“The main difficulty transgender men have faced is getting hormone medicines. When their hormone stocks finished, they couldn’t go to the hospital to get medicines because of the curfews. At times they also couldn’t complete the process to get their gender officially recognized because clinics were closed, and surgeries got delayed,” a trans man in Sri Lanka told Amnesty International.

Humiliation and abuse directed at trans people

The report showed that most transgender people in Asia are unable to obtain legal ID documents that reflect their gender identity, which not only made it difficult for them to access relief packages and Covid-19 vaccines, but is a major barrier for them in their everyday lives.

“They said the virus was the great equalizer but in fact it – as well as the response to it – has greatly exacerbated existing inequalities. The systems that were already inaccessible became almost impossible to access for trans people,” one trans activist in the Philippines told Amnesty International.

The inability to produce an ID that reflected their gender expression also exposed transgender people to greater harassment, abuse and violence.

“Trans women were arrested for being out during the curfew. Most cisgender people just get fines but trans women are humiliated by the officers. There are even reports where trans women were asked to remove their wigs and/or clothes and provide their IDs. Law enforcement officers often go overboard with trans communities when they enforce these policies,” said a trans activist from the Philippines.

In addition to dealing with the Covid-19 crisis, trans people lived through what was termed their “deadliest year on record” with 375 trans and gender diverse people reported to have been killed globally between 1 October 2020 and 30 September 2021, including 44 people in Asia. Between 1 October 2021 and 30 September 2022, 327 deaths of trans and gender diverse people were recorded globally, with 40 in Asia. The actual figures for both years are likely to be much higher due to lack of adequate reporting at the national levels. This shocking violence is rooted in their long-standing marginalization, which is reflected in their lack of human rights.

“The culturally rich history of transgender and gender diverse people in many countries across the Asia Pacific, and indeed world over, has been overshadowed by structural discrimination, violence and stigma. Governments must not turn away from their suffering, but address the structural conditions and inequalities that shape trans people’s everyday lives, choices and opportunities, which, if left unchanged, will continue to make them particularly vulnerable to future crises,” Nadia Rahman said.