Table 1.

The Risks and Needs of Transgender Community During Pandemics and the Proposed Interventions.

Risks & needs	Possible interventions
Stigma, Discrimination & Exclusion	Address knowledge, attitude and practice gaps through accurate and consistent effective communication, information, education activities Involvement of media, to eradicate myths and misconceptions on them, especially social media, for the swift and economical reach to a large population Significant ones of transgender persons to be sensitized regarding their various psychosocial and sexual needs Community sensitization on “transgender persons,” their sexual expressions, roles and social interactions as natural variant of human sexuality Create social awareness through short films, videos and other IEC materials Prevent “transphobia” and “hate speech” in the society Develop “healthy sense of self,” regarding sexual orientation and identity Training to legal personnel to create sensitization at all service sectors to prevent all types of violence and abuses against them Creating awareness about helplines and support networks related to violence and abuses Enact legislations to address the rejection and isolation of transgender persons Active and direct involvement of transgender persons while combating COVID-19 and implementing the response and welfare measures Establish and strengthen regional transgender networks at the community level to link them with protective resources, facilities and services. Ensure their privacy is not breached while using technologies Empowerment and capacity building
Health and Wellbeing Needs	Disseminate targeted information to them including transmission, treatment and prevention of Covid-19 infection and the means to access it including technologies Sensitization about preventive measures like hygiene protocols (mask, hands) and physical distancing Assure priority viral testing and detection among them so that early treatment and prevention can be provided Screen for other medical co-morbidities like diabetes, hypertension, etc. Ensure active HIV and STD screening and other health checkups timely Ensure adequate quarantine facilities and improvise surveillance Ensure social distancing does not lead to further social exclusion Advocate for healthy social connectedness and intimacy through digital means Facilitate rations (nutritious foodstuffs, groceries) and other basic services related to pure water, sanitation, shelter etc. and relive them from the insistence of any identity cards to avail it Assure the provisions of reasonable accommodation, basic living facilities, quarantine amenities, and hygiene measures for homeless and person living in overcrowded settings Imperative to have a multisectoral and multidisciplinary local level pandemic preparedness and response plans Promote and monitor harm reduction and preventive measures for impulsivity, high risk behaviors (sexual, substance abuse etc.) Ensure the quality online services including telemedicine and professional services tailored to the needs of them Guarantee the continued treatment and supply of essential medication including hormone replacement therapy, anti-retroviral drugs and other life saving medicines Promotional measures for health and mental health communications including copying strategies during crisis and emergencies Provide training for the health care providers (from primary level) to prevent inequalities and screen for common mental health illness and take actions Establish helpline and online counseling facilities and integrate it along with other helplines Forbid the refutation of treatment and establish measures to strengthen help seeking behaviors Promote positive and affectionate parental and familial interactions Strengthen laisoning and supports networks Prioritize health needs and conditions of elderly, ensuring prompt supports
Socio-Economic Needs	Identify and mitigate the unintended financial setback of this pandemic, focusing on fiscal drive and recovery plans Government to provide special allowances and loans for informal and temporary workers, daily wagers and unemployed persons Specific funds for transgender organizations and associations Regulation and compensation for loss of job and drop of remuneration Develop and extend social welfare and protective measures (e.g., paid medical leaves, unemployment benefits, health insurances) to all employees Encourage appropriate flexible working arrangement like tele- services Ensure socialization and participation of transgender persons in the formal employment sectors Encourage union of all stakeholders to collaboratively involving in raising funds and investments minimizing the misery and dodging harm to the entire economy Ensure labor rights and secure working environments Hurdle-free availability of the ration cards or necessary ID cards to avail relief packages by the government or make it hurdle free Constructive and consistent social dialogue between all stakeholders in developing and implementing effective responses measures Networking with governmental and nongovernmental organizations as well as other private settings for the effective rehabilitative and palliative services Endorse national or international research on the impact of Covid-19 on transgender community to address it more effectively