(iPoster) Health Policy Inclusion and Healthcare Experiences of Third Gender Communities

• In Event: Poster Session: Women, Gender, and Politics Research

Abstract

Hijra people in Bangladesh, recognized as a “third gender,” continue to experience widespread marginalization despite formal legal recognition. This study examines how social exclusion affects healthcare delivery and everyday healthcare experiences among Hijra communities in Dhaka City. The research uses qualitative methods, drawing on four in-depth focus group discussions with 28 Hijra participants and three interviews with key informants. Participants were selected using purposive sampling to ensure representation of diverse lived experiences within the community. Findings indicate that exclusion persists across multiple domains, including family life, education, employment, housing, and civic participation, and that these conditions directly affect health and access to care. Many participants described discrimination in clinical settings, disrespectful behavior from providers, breaches of privacy, and denial of services. Stigma also discourages care-seeking, leading to delays in treatment and reliance on informal or unsafe options. Economic exclusion further reduces the ability to afford medicines, diagnostic tests, and follow-up visits. Recognition of a third gender has not consistently translated into institutional changes in hospitals, clinics, or health programs; respondents reported gaps in administrative procedures, a lack of respectful communication, and the absence of inclusive service protocols. This study contributes to health politics and health policy research by showing the limits of symbolic legal recognition when health institutions remain socially exclusionary. Policy recommendations include enforceable anti-discrimination guidelines in healthcare settings, provider training on gender diversity and respectful care, confidential reporting mechanisms for abuse, and inclusion of Hijra populations in targeted public health and social protection programs. Further research should examine healthcare access and living conditions among Hijra communities outside Dhaka and assess the implementation outcomes of third-gender policies across Bangladesh.

Author

• Unregistered Participant