In India, transgender men and women are marginalized and often face acute stigma discrimination due to the transphobia. Access to health is also a big challenge for them, due to the structural barriers such as discrimination by healthcare providers, gender-based violence (GBV), socio-economic marginalization, and lack of family support. Social marginalization and exclusion push transgender community to engage in high-risk sexual activities, increase vulnerabilities towards HIV/AIDS and create huge gaps for services related to HIV prevention & care needs. A ‘Holistic Comprehensive Health Response’ is essential to reduce such gaps and work towards better health outcomes such as increase health seeking behaviour, reduction in structural barriers to access health and community leadership towards human rights.

Manipur State AIDS Control Society (MACS), National AIDS Control Organization (NACO) and ITECH India with support from PEPFAR came together to demonstrate one of the successful trans health intervention through ‘holistic healthcare’ for improving HIV &health service access among transgender (TG) men and women in India. With the vision to create a ‘Sustainable Comprehensive Health Service Model’ for Transgender Communities, a functional “Transgender Health and Wellness Centre” was inaugurated in Imphal, Manipur on 25th March 2021 at Jawaharlal Nehru Institute of Medical Sciences (JNIMS), Imphal. The Transgender Health and Wellness Centre, a public-private partnership between India and the United States, and first of its kind in the North East India consists of two units – a help desk which inside the JNIMS and a wellness centre which is located across the JNIMS building. The centre was inaugurated and graced by the Hon’ble MLA and Advisor of Health to Hon’ble Chief Minister, Manipur along with the Principal Secretary (Health & FW), Government of Manipur and President, Manipur State AIDS Control Society and the Consul General, US Consulate General, Kolkata. The guests of honour included Joint Secretary, NACO, MoHFW, Government of India, Director-DGHT, CDC India and Country Director, UNAIDS and Project Director, Manipur State AIDS Control Society.

The Overall Vision (“Dream”) of the Manipur Transgender Health and Wellness Centre is to be a ‘Sustainable Comprehensive Health Service Model’ for Transgender Communities in Manipur covering North East INDIA which can be replicated partially or fully in other parts of South ASIAN Sub-Continent. The Overall Mission (‘Direction”) of the Manipur Transgender Health and Wellness Centre is to provide overall Health, Wellness, Gender affirmation support and Welfare Services along with Capacity Building and Skills Building for Empowerment of the Transgender
Communities through Public Private Partnership.

The Transgender Health and Wellness Centre is functionally managed by I-TECH India and Maruploi Foundation (a community-based organisation of Nupi Manbi/transgender) and is expected to cater to specific needs of transgender population.

Currently the clinic provides primary clinical services to the transgender community including Syphilis, HIV, HBV, and HCV Screening. The other clinical services include testing for Haemoglobin, Blood Group and RH Type, and Random Blood Sugar. The clinic also provides services like mental health support counselling, HIV prevention services, partner testing, ARV linkages, TB screening, linkages for the gender change transition support, welfare support and
gender base violence support, Beauty treatment services (through the community beauty parlour), Support group services, COVID-19 awareness and vaccination support, General health support, and Free mask and sanitizers distribution.

The unique feature of this initiative is the ‘Public – Private Partnership approach’ which has linked JNIM (Public Health Care Hospital) and Shija (Private Hospital offering gender change services) under one roof of wellness centre through community led referrals. The Wellness centre is also looking in the age wise & identity specific vulnerabilities around substance abuse, marital status and SHRH needs and specific needs around hormone changes during adolescence.

Though the centre has been inaugurated recently, we are already receiving several human stories from the transgender clients who are benefiting from the wellness centre. Some personal stories are mentioned below:

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