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Personal, social risks aplenty for trans individuals
View(s):By Minaza Hassan
Transgender individuals are at a significantly higher risk of suicide, especially when they face rejection, harassment or denial of medical care.
In Sri Lanka, there have been instances where even basic medical services like puberty blockers or gender affirming care have been withheld, said former national consultant and psychologist, Shiyamalan Viyakesh.
Gender dysphoria is often misunderstood and wrongly labelled as a mental illness. It refers to the distress caused by a mismatch between a person’s experienced gender and their assigned gender at birth, clarified Mr. Viyakesh.
Echoing the thought, Social Psychologist, Dr. Mish’ari Weerabangsa said, the idea that gender dysphoria is a mental illness or delusion largely comes from the fact that it is listed in diagnostic manuals used by psychologists, like the Diagnostic and Statistics Manual (DSM 5), however, it is important to understand that being listed in these manuals doesn’t automatically mean it’s a disorder in itself.
According to globally recognised international standards of care, such as the World Health Organisation (WHO), the treatment for gender dysphoria, which is a symptom and not an illness, is transition and affirmation of the gender the individual feels that they are, said Dr. Weerabangsa.
“Many people pathologise gender dysphoria. The response represents their internal belief shaped by society. From a young age, we’re all taught to internalise very rigid ideas of gender, what boys should do and how girls should behave. These aren’t simply beliefs, they’re deeply embedded customs, absorbed so thoroughly that they begin to feel natural or inevitable. In many ways, gender becomes a kind of social regime,’’ said graduate student and trans woman Ms. Malithi (name changed to preserve anonymity).
When someone deviates from these expectations, or even expresses the desire to do so, it unsettles people. Gender dysphoria, at its core, is that conflict between internal identity and imposed norms. But instead of seeing that as a valid human experience, many people react by projecting their own discomfort onto us, added Ms. Malithi.
There’s a weight in a few simple words that many people never have to think about: “I feel at home in my body.” For those privileged enough to take that for granted, it’s just a given. Being yourself doesn’t require explanation, said Ms. Malithi.
Trans people are often subjected to minority stress, a term used to describe the chronic stress faced by marginalised groups due to stigma, discrimination, and social exclusion, said Dr Viyakesh, former national consultant and psychologist, who had also worked with several trans-people.
Trans people often live with deep loneliness, anxiety, and self-doubt, intensified by constant fear for their safety. Rejection from family, which should be a source of care, adds lasting emotional harm. Relationships become difficult when early bonds are built on neglect or abuse. Discrimination and lack of legal protection make daily life dangerous, especially for trans women in rural or militarized areas, said Ms. Azriel Dolores who is also a trans woman.
“The media often uses us as part of humour and entertainment. Men who are not trans would dress up as women in comedy skits, not to represent trans women, but to mock us. These performances often exaggerate, insult and laugh at how trans women speak, dress, or behave, turning our lived experiences into a joke. This kind of portrayal is deeply hurtful,’’ said Project Officer of Diversity and Solidarity Trust (DAST), Dinushi Lavanya, who is also a trans person.
While the Constitution of Sri Lanka guarantees freedom from discrimination and equal treatment under the eyes of law, it does not explicitly include sexual orientation, gender identity and expression and sex characteristics, said Mr. Viyakesh.
Trans individuals continue to face institutional and interpersonal discrimination on various levels, said Mr. Viyakesh.
Speaking from personal experience of being denied medical care as a trans individual, Devon (name changed) said: “When I went in for gender-affirming surgery in Sri Lanka, the doctor refused to treat me despite being approved for it. She said I didn’t “look trans” and called in other doctors to scrutinise me like I was an object. They asked invasive questions, demanded to see old photos, and mocked me in front of the entire ward and denied treatment claiming that there are real and serious patients that need attention.”
There is no state policy guaranteeing gender-affirming healthcare such as hormone therapy or surgeries, said Mr. Viyakesh.
Furthermore, Sri Lanka does not have a comprehensive gender recognition law. However, a 2016 Health Ministry circular allows trans individuals to change their gender on official documents, but only after medical or surgical transition and psychiatric approval. This medical process has been criticised for violating the right to self-identify and bodily autonomy, as outlined in international standards like the Yogyakarta Principles, said Mr. Viyakesh.
Trans people also face legal risks under the outdated Penal Code sections (365 and 365A), originally targeting same-sex relations, but often misused against trans individuals, especially trans women,
Mr. Viyakesh said.
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