For two years in slum neighborhoods outside Mumbai in India, a group of trans women known as “Sakhee didis,” or trusted sisters, have been on a mission to vaccinate migrant children in the densely populated settlements.

Twelve trans residents in the neighborhoods were recruited by two groups — NGO ZMQ and Gavi, the Vaccine Alliance — for the “Sakhee Project,” to educate and raise vaccination numbers among a population of mostly Muslim migrants from other Indian states.

Related

Indian court rules that trans women are women

The effort was a resounding success, but followed a rough start.

“People thought we had bad intentions,” recalled Tulsi Agarwal, one of the transgender women staffing the project. “Some even believed we would kidnap their children and turn them into eunuchs.”

Never Miss a Beat

Subscribe to our newsletter to stay ahead of the latest LGBTQ+ political news and insights.
Subscribe to our Newsletter today

Trans women have conflicting reputations in India, as both modern-day outcasts and ancient bearers of blessings and good fortune for families and communities. Early days of the two-year pilot program were devoted to changing one estimation for the other.

“We are always seen as beggars or troublemakers,” said Amrin Khan, another Sakhee didi. “We don’t get respectable jobs. This was a chance to earn with self-respect – but more than that, it was a chance to serve society.”

Wadia Qureshi, another member of the group, said the Sakhee didis “were determined to make ourselves useful in a noble mission.”

Program organizers recognized unique traits among trans women that would be helpful in the outreach effort. They were fluent in multiple languages and deeply embedded in informal neighborhood networks. The women often knew when a child was born or when a mother was pregnant before the formal health system did.

And cultural skills — like storytelling, singing, and humor — could help turn intimidating public health messaging into “conversations that felt familiar rather than threatening,” organizers said.

“Urban slums are crowded and complex,” said Hilmi Quraishi, founder of ZMQ. “Migrant families often fear authorities, especially if they lack documents. The program succeeded because it recognized strengths that already existed within the transgender community. We needed a bridge between the health system and the community.”

“At first, we were chased away,” Amrin Khan said. “Later, people started inviting us in, offering us tea, and asking for advice. They would say, ‘Come in, sister. Sit down and talk.’”

1,500 children received life-saving vaccines over two years, with the Sakhee didis visiting approximately 40 households every day. Health workers reported they reached families they wouldn’t have otherwise.

“They made our work much easier,” said Yasmeen Khan, an auxiliary nurse and midwife. “When we went with them, people opened up. They were excellent communicators and played a crucial role in overcoming vaccine hesitancy.”

NGO ZMQ hasn’t said if a permanent program will follow the successful pilot, but the innovative outreach has changed the lives of migrant children and the Sakhee didis alike.

The women said the work gave them a sense of legitimacy they hadn’t known before.

“Earlier, people avoided us,” one worker said. “Now, when we talk about children’s health, they listen.”

Subscribe to the LGBTQ Nation newsletter and be the first to know about the latest headlines shaping LGBTQ+ communities worldwide.