Breaking down barriers to trans and gender-diverse-inclusive healthcare in Uganda

Sarah Nangobi (not her real name) is a nurse at a public health centre in Jinja, one of Uganda’s busy commercial hubs. Like many of her colleagues across the country, she has encountered trans and gender-diverse patients seeking care. But unlike before, she no longer hesitates when they walk through her clinic doors.

“I used to feel confused when someone’s appearance didn’t match their national ID," Nangobi admits. “I didn’t know how to address them, and sometimes I would just refer to them elsewhere because I was uncomfortable."

If you work in healthcare in Uganda, this might sound familiar. Many medical personnel have struggled with providing services to trans and gender-diverse patients, often due to a lack of knowledge, cultural biases, or institutional barriers that leave both providers and patients frustrated.

With support from UNAIDS, this was what Tranz Network Uganda (TNU) was trying to address with its groundbreaking healthcare provider training program. As a leading advocacy organisation, TNU focuses on advancing the rights and well-being of trans and gender-diverse people across Uganda.

The training sessions conducted in both Kampala and Jinja engaged healthcare workers on how to provide respectful and human rights-based, inclusive services to patients in a culturally sensitive yet medically appropriate way. The initiative brought together 50 healthcare providers from central, eastern, western, and northern regions.

This intervention was necessary because in Uganda, healthcare access for trans and gender diverse people remains severely limited, yet the community faces disproportionate health challenges. Let us look at the reality on the ground:

Countless trans and gender-diverse Ugandans continue to face discrimination, stigma, and outright denial of services in health facilities. From harsh language to refusal of care, many trans patients report being humiliated or turned away simply because their gender identity does not conform to social expectations. For example, according to a 2025 Ethnographic Study by TNU, 58% have faced health care discrimination. Additionally, slightly more trans women were denied access (68%) and transmen, a bit lower (62.5%).

When it comes to the broader health landscape, trans and gender diverse people face elevated risks of HIV infection, mental health challenges, and other health complications, yet they often avoid seeking care due to fear of mistreatment. To put this into perspective, imagine having a treatable condition but being too afraid to visit a hospital because you might be ridiculed or rejected. That’s the reality many trans and gender-diverse Ugandans face daily.

Yet according to Uganda’s Ministry of Health, all health services in the country are intended to be non-discriminatory. In a recent statement, the ministry emphasised that “no one should be denied access to health care based on their gender identity, sexual orientation, or any other status." This is in line with Uganda’s Patient Rights and Responsibilities Charter (2019), which states that “no health facility or health provider shall discriminate between patients on grounds of… sexual orientation or other such grounds" and that “every person in need of health care is entitled to impartial access to treatment."

Thus, it is important to note that even though healthcare systems have excellent potential to promote good health outcomes for all people, they often fail to serve marginalised communities like trans and gender-diverse persons inclusively and respectfully.

“Healthcare providers play a vital role in ensuring that every person, regardless of their gender identity, can access quality care with dignity," explained a TNU program coordinator. “Building knowledge and empathy among frontline workers will strongly help break down the barriers that prevent trans and gender-diverse people from seeking the care they need."

Consequently, by promoting understanding and respectful practices, healthcare providers can help break the culture of silence and stigma associated with trans and gender diverse health issues. “How you treat a patient creates a lasting impact. Simple respect and appropriate language can transform someone’s entire healthcare experience," advised one of the training facilitators.

The training sessions focused on several key areas essential for providing trans-inclusive care. Understanding the lived realities of trans people was paramount, with facilitators drawing on ethnographic research to highlight the daily challenges faced by trans and gender diverse Ugandans in accessing health services. Participants explored practical steps to create safer, more welcoming spaces for trans and gender-diverse patients, from using appropriate language and pronouns to challenging disrespectful behaviour within health teams.

Healthcare workers were reminded of their duty to uphold the rights, confidentiality, and dignity of every patient, in line with professional codes of conduct. Uganda’s Patient Charter reinforces this obligation, stating that “patients have the right to privacy in the course of and care” and that “information concerning the patient’s health… may only be disclosed with informed consent.”

As Sarah Nangobi explained to her colleagues during follow-up discussions in Jinja, “We need to remember that behind every patient is a human being deserving of our care and respect. When we create a welcoming environment, people are more likely to seek help early, which leads to better health outcomes for everyone."

Nangobi believes that healthcare providers should not wait for trans and gender diverse patients to educate them about inclusive care, but should instead take the initiative to learn about the unique challenges these communities face and how to address them professionally.

By the end of the training sessions, participants agreed on a shared commitment to continue building trans-inclusive services. This includes further mentorship, stronger partnerships with local and community health leaders, and working with the Ministry of Health to improve policies and practices that protect trans and gender-diverse Ugandans’ right to health.

“Health is a human right," one healthcare provider reflected, “and that right should not be limited by how you identify."

For TNU, this work represents a crucial step in a broader mission to create a more inclusive healthcare system. Through partnerships, community dialogues, and ongoing advocacy, TNU and its allies remain committed to dismantling the social and institutional barriers that keep trans and gender-diverse Ugandans from accessing the health and dignity they deserve.

The impact of these efforts extends beyond individual encounters. When healthcare providers are equipped with knowledge and empathy, they become advocates for change within their institutions, creating ripple effects that can transform entire healthcare systems. This is not just about treating illness; it’s about affirming the fundamental human dignity of every person who seeks care.