THE neglect that the hijras face in public healthcare system in Rajshahi is worrying as such issues push many of them to resort to unsafe and unregulated treatment options. The hijras has been recognised as the third gender. Yet, a recent study that interviewed hijras in areas of the Rajshahi City Corporation, published in the Indonesia-based journal Interdisiplin, lays out a comprehensive account of how discrimination permeates every stage of their medical journey, from approaching hospital gates to interaction inside consultation rooms. Respondents have described being ridiculed on their way to pharmacies, spoken to with open contempt at medicine counters and subjected to intrusive or inappropriate remarks about their bodies or gender identity in the presence of other customers. Inside public hospitals, the strictly binary system of ticket counters, queues and wards leaves the hijras with a coercive choice between entering the men’s line and facing bullying or joining the women’s line and encountering shoving and verbal hostility. Many have reported that fellow patients demanded their removal altogether. Even in consultation rooms, physicians often rush through appointments, dismiss symptoms or attributes illness to their identity while some nurses decline bedside care.
With nearly a half of them resorting to quacks, self-medication or unregulated pharmacies and only 4 per cent accessing costly private clinics, as the study shows, the community navigates a healthcare environment that is structurally exclusionary and routinely hostile. The gravity of this situation lies not only in the frequency of reported abuses but in the structural logic that allows such discrimination to persist. The binary configuration of public hospitals where every administrative, logistical and clinical process is designed around two genders, creates predictable points of exclusion that are replicated across the country. Similar reports from Dhaka, Chattogram and Khulna in recent years indicate that hijra patients routinely face denial of services, derogatory treatment and intrusive questioning, suggesting a nationwide pattern of institutional unpreparedness rather than a localised lapse. The hierarchy within public facilities further entrenches the problem. Physicians, lacking training in gender diversity, misinterpret symptoms or avoid meaningful engagement. The elements amount to a structural barrier that exposes hijras to medical neglect, unsafe treatment alternatives and heightened vulnerability to chronic illness and mental distress. A redress requires more than symbolic recognition. It demands systemic reforms and institutional accountability designed to create safe, inclusive and professionally competent healthcare access.
The study findings highlight an urgent need for targeted action. Public hospitals should implement gender-inclusive registration, train staff in hijra-sensitive care and establish safe contact points for the community. Legal recognition alone cannot safeguard their health. Without systemic reform, hijras will continue to rely on unregulated treatment and face preventable harm. Policymakers, medical institutions and civil society should act decisively to make healthcare equitable for all genders.
