COMMUNITY CENTRE AND HEALTH CARE CENTRE

FOR TRANSGENDERS

SHRADDHA MIRAJKAR
2BV13AT038
BVBCET
CONTENT
1. INTRODUCTION
• LGBT COMMUNITIES
• TRANSGENDERS IN INDIA
• PROMBLEMS FACED BY TRANSGENDERS
• LGBT RIGHTS
• HEALTH CARE
• NEED FOR THE STUDY
• OBJECTIVES
2. LITERATURE STUDY
• HOPE HOUSE, WASHINGTON DC
3. LOCATION
 WHAT ARE TRANSGENDER?
• Transgender people are people who have a gender identity, or gender expression, that differs from their assigned sex. Transgender people
are sometimes called transsexual if they desire medical assistance to transition from one sex to another.

COMMON MISCONCEPTIONS
• A common misconception is that a transgender person is therefore gay. However, being transgender involves gender identity and not sexual
orientation; a transgender person may be of any sexual orientation. Another important misconception is that one who crossdresses is
transgender; however, many crossdressers are comfortable with their assigned sex.
• Being transgender does not mean having a mental disorder; it is not something that can be cured. In fact, many transgender people
experience gender dysphoria, which is a disconnect between one's assigned sex at birth, and with which gender the person identifies.

LGBT community(LESBIANS, GAYS, BISEXUAL AND TRANSGENDER)

• The concepts of gender identity and transgender identity differ from that of sexual orientation. Sexual orientation describes an
individual's enduring physical, romantic, emotional, or spiritual attraction to another person, while gender identity is one's personal sense
of being a man or a woman.Transgender people have more or less the same variety of sexual orientations as cisgender people.In the past,
the terms homosexual and heterosexual were incorrectly used to label transgender individuals' sexual orientation based on their birth sex. 
• Despite the distinction between sexual orientation and gender, throughout history the gay lesbian, and bisexual subculture was often the
only place where gender-variant people were socially accepted in the gender role they felt they belonged to; especially during the time
when legal or medical transitioning was almost impossible. This acceptance has had a complex history. Like the wider world, the gay
community in Western societies did not generally distinguish between sex and gender identity until the 1970s. Today, members of the
transgender community often continue to struggle to remain part of the same movement as lesbian, gay and bisexual citizens, and to be
included in rights protections. And in fact, the role of the transgender community in the history of LGBT rights is often overlooked, as
shown in Transforming History.
 INTRODUCTION
• The eunuchs or hijras have been an integral part of Indian society since time immemorial. Eunuchs were prized as guards of harems, and
as companions, by kings and emperors.
• An estimated 5–6 million eunuchs live in India. In modern day India, eunuchs often live a ghetto-like existence, in their own
communities. They make a living by dancing and celebrating in births and marriages but often have to resort to other means to make both
ends meet.
• Eunuchs are given a homogenous social identity, irrespective of their physical or endocrine status. The Sanskrit term “tritiya prakriti,” or
third nature, is used to classify them. They are considered infertile persons, with a female gender identity, with masculine secondary
sexual characteristics, with or without male external genitalia, with feminine gender role, with predominantly homosexual identity. While
the sexual identity of eunuchs is considered homosexual by the general public, no work has been done to assess their sexual orientation
or endocrine status.
• The eunuchs can therefore be termed as male-to-female (MTF) transsexuals. The etiology of transsexualism or gender identity disorder is
controversial. MTF transsexual persons may have abnormal hormonal imprinting, genetic makeup, or psychological attitude toward
gender. They constitute a heterogenous group of people, rather than conforming to a single genotypic or sexual stereotype.

