- There is little point in a ruling unless it is enforced
The ICD, International Classification of Diseases, is the ‘standard diagnostic tool for epidemiology, health management and clinical purposes,’ directed and coordinated by the WHO. It contains a section dealing with the preference for a gender other than the birth gender, also known as transgender. The WHO uses the term ‘gender incongruence’ instead of transgender.
Right up to very recently the WHO had classified gender incongruence as a pathological condition, a mental disorder. But now, the WHO has made an important amendment which has been welcomed by many human rights organisations, and medical practitioners.
The Coordinator for the Adolescents and at-Risk Populations team of the WHO has stated that with a better understanding of the matter they have realised that gender incongruence “wasn’t actually a mental health condition,” and that classifying it as such was “causing a stigma.” “So, in order to reduce the stigma while also ensuring access to necessary health interventions, this was placed in a different chapter.”
Gender incongruence in the ICD 11 will now be found in the chapter dealing with sexual health, which may come as a shock to a society such as Pakistan – and other similar societies, where transgender persons are still considered an abomination and treated as such.
Naturally, change takes time, particularly change as radical as one that would permit transgender persons to live the discrimination free life to which each human, and each citizen is entitled. But it is certainly helped along by changes such as the above.
Pakistan contradicts itself in the matter of transgender persons. Persons who do not answer to the gender of their birth are both treated with contempt and held in awe. They are rarely refused alms because it is believed that their curses are effective, yet they are invited to perform, sing and dance at weddings because it is believed their presence brings good luck.
Pakistan possesses a legal Act to protect the rights of transgender persons which was passed into law by the president in 2018. Under this law Pakistanis may identify as whichever gender they prefer
Pakistani society is divided between the more educated and the conservatives who almost unilaterally condemn intimacy among individuals of the same birth sex. And yet there is a small group called the ‘Tanzeem e Ittehad e Ummat’ which in 2016 declared transgender marriages legal under Islamic law.
Pakistan’s laws themselves are confused since they are a mixture of colonial laws (the Penal Code), the Hudood Ordinance which was enacted in 1977 and was part of the ‘Islamisation’ of the country, it prescribed extreme punishments for various things among them same-sex acts. And then there is are some newer laws which are more enlightened.
As listed in \https://en.wikipedia.org/wiki/LGBT_rights_in_Pakistan: in 2009 a Supreme Court ruling said that transgenders were entitled to equal benefit and protection under the law. It called upon the government to protect transgender persons from discrimination and harassment.
The following year once again, the Supreme Court ordered the full recognition of the transgender community, including the provision of free medical and educational facilities, microcredit schemes and job quotas for transgender people in every government department.
In 2017, the Lahore High Court ordered the government to include transgender people in the national consensus.
In February 2018, a Senate committee determined that transgender people could inherit property without being required to have their gender decided by a medical board.
Pakistan possesses a legal Act to protect the rights of transgender persons which was passed into law by the president in 2018. Under this law Pakistanis may identify as whichever gender they prefer. That preferred gender will then be stated on their official documents. A transgender person is given the right to inherit property and run for public office. Sexual discrimination is forbidden under this law and the government is obliged to provide the same assistance to transgender persons as it must to cisgenders.
Yet in Kohat in Pakistan, earlier this month, a transgender person died because the hospital would not send a doctor to treat him. And earlier, in 2016, a young transgender woman Alisha was taken to a hospital in Peshawar after being shot several times. She bled to death in that hospital while doctors debated which gender ward she should be taken to. In both these cases it is striking that the prejudice that led to the death of two persons stemmed from the same community of professionals which in another country made a historical amendment to the way transgenders are categorised.
It is hoped that in the same way as the new WHO categorisation is likely to help remove the stigma surrounding transgender sexuality, its recent Supreme Court rulings will make a difference in Pakistan. But they are unlikely to do so unless transgressions are punished. There is little point in a ruling unless it is enforced.
