India: Guidelines for the assessment of medical fitness of trans seafarers

According to the Directorate, a transgender applicant’s medical fitness shall be assessed on a ‘case to case basis’. Candidates have to declare their gender as per the certificate of identity issued by the TC District Magistrate as prescribed in the ‘Transgender Person (Protection of Rights) Act, 2019.

The candidate has to declare that they are taking any treatment for hormone replacement therapy (HRT). As per the declared gender, candidates will be examined for medical literacy as per medical examination rule 2000 and a medical fitness certificate to be issued.

The transgender applicants undertaking a regular examination will register with the gender as per their ‘Certificate of Identity’ issued by the Government of India (male, female, or transgender).

DGS medical examiners undertaking these initial medical examinations will obtain a detailed medical report from their treating specialists (an endocrinologist or reconstructive surgeon) assisting the applicant in gender re-assignment (if any) to complete the examination report.

However, they will not issue a ‘fit’ medical certificate and will declare them ‘temporary unfit’ for a detailed evaluation at an appropriate center, and will forward the application to DGS.

Medical Examiner at DGS will issue a Temporary Unfitness’ letter and recommend further review at the earlies. The applicant will be evaluated in accordance with the following broad guidelines:

• Those transgender applicants who have been taking hormone therapy or had gender reassignment surgery within the past five years will be screened for their mental health status (there a recommended checklist in the circular bellow).
• The applicant shall submit a detailed report to the treating endocrinologist containing the details of the hormone therapy the applicant has been taking, including its duration, dosage, and frequency. record of changes in therapy, hormone assay reports, and any documented side effects.
• If the applicant is on hormone replacement therapy, as with any medication, on the commencement of hormone therapy or any change in the drug or adjustment of its dose, the applicant will be declared legally unfit’ for at least three months. – This duration can vary depending upon the risks and side effects that might affect SAFB exercise and the privileges of the medical assessment.
• Applicants who undergo surgical procedures for gender reassignment will be declared medically’ unfit’ for a minimum period of three months after the procedure or until a complete clinical recovery has been achieved. There is no impairment of the applicant’s functional ability, and there is no significant risk of incapacitation related to the surgical procedure.

The marine medical disposition of the applicants who satisfy the conditions listed above, as well as the mental health status checklist, can be found in the circular bellow:

download THE circular HERE