Kerala has been at the forefront of LGBT issues in India. Kerala is one of the first states in India to form a welfare policy for the transgender community. In 2016, the Kerala government introduced free sex reassignment surgery through government hospitals. Queerala is one of the major LGBT organisation in Kerala. It campaigns for increased awareness of LGBT people and sensitisation concerning healthcare services, workplace policies and educational curriculum. Since 2010, Kerala Queer Pride has been held annually across various cities in Kerala