THE TRANSGENDER OF INDIA

In India, transgender people include hijras/ kinnars (eunuchs), shiv-shaktis, jogappas, Sakhi, jogtas, Aradhis etc. In fact, there are many who do
not belong to any of the groups but are transgender persons individually. They constitute the marginalised section of the society in India, and thus
face legal, social as well as economic difficulties.
India has a large community of eunuchs who are men with gender identity disorders. While this community has been studied from a social and
medical point of new, no endocrine work has been done in them.
The problems faced by the transgender people in India include:
• The main problems that are being faced by the transgender community are of discrimination, unemployment, lack of educational
facilities, homelessness, lack of medical facilities: like HIV care and hygiene, depression, hormone pill abuse, tobacco and alcohol
abuse, penectomy, and problems related to marriage and adoption.
• The other fields where this community feels neglected are inheritance of property or adoption of a child. They are often pushed to
the periphery as a social outcaste and many may end up begging and dancing. This is by all means human trafficking. Sometimes
running out of all options to feed themselves, they even engage themselves as sex workers for survival.
• Transgenders have very limited employment opportunities. Transgenders have no access to bathrooms/toilets and public spaces. The lack of
access to bathrooms and public spaces access is illustrative of discrimination faced by transgenders in availing each facilities and amenities.
They face similar problems in prisons, hospitals and schools.
• Hijras face discrimination even in the healthcare settings. Types of discrimination reported by  Hijras/TG communities in the healthcare
settings include: deliberate use of male pronouns in addressing Hijras; registering them as 'males' and admitting them in male wards;
humiliation faced in having to stand in the male queue; verbal harassment by the hospital staff and copatients; and lack of healthcare
providers who are sensitive to and trained on providing treatment/care to transgender people and even denial of medical services.
Discrimination could be due to transgender status, sex work status or HIV status or a combination of these.
• These people are shunned by family and society alike.
• Till recently, they were excluded from effectively participating in social and cultural life.
• Politics and decision-making processes have been out of their reach.
• Transgender people have difficulty in exercising their basic civil rights.
• Reports of harassment, violence, denial of services, and unfair treatment against transgender persons have come to light.
• Sexual activity between two persons of the same sex is criminalised, and is punishable by incarceration.
 LGBT RIGHTS AROUND THE WORLD
The states Tamil Nadu and Kerala in India were the first states to introduce a transgender (hijra/ aravani) welfare policy.
LGBT rights are considered human rights by the Amnesty International and civil rights by some. LGBT rights laws include, but are not limited to,
the following:
• allowing men who have sex with men to donate blood
• government recognition of same-sex relationships (such as via same-sex marriage or similar unions)
• allowing LGBT adoption
• recognition of LGBT parenting
• anti-bullying legislation and student non-discrimination laws to protect LGBT children and/or students
• immigration equality laws
• They were legally granted voting rights as a third sex in 1994.
• anti-discrimination laws for employment and housing
• admission in government colleges with full scholarship for higher studies; alternative sources of livelihood through formation of self-help
groups (for savings) and initiating income-generation programmes (IGP).
• hate crime laws providing enhanced criminal penalties for prejudice-motivated violence against LGBT people
• equal age of consent laws
• equal access to assisted reproductive technology
• access to sex reassignment surgery and hormone replacement therapy
• legal recognition and accommodation of reassigned gender
• laws related to sexual orientation and military service
 POPULATION OF TRANSGENDER IN INDIA

• There is finally an official count of the third gender in the country — 4.9 lakh. While transgender activists estimate the numbers to be six to
seven times higher, they are thrilled that such a large number of people identified themselves as belonging to the third gender, despite the fact
that the census counting happened well before the Supreme Court order gave legal recognition to the third gender in April 2011.

Of the total number of transgenders identified by the census, almost 55,000 are in the 0-6 population. This has come as a big surprise to the
community as they did not expect so many parents to identify their children as belonging to the third gender.
• Over 66% of the population identified as third gender lived in rural areas, very close to the 69% of the overall population that lives in
villages. The census data also revealed the low literacy level in the community, just 46%, compared to 74% literacy in the general population.
• The highest proportion of the third gender population, about 28%, was identified in Uttar Pradesh followed by 9% in Andhra Pradesh, 8%
each in Maharashtra and Bihar, over 6% in both Madhya Pradesh and West Bengal and well over 4% in Tamil Nadu, Karnataka and Odisha.
Rajasthan accounted for over 3% of the total transgender population and Punjab for 2%.
HEALTH CARE
HETEROGENEITY
• Although the community appears a homogenous monolith to outsiders, Indian eunuchs include a wide variety of medical, psychological,
and endocrine conditions and variants.
• Some eunuchs are born with intersex disorders of sexual differentiation and are handed over to the community leaders by their patients.
Other MTF transsexuals choose to join the community of their own free will, and undergo crude, yet radical, gender reassignment surgery.
Yet others are coerced into doing so because of a multitude of factors.
• Physical intersex and gender identity disorder are two different conditions. Some oraganisation is needed to focus upon the potential role
of endocrinology in the management of eunuchs with gender identity disorder.

ENDOCRINE MANAGEMENT: CAVEATS
• As there is considerable variation among different eunuchs, a customized, tailor-made approach to endocrine management will be
required. Comprehensive psychological, medical, endocrine, genetic, and laboratory assessment will be necessary before beginning
endocrine therapy.

