“ Seperti main lotre ” (“like playing the lottery”): testamentary exclusion, administrative burden, and death-benefit access among low-income transpuan in a community-enrolled scheme in Indonesia, a critical documentary case study

Background: Transgender women in Indonesia (transpuan or waria) often experience family estrangement and rely on community networks for care during illness, aging, and death. Aims: To examine how BPJS Ketenagakerjaan’s death-benefit (Jaminan Kematian, JKM) eligibility and verification rules shaped access for low-income transpuan enrolled through a community-subsidized scheme, many described as middle-aged or older, and explore the implications for health and rights Methods: A critical documentary case study of a claims dispute documented from 2022 to April 2024 (with contextual documents to July 2026), drawing on regulations, the agency’s technical guideline, oversight-body statements, news reports, and community documentation. Data were analyzed using chronological reconstruction, legal analysis of primary regulatory texts, and reflexive thematic analysis. Results: Of nine claims reported by March 2024, only two received the full benefit (IDR 42 million); most yielded only the funeral payment (IDR 10 million). Three mechanisms operated within the dispute: heir-centered eligibility that erases chosen family; a notarial-deed requirement in an internal guideline that appears to exceed the governing regulation; and contested verification of employment and chronic-illness status. Two further themes give context and interpretation: upstream documentary precarity filtered through neighborhood-level stigma (evidence from other cities) and anticipatory distress about an undignified burial. The agency’s strongest counter-arguments, including fraud control and will formalities, are examined. Conclusions: Administrative rules that presume heteronormative kinship may function as a structural determinant of health for transpuan, many of whom are older; no health outcomes were measured, so the health link is a plausible pathway rather than a finding. Amid escalating persecution since 2025, recognizing testamentary beneficiaries and community custodians, limiting verification to the facts the regulation makes relevant, and integrating social-protection navigation, with strong data protection, into transgender health services are urgent.