INVISIBLE CITIZENS Transgender Bodies and the Right to Health in India, Brazil and South Africa CEU eTD Collection Debjyoti Ghosh SJD, Comparative Constitutional Law, Central European University, March, 2018 Supervisor: Professor Judit Sandor, Central European University Declaration of originality This dissertation contains no material which has been accepted for a degree or diploma by the University or any other institution, except by way of background information and duly acknowledged in the thesis, and to the best of my knowledge and belief no material previously published or written by another person except where due acknowledgement is made in the text of the thesis, nor does the thesis contain any material that infringes copyright. ____________________________ (Debjyoti Ghosh, Kolkata) CEU eTD Collection 2 Table of Contents ABSTRACT ............................................................................................................................6 ACKNOWLEDGEMENTS ..........................................................................................................7 GLOSSARY OF TERMS AND ACRONYMS ....................................................................................9 TERMS ...............................................................................................................................9 ACRONYMS ........................................................................................................................ 15 INTRODUCTION ................................................................................................................... 18 VIEWING THE TRANSGENDER IDENTITY THROUGH THE LENS OF HIV/AIDS ............................................... 20 CHOICE OF JURISDICTIONS ....................................................................................................... 22 IBSA AND HEALTH ................................................................................................................ 27 EVALUATING TRANSGENDER CITIZENSHIP THROUGH THE LENS OF HEALTH IN IBSA ...................................... 29 CHOICE OF TERMINOLOGY....................................................................................................... 31 METHODOLOGY................................................................................................................... 32 TOUR D’HORIZON ................................................................................................................ 33 1. THE RIGHT TO HEALTH FROM A SOCIAL RIGHT TO A HUMAN RIGHT................................... 36 1.1. INTRODUCTION.............................................................................................................. 36 1.2. THE ORIGINS OF THE RIGHT TO HEALTH IN MOD ERN INTERNATIONAL LAW .......................................... 38 1.3. CONVENTIONS, COVENANTS AND THEIR DIFFERENT APPROACHES TO HEALTH ...................................... 42 1.4. DIFFERENT APPROACHES TO HEALTH BEYOND ACCESS TO HEALTHCARE .............................................. 47 1.5. DETERMINANTS OF HEALTH ............................................................................................... 51 1.6. THE ROLE OF PUBLIC HEALTH IN THE RIGHT TO HEALTH ................................................................ 53 1.7. JUSTICIABILITY OF THE RIGHT TO HEALTH................................................................................. 55 1.8. IBSA AND THEIR CONSTITUTI ONS ......................................................................................... 58 1.9. CONSTITUTIONALLY PROTECTING THE RIGHT TO A HEALTHY LIFE ...................................................... 64 1.10. THE “JUDICIALIZATION” OF THE RIGHT TO HEALTH .................................................................... 66 1.10.1. Brazil ................................................................................................................ 68 1.10.2. India................................................................................................................. 72 1.10.3. South Africa....................................................................................................... 76 1.11. THE INTER-AMERICAN COURT OF HUMAN RIGHTS AND THE RIGHT TO HEALTH IN BRAZIL....................... 81 1.12. CONCLUSION .............................................................................................................. 89 2. TRANSGENDER CITIZENSHIP .......................................................................................... 93 2.1. INTRODUCTION.............................................................................................................. 93 2.2. NAVIGATING THE SPACE BETW EEN THEORY AND PRACTICE ............................................................ 95 2.2.1. Being Human ...................................................................................................... 95 2.2.2. Theorising Human Rights ...................................................................................... 96 2.2.3. Of Monsters and Exceptions .................................................................................. 99 2.2.4. Regulating the body through biopolitics ................................................................ 101 2.2.5. Monster Management ........................................................................................ 104 2.2.6. Personhood between Redistribution and Recognition .............................................. 108 CEU eTD Collection 2.2.7. Gender categories as social constructions .............................................................. 112 2.3. HISTORICISING CITIZENSHIP.............................................................................................. 115 2.3.1 Ancient citizenship norms and the exclusion of the woman........................................ 116 2.3.2. The Roman notion of the Patricians and the Plebeians ............................................. 118 2.3.3. The Magna Carta and the notion of all “free men” .................................................. 119 2.3.4. American Independence and natural rights to equality ............................................ 120 2.3.5. The birth of the French Republic and the equality of all men ..................................... 121 2.3.6. The Slavery Paradox ........................................................................................... 123 3 2.4. THEORETICAL CONSTRUCTS ON CITIZENSHIP ........................................................................... 126 2.4.1. Making of the universal notions of Citizenship ........................................................ 126 2.4.2. Challenging universal citizenship .......................................................................... 128 2.4.3. Gender in the rights framework............................................................................ 132 2.4.4. Sexual and Intimate Citizenship ............................................................................ 135 2.4.5. Transgender Citizenship ...................................................................................... 139 2.5. CONCLUSION .............................................................................................................. 142 3. SOUTH AFRICA........................................................................................................... 144 3.1. INTRODUCTION............................................................................................................ 144 3.2. THE SCRAMBLE FOR SOUTH AFRICA – COLONISING THE LANDS ..................................................... 148 3.3. “TRANS”ING HISTORY – A BRIEF OVERVIEW OF TRANSGENDER PEOPLE IN SOUTH AFRICA....................... 149 3.4. CHANGING NARRATIVES IN THE RAINBOW NATION ................................................................... 153 3.5. CREATING THE LEGAL BODY OF THE SOUTH AFRICAN TRANSGENDER CITIZEN ..................................... 155 3.6. THE ALTERATION ACT NO. 49 OF 2003 – LAW AND IMPLEMENTATION........................................... 160 3.7. THE CASE OF KOS – CHALLENGING THE NOTION OF MARRIAGE AND UNION ...................................... 165 3.8. CONCLUSION .............................................................................................................. 173 4. BRAZIL ...................................................................................................................... 176 4.1. INTRODUCTION............................................................................................................ 176 4.2. BRAZIL, FROM A COLONY TO A FEDERAL REPUBLIC .................................................................... 177 4.3. REALISING THE NOTION OF TRANSGENDER IN BRAZIL................................................................. 181 4.4. CREATING THE VOCABULARY ............................................................................................ 181 4.5. TRANSGENDER-ORIENTED MOVEMENTS ............................................................................... 183 4.6. EXERCISING CITIZENSHIP RIGHTS FOR TRANSGENDER PEOPLE IN BRAZIL............................................ 185 4.7. CONCLUSION .............................................................................................................. 189 5. INDIA........................................................................................................................ 191 5.1. INTRODUCTION...........................................................................................................