This is the Abstract Presentation of Sobo Malik of Khwaja Sira Society of Pakistan. This presentation was part of the 14th session of #APCRSHR10 Virtual, on the theme of "Sexual orientation and gender identity and SRHR in Asia Pacific". Chair: Dr Chivorn Var, Convener of APCRSHR10 and Executive Director of Reproductive Health Association of Cambodia (RHAC) Plenary Speaker: CheyLeaphy Heng, Program Team Manager, Rainbow Community Kampuchea (RoCK) | "UPR as an advocacy strategy for SOGIE-SC issues in Cambodia" ABSTRACT PRESENTERS: * Saroj Tamang | Male-to-Female Transgender Community barrier and challenges in access of Sexual Health Services * Saritha P Viswan | A review of transgender issues in India * Sobo Malik | Limited Access to Health Rights Resulting in Increase Self Medication * Ciptasari Prabhawanti | Sexual Identity, Sexual Orientation, Sexual Risk and Condom Use Behaviors of Clients of Transgender Sex Workers in Jakarta, Indonesia For further information, visit www.bit.ly/apcrshr10virtual14 Conference website: www.apcrshr10cambodia.org or check out www.bit.ly/apcrshr10virtual Thanks

1. LIMITED ACCESS TO
HEALTH RIGHTS
RESULTING IN INCREASE
SELF MEDICATION
A Research on the Transition Process carried out by
Transgender People In Pakistan
SOBO MALIK
KHAWAJA SIR SOCIETY

2. Background on Objective
• Khawaja Sira Society is working since 2012 on Health Rights of
Transgender People of Pakistan.
• Being part of Trans Based and Trans Led Organization Khawaja Sira
Society I came across number of cases from Transgender Person on
Self Medication.
• The lack of medical facilities and non availability of specialized doctors
on hormonal therapy (endocrinologist) led us to research on the
methods of hormone intake and consequences.

3. Research Method
One on one interview has been conducted with 15 Transgender woman
between the age of 18 to 28 who are on the self medication from minimum
of last six months. A standard but open ended questioner was developed
which has been filled by the each transgender and an open one on one
discussion on their transition history, issues and access to medication was
conducted. Confidentiality of the participants was the first priority to be
maintained and standards as per Khawaja Sira Society Manual was followed.

4. Findings
• 15 out of 15 participants have mentioned that they started the intake
of medicines without consulting to any doctor or hormonal test.
• 12 out of 15 were following the same dose as taken by their other
Transgender friends whereas 3 out of 15 have some research through
internet but never consulted any doctor.
• 13 out of 15 reported that they suffered depression and anxiety after
the intake of Hormonal medicines within the period of 2 months
whereas 6 out of 15 also reported severe pain in lower abdomen and
testicles.
• Depression has also led to use of drugs reported by 5 out of 13 and 1
out of 13 also reported her suicidal attempt.

5. Conclusion
• Open to high risk of Mental and Physical Problems due to lack of
awareness and medical facilities in Pakistan
• Need to have a Psycho Social support interventions (counselling,
awareness sessions and knowledge enhancement)
• Need to establish referral linkages with healthcare settings including
transitioning process
• Need for post follow up mechanism (routine checkups, consultation
and prescribed doses after hormonal tests).

6. Action Plan 2020-2021
• Advocacy toolkit and action plan to get access for health rights
• Sensitization guidelines for health care providers
• Hormonal Guidelines (Hormonal Replacement Therapy)
• Drop In Center Services (Psycho Social Support)
• Referral Linkages with Government and Private Health Centers