DIAGNOSIS OF TRANSSEXUALISM
• Diagnosis of transsexualism needs to be made by an endocrinologist and a psychiatrist or psychologist. The endocrinologist is best
placed to rule out disorders of sexual differentiation, while the mental health professional decides if the eunuch fulfil the criteria for
gender identity disorder.
• Adult, transsexual eunuchs are eligible for cross-sex hormonal therapy if they fulfil the criteria for transsexualism.
• Adult transsexual eunuchs demonstrate readiness for therapy of their female gender identity consolidated by real-life experience or
psychotherapy, if they have stable mental health, and if they are likely to take hormones in a responsible manner.
INDUCTION OF PUBERTY
• It is extremely rare to encounter prepubertal boys in Indian eunuch communities. Occasionally, however, a prepubertal male-to-female
transsexual may request induction of puberty.
• In India, this is an issue with grave ethical, moral, and legal implications. Until clear consensus is generated about the ability of
adolescents to give consent for major medical decisions, this is an area best left untouched.

FEMALE HORMONAL THERAPY
• The aims of hormone replacement therapy in eunuchs are to minimize endogenous androgen levels, suppress masculine secondary sexual
characteristics, and use exogenous female sex steroids to achieve feminine characteristics.

CONSULATION
• Personal medical consult for the people who are in the state of confusion or psych consultation for the people who are undergoing mental
depression

SURGERY
• While Western recommendations recommend genital sex reassignment as a final step of transsexualism, Indian eunuchs have often
undergone crude surgery before presenting to the endocrinologist. This may include orchidectomy and partial or complete penectomy.
NEED FOR THE STUDY
• Inspite of persistent efforts to ensure safe living conditions for the citizens of the country, there is one community that faces criticism at
every stage of their existence. The community of eunuchs, more often referred to as Hijras is often deprived of their right to live and
work like ordinary human beings by the society. This discrimination has made Hijras one of the most disempowered groups in india.
• These people live a life of moritification, insult, oppression and neglect by the family, media and establishment given legitimacy by the
legal system. Most hijras have a lower middle class background which makes them susceptible to harassment. Though the government
has given the transgender certain rights they lack legal protection against such issues

OBJECTIVES
•  To serve a specific community need, the underground level houses revenue-generating parking lot.  To engage the community, the
ground level includes an indoor/outdoor community event space, hosting regular public gatherings.  The design of Hope House will
foster an environment for healing and growth that these young people need during their transition into independence.
• Since physical intersex and gender disorder are two different things, a psych consultation or a clinic can be provided for the people
undergoing gender confusion.
• A community centre for the people who have under gone theraphy where in they can be taught various arts or techniques which may help
them to can earn a livelihood, such as weaving embroidery, dancing, singing, sewing, pottery, organic farming etc.
• In India Lack of communication between health providers (specially, endocrinologists) and eunuchs, lack of awareness about potential
endocrine treatment among eunuchs, a keep distrust of the modern medical system, and a desire to preserve their privacy are some of the
reasons why Indian eunuchs do not seek endocrine help.
• Hence a medical centre for such community can be provided where in they are provided theraphy or sugery after consultation with the
doctors.
 LITERATURE STUDY
HOPE HOUSE - Center for Homeless LGBT Youth

• LGBT youth homelessness in America has become an epidemic This project proposes to design a transitional housing center for
homeless gay and transgender youth in central Washington, DC. Incorporating appropriate color, materiality, lighting, and spatial layout,
Hope House will be model center that is safe, inclusive, and home-like.
• Gay and transgender youth make up about 5 to 10 percent of the general population, yet account for a disproportionate 40 percent of
homeless youth. It is estimated that about 1.6 million 14- to 24-year-olds are homeless, and 550,000 of them are LGBT. Across the
country, there are only 4,000 beds in homeless shelters reserved for youth, with just 350 of these specifically dedicated for LGBT youth.
For every 1 teen sleeping in a shelter, there are over 1,600 on the streets. The need for basic housing for these vulnerable youth is
overwhelming.
• Hope House provides safe housing for 34 total residnets: long-term, dormitory-style housing for 17 residents, as well as short-
term/emergency housing for 17 more.  Incorporating adaptive reuse, a traditional/historic DC elementary school will be transformed and
moved to an ideal site.  To serve a specific community need, the underground level houses revenue-generating parking lot.  To engage the
community, the ground level includes an indoor/outdoor community event space, hosting regular public gatherings.  The design of Hope
House will foster an environment for healing and growth that these young people need during their transition into independence.

