A joint research project carried out from May 2022 to January 2023 to understand the barriers faced by LGBTI+ community in accessing health services showed that the LGBT+ individuals experience unequal treatment in society and they are the ones who face health disparities.
It is the first of its kind in the country and it tried to be inclusive so to understand the matter deeper.
The study included members of the Transgender Men (TGM), Transgender Women (TGW), Men who have Sex with Men (MSM) and Women who have Sex with Women (WSW) above the age of 18 years residing in the towns of Thimphu, Mongar, Gelephu and Phuentsholing as key population.
An official said that a total of 282 participants were included in the study whereby majority of them identify their sexual orientation as heterosexual (41 percent) compared to gay (22.7 percent), bisexual men (27.2 percent), bisexual women (9 percent).
Coming to access to health service by the above Key Populations (KPs), she said, “69 percent of the respondents highlighted that they visited health facilities including hospitals and Primary health centers while 31 percent did not visit health facilities, but visited private pharmacies and opted for self-treatment.”
In the process of study, the KPs have shared some of the barriers they come across while accessing to the health service. Long waiting time at heath facilities, Privacy and confidentiality at health facilities, Knowledge and attitude of health workers and Inclusive reporting system are some of the barriers respondents have shared.
“Stigma and discrimination came as strong factor that intersects with all other gender domains that affects health care access for the KPs. Stigmatization and association only with Sexually Transmitted Infections deter them from coming to health centers as well,” she added.
The study further showed that among gender identity, 81 percent TGW and 74 percent of TGM has experienced high stigma compared to men (20 percent) and women (33 percent).
Meanwhile, she said that the possible intervention at the moment is to advocate using social media platform, use of monastic body to advocate and add a curriculum in the school and medical universities.
She said, “Majority of the participants of our study including the health workers themselves indicated that they were not trained or competent to provide gender sensitive health care services.”
Need of more representative research to provide evidence for advocacy and planning interventions in Bhutan, filling the current gaps in education and training of health workers and incorporation of topics on sexuality and gender identity in universities and academic programme for health workers are some of the recommendations made after the findings.
Development of a policy on gender sensitive health services and strengthening routine data collection and surveillance on disparities, which includes LGBT population are other recommendations made.
Currently, there are no studies on Tuberculosis (TB) and dengue infection in TGM, TGW, MSM and WSW in Bhutan.
The study was initiated by Pride Bhutan in collaboration with Herd International, Institute of Health Partners and with fund support from WHO-TDR. The project is titled as ‘Exploring the intersections of sex and gender dimensions with other social stratifies in accessing TB and Dengue health care services by TGM, TGW, MSM, and WSW in Bhutan.’