Issues Impacting the Trans Community in the Asia Pacific

An interview with Cianan Russell, Human Rights and Advocacy Officer, Asia-Pacific Transgender Network

Asia Pacific Transgender Network (APTN) engages with a range of partners, globally and across Asia and the Pacific, to support, organize, and advocate for comprehensive healthcare and the protection of legal, social, and human rights for trans and gender diverse people. Since its founding in 2009, APTN has published several key reports, policy and technical briefs, in partnership with other community-based groups and multilateral organisations, that have been used to inform policy and laws.

Rashima Kwatra, OutRight’s Communications Officer, sat down with Cianan Russell, Human Rights and Advocacy Officer, to learn more about APTN and the issues impacting trans communities across the Asia-Pacific region.

Rashima Kwatra: What are the three most pressing issues impacting the trans community in the Asia-Pacific?

Cianan Russel: Access to healthcare, safety and security, and legal gender recognition.

In much of the region, trans issues are not heavily legislated, not heavily integrated into government or policy and so that creates an access barrier that is cross-cutting. In countries where trans people can’t gain access to legal gender recognition, they often also cannot get access to healthcare, or have issues facing safety and security. They work in tandem.

Specifically about healthcare, in the vast majority of the region, it is not possible for trans people to medically transition and legally, to gain access to hormones, surgery, mental health support during the process. In places where it is legal, the process is highly pathologizing someone has to get a diagnosis, use that diagnosis repeatedly as they move forward in whatever way they want to transition. These diagnosis come from policies that are not generated here, so the people who are writing the diagnostic criteria are not from this part of the world and that creates problems with cultural and local ideas about what it means to be a trans person and the international guidelines that exist.

In addition to problems in gaining transitional healthcare, Trans people have problems gaining health care at all in part because of societal prejudice. So if you break your arm or chip a tooth and try to go to the doctor and your identification says a name that doesn't match your presentation or gender marker, that creates a hotbed for discrimination. Or if it does match your gender presentation, because your presentation doesn't match your identity, it creates a situation where people's mental health can be harmed by trying to deal with these situations. In addition, in some places, trans people have been told by health insurance providers or doctors incorrect information about healthcare because of the prejudice of the doctor or insurance provider which can cause a lot of physical and mental damage to the person.

Finally there is the potential for things to be really quite bad. About 18 months ago, or rather a year ago, a trans woman in Pakistan was shot, her name was Ayesha, when her friends took her to the hospital, the hospital refused to put her in either the men's ward or the women’s ward and she died because of waiting to be served. Eventually they got her into the hospital, but it was too late. She waited several hours, and by the time she was seen by a doctor she had died. There has been a lot of activism over this case in particular, and the policies have changed in that one part of Pakistan, but this could and does happen in many places in this part of the world, and all over the world.

Rashima Kwatra: Which countries are most legislatively progressive when it comes to the rights of trans individuals?

Cianan Russel: Nepal’s legal landscape for trans people is the most accessible and the least restrictive in the region. For example, a person can change their gender marker on their citizenship card by declaration with no need for approval or verification by a third party. The current Nepalese policies certainly has some problems, but it is by far the best in the region in terms of accessibility.

Rashima Kwatra: Is it difficult to work on these issues as a regional organization taking into consideration the vast cultural, religious, and political differences between countries? How do these issues impact the way the organization functions?

Cianan Russel: There is a steep learning curve with this kind of work at the regional level, being sensitive and aware, and knowledgeable about all the places we do work at once. That said, I don’t know that I would say that it is difficult, this is what our organization is designed to do. To work multinationally, this is who we design our programs, materials. More than difficult I would say that it is extensive, we are never able to secure enough money for translations and in places where English or Mandarin Chinese are not the primary languages, trans communities are deeply deeply underserved because they cannot access a really large amount of information that is available to the rest of the world, on some level. And so part of our working style accounts for that issue and when we get funding from international donors, we do a lot of sub granting to national level partners and we end up doing technical assistance and capacity building as the go between in that type of funding model so our access to englisht, our understanding of the international landscape , allows our national level partners to gain access in a way that they might not have been able to because of language issues.

Rashima Kwatra: What are APTN’s biggest programs focused on? Are there countries or issues that the organization prioritizes?

Cianan Russel: Our three priority areas are what I had spoken to you about earlier, this is where we do most of our work. And access to health, meaning general health care, the HIV/AIDS response, and transitional care. We do a lot of work in legal gender recognition and policy development and that can be anywhere from consulting on the content of a draft bill to facilitating a research project to find data that can then be to lobby to engaging in UN spaces. Finally one of our major pieces is about technical assistance and capacity building of our partners and wanting to build a robust movement in the region.

Rashima Kwatra: What changes do you see happening in the near future to advance the rights of trans individuals?

Cianan Russel: It is a really exciting time because many countries around the world are paying attention and trying to do policy revision and legislation related to trans folks. And many other countries are looking at countries that don’t have legislation and calling them out in the in UPR, in front of Treaty Bodies, or inside regional human rights organizations. And for us, what that means is that we need to amplify our efforts to make sure that trans voices from this part of the world are leading the discussion as legislation moves forward, as policy change gets put into place so that they are not models that are imported and placed upon local trans people.

A lot is happening. We are hosting a conference in the middle of September, and this is an example of that. As I was telling you before, it is 19 countries with a focused delegation from each country, it will be about 150 participants. Conferences like this were unheard of even 3-4 years ago -- trans specific, 150 people, in the Asia Pacific. This is new territory and this is because of a shift in people’s awareness, governments, donors, and the general public, all becoming more aware of trans issues.  Part of this comes from western media, and part of it is dovetailing local activism with media uptakes.

Rashima Kwatra: Is there anything else about the organization or about issues impacting trans individuals in this region that you would like our readers to understand?

Cianan Russel: Historically, efforts to address trans rights and trans people have likely and unintentionally have decentered trans people by attempting to meet needs that we are not voicing. And at APTN it is important for us that the expertise and skills and opinions of trans people from Asia and the Pacific are the foundations of our actions and our work. Trans people are experts in every field in the same way that cis people can be experts in every field. And our expertise are more valuable than just the front page story and the flashy costume.