The goal to achieve Universal Health Coverage is extremely important for trans, gender diverse and intersex people, as socio-economic injustice disproportionately affects these communities:

• Structural oppression prevents us from accessing our basic right to health, and efforts to remove these barriers invariably exclude our communities.
  • Many of us are poor, or extremely poor, and paying for healthcare is not an option.
  • Others are excluded from healthcare coverage because of who we are and the bodies we have, because we live in countries where the healthcare system frames our gender identity and/or our sex characteristics as “pre-existing conditions,” thus excluding us from health insurance cover.
  • Those of us with intersecting identities/situations face insurmountable barriers accessing to health and its coverage, including people of color and/or from ethnic and/or religious minorities, people living in poverty or who are homeless, migrants, sex workers, those who are imprisoned, people living with HIV and people living with disabilities.
• The end of unconsented and unnecessary medical interventions and treatment on intersex persons is essential in the promotion intersex people’ health, well-being and socio-economic justice. “Normalizing” procedures forced on intersex people result in multiple surgeries throughout their lifetime in order to alleviate ongoing issues arising from these procedures, which most intersex people have to pay for out of pocket.
• Gender affirming healthcare is extremely inaccessible in countries where it is not covered by healthcare insurance, placing huge financial burden on those who pay out of pocket for treatment, thus contributing to poverty and socio-economic injustice. According to WHO, “protecting people from the financial consequences of paying for health services out of their own pockets reduces the risk that people will be pushed into poverty.” The reality is that many of us are already living in poverty, so paying for our own healthcare is simply not possible.
• Stigma, discrimination and violence still exist in many medical facilities and institutions across the world, including providers of healthcare coverage. Many trans, gender diverse and intersex people are unable to access healthcare or healthcare coverage due to anticipated or actual mistreatment from healthcare professionals or policy providers.
• Institutionalized legal pathologization exists in many countries, where public and private healthcare systems still require a pathologizing diagnosis prior to accessing healthcare coverage and psycho-medical classifications are written into gender identity laws. We areforced to submit to being psycho-pathologized, both medically & legally, in order to access healthcare and healthcare coverage. Global data on legal pathologization can be found at transrespect.org, a TGEU project.
• In some countries, trans and gender diverse people are given the option of accessing healthcare coverage if they join the army. No one should be forced to actively engage in violence in order to access healthcare. Previously, this was the case in the USA, however from 12 April 2019, transgender people joining the United States military are only allowed to enlist and serve “so long as they adhere to the standards of their biological sex.”
• Access to gender affirming treatments and protheses, as well as access to treatment for HIV, hepatitis C and tuberculosis can be extremely challenging for many of us. Being afforded reasonable accommodations for rehabilitation and palliative care, such as accommodation in gender-segregated facilities, is an ongoing challenge for many in our communities across the world.

• Read more about how pathologization contributes to a range of human rights violations across civil and political, economic, social and cultural rights in GATE’s publication “Gender Is Not An Illness“

  Find out more about the Yogyakarta Principles and intersex persons in GATE’s Fact Sheet “Intersex and the YP+10“