DESIGN AND CONCEPT

Adaptive re-use of historic Ross School in Central The Ross School not only met the programming needs (minimum 26K square
Washington DC Northwest. feet and 2-3 levels), but it's historic architecture was fitting for the site in a quiet
NW Washington DC neighborhood.  Using a school was also appropriate, since
school are traditionally known as protective places for children and places of
nurturinig growth.
GROUND FLOOR PLAN
Level One - Main Lobby from entrance.  The "yellow The "twister" or "storm" sculpture suspends from the center of the three-
brick road" staircase leads residents from the story atrium.  It is made of twisted reclaimed wood strips that wrap around
monochrome gray world into a world of color and 69 glass prisms (marking the year of the Stonewall Riots in 1969 that
acceptance. started the modern gay rights movement).  The prisms catch the sunlight
from the glass roof structure, refracts the light, and showers the rainbow
spectrum of light throughout the main atrium.

The large living room sitting area in the main lobby The Level Two atrium central corridors continue the "yellow brick
serves and a hangout, a meeting place, and also hosts road" with the runner rugs and yellow pendant lighting, leading
events to the public. residents to their shared social spaces.
FIRST FLOOR PLAN
 The sitting area in the main atrium serves as a warm, From the atrium sitting area, residents can view the "twister"
inviting meeting place, with it's two-way indoor-outdoor sculpture and the "yellow brick road" staircases.
fireplace and grand piano.

The main dining room seats all 34 residents of Hope House, as Right next to the dining room, the residents' kitchen is another
well as staff and guests.  It also serves as another informal space to gather and socialize.  Residents can share a midnight
gathering space and activity area.  Residents have a beautiful view snack or make their own meals.  The two-way fireplace is shared
of the "yellow brick road" staircase and atrium. with the adjacent living room.
The residents' kitchen has plenty of light and has The residents' primary social space is the main living room, with
plenty of room for all 34 residents to try out their plenty of seating, separate reading and socializing nooks, and a
culinary skills. warm fireplace.

The wrap-around outdoor deck on Level Two has includes The living room also has plenty of light and access to the wrap
more than 3,500 square feet of protected, semi-private around outdoor deck.  Situated in the southwest corner, it has
outdoor living spaces.  Along with plenty of seating for all beautiful views of the evening sunsets.
the residents, staff, and guests, there are also built-in grills
for outdoor cooking, as well as a two-way, indoor-outdoor
fireplace to warm up the chilly nights.
 With ample windows and a collapsable wall, Across the atrium from the living room, there is a Semi private beds with
the rec room also receives plenty of natural more active rec room, complete with video games, lots of storage space
sunlight and has access to the wrap-around pinball, pool, a popcorn machine, and a large 10-foot
outdoor deck. project screen for residents to enjoy movie nights or
the big game!

The study room also has bookshelves for storage Adjacent to the rec room, there is a study room and Common sharing spaces
of books and other school supples, as well as a computer lab for the student residents.  There are such as study, lounge etc
few desks for group study and activities. 10 desktop computer stations and lounge spaces to
curl up and read a book or work on laptops.
SECOND FLOOR PLAN
 LOCATION

HYDERABAD:
• It is the second largest city with transgender population. The transgender population in Hyderabad is estimated to be a little over 44,000.For,
the new `others' column (in the gender section) introduced in the Census this year for the benefit of transgender, is being ignored owing to
family and peer pressure apart from `identity' issues, claim transgender in the city.

Though elated at the government's recognition of this section of society, some local transgender already counted in the 2011 Census
confessed that they were forced to tick the `female' box because of parents and friends.

CRIME RATE
• The transgender who live here are not only disrespected and looked down upon but also suffer through heinous sexual abuse. They are also
forced to sing and dance in captivity. They are also forced into prostitution.
• 44 percent of lesbians and 61 percent of bisexual women experience rape, physical violence, or stalking by an intimate partner
• 26 percent of gay men and 37 percent of bisexual men experience rape, physical violence, or stalking by an intimate partner
• 46 percent of bisexual women have been raped, compared to 17 percent of heterosexual women
• 22 percent of bisexual women have been raped by an intimate partner, compared to 9 percent of heterosexual women
• 40 percent of gay men and 47 percent of bisexual men have experienced sexual violence other than rape, compared to 21 percent of
heterosexual men
• Nearly half (48 percent) of bisexual women who are rape survivors experienced their first rape between ages 11 and 17.
 CONCLUSION

• The eunuchs are an important, and integral, part of Indian society. No celebration is considered complete without their participation and
blessing.
• Yet, they remain a neglected part of our population. Although they have obvious endocrine dysfunction, no systematic attempt has been
made to evaluate, assess, and improve their endocrine health. This is in sharp contrast to the yeoman work done by other scientists, from
allied disciplines, to destigmatize the eunuchs.
• A concerted effort is needed by endocrinologists, and allied specialties, to understand the endocrinology of eunuchs and to optimize it.