When Dr Koyyala Ruth John Paul came out to her family as a transgender woman, she says she was beaten and forced to leave home. She was in the third year of her medical course. At a time when she could have lost the chance to continue her education, she found support among members of the transgender community and kept studying.Today, the doctor from Khammam district in Telangana has completed her MD in Emergency Medicine. At 31, she is among the first Dalit transgender women in India to achieve this qualification, as reported by The Indian Express. But the degree has not ended her struggle. She is still seeking official recognition of her gender in records and wants to work in a government hospital.
Forced to leave home, she found support in her community
Dr Ruth is the youngest of three siblings and grew up in Khammam. Her father died of a cardiac arrest in 2006, after which her mother, a daily wage labourer, raised the three children. Books remained an important part of her life. She says she was inspired by the life and work of Dr BR Ambedkar, particularly his emphasis on dignity, education and the fight against caste discrimination.Ruth completed her Class 10 and Class 12 examinations with good results. She enrolled for medicine using the gender assigned to her at birth. However, during her third year of medical studies, she came out to her family. She said that her family struggled to accept her identity. “They beat me and threw me out of the house,” she said.She said she saw begging and sex work as the two options available to her at the time. She eventually connected with educated members of the transgender community, who helped her continue her studies. Hyderabad-based transgender activists Rachana Mudraboyina and Vyjayanthi Vasantha Mogli supported her during this period. She completed her MBBS in 2019 from a medical college in Hyderabad. Her relationship with her family has since improved. They are now reconciled and support her.
A medical career, but repeated rejection
In August 2023, she joined the Employees’ State Insurance Corporation (ESIC) Medical College and Hospital in Hyderabad for an MD in Emergency Medicine.
After completing her MBBS, Ruth faced difficulties finding work. As per a 2022 TOI report, 15 hospitals in Hyderabad had turned her away after her graduation in 2018. The report also said that she and another transgender doctor, Prachi Rathore, were appointed as medical officers at the state-run Osmania General Hospital, becoming the first transgender duo to get government jobs in Telangana.“It is a huge day for me and my community. I really did not expect this because I was rejected ever since I graduated. They never told me outright, but the reason was apparent,” Ruth told TOI at the time.Her next challenge was securing a postgraduate medical seat. She appeared for and cleared NEET-PG three times between 2021 and 2023. Although the application form allowed her to register as an SC transgender woman, she said she was placed in the women’s category during counselling.She approached the Telangana High Court in 2021, seeking recognition as a Scheduled Caste transgender woman for admission purposes. In 2022, the National Medical Commission (NMC) wrote to her that she could not be included in the transgender category during counselling because there was no precedent for such an inclusion.The issue also came before the Telangana High Court in June 2023. As reported by The Times of India, the court questioned whether prejudice was preventing a transgender candidate from securing a postgraduate medical seat. It sought details of the marks of candidates admitted under the Scheduled Caste and Other Backward Classes categories.The court’s observations came amid a dispute over how Ruth should be considered during NEET-PG counselling. Her lawyers argued that transgender candidates should be recognised as a separate category in accordance with the Supreme Court’s directions.In August 2023, she joined the Employees’ State Insurance Corporation (ESIC) Medical College and Hospital in Hyderabad for an MD in Emergency Medicine. At the time, she had become the first transgender person to join a postgraduate medical programme in the state. She had wanted to specialise in obstetrics and gynaecology, but was allotted Emergency Medicine.The legal dispute over her recognition as a transgender candidate continued. According to the Indian Express report, the case is still pending before the Telangana High Court. In 2023, the court passed an interim order allowing her admission, but in the women’s category. She said she was thrilled when the MD examination results were announced on October 9.
Why she chose medicine
For Ruth, becoming a doctor was not only about completing a degree. She was also concerned about the difficulties transgender women faced in accessing healthcare. She says that she had seen transgender women in her neighbourhood living with HIV/AIDS who struggled to receive proper medical attention because of their identity.After facing difficulties finding work, she joined Mitr Transgender Clinic, a specialised healthcare network for the transgender community that was initially funded by USAID. The Hyderabad clinic shut down after funding cuts in 2025. It reopened in May that year as Sabrang Clinic in Narayanguda.She now works at ESIC Hospital in Hyderabad. Her older brother’s name, John Paul, is the surname she has chosen to use. According to her, he had wanted to become a doctor, but their mother could not afford to fund his education.Completing her MD has taken Ruth another step towards the career she wanted. But she says she still wants her gender to be correctly reflected in official records and hopes to work in a government hospital, where she can treat people who cannot afford private healthcare.
