The Future of Mental Well-being for Trans Persons in India

The role of society and healthcare professionals.

The first official count of the third gender in India in 2014 was 4.9 lakh. While transgender activists estimate the numbers to be six to seven times higher, such a large number of people identified themselves as belonging to the third gender, despite the fact that the census counting happened well before the Supreme Court order gave legal recognition to the third gender. Of the total number of transgenders identified by the census, almost 55,000 are between the ages of 0 to 6 years. Over 66% of the population that identified as the third gender lived in rural areas. The proportion of those working in the transgender community is also low (38%) compared to 46% in the general population. Only 65% of the total working population are main workers who find work for more than six months in a year compared to 75% in the general population. This census established that the transgender community in India continues to lack equality in terms of educational and employment opportunities.

The main problems that are being faced by the transgender community today are discrimination, unemployment, lack of educational facilities, homelessness, lack of medical facilities: like HIV care and hygiene, depression, hormone pill abuse, tobacco and alcohol abuse, penectomy, and problems related to marriage and adoption. Many of them are pushed to the periphery as social outcasts and are forced to earn their living by methods like begging or becoming sex workers. Trans persons have very limited employment opportunities. Their lack of access to bathrooms and public spaces is illustrative of the discrimination faced by trans persons in availing all facilities and amenities. They face similar problems in prisons, hospitals and schools. This constant discrimination creates an environment that is not conducive to their personal development or mental well being.

The Supreme Court’s judgement on transgender rights covers persons who want to identify with the third gender as well as persons who want to transition from one identity to another, i.e. from male to female or vice versa. The Court has directed Centre and State Governments to grant legal recognition of gender identity whether it be male, female or third gender. In recognising the third gender category, the Court ruled that fundamental rights are available to the third gender in the same manner as they are to males and females. Further, non-recognition of the third gender in both criminal and civil statutes such as those relating to marriage, adoption, divorce, etc is discriminatory to the third gender. Centre and State Governments have been directed to take proper measures to provide medical care to Transgender people in the hospitals and to also provide them separate public toilets and other facilities. Further, they have been directed to operate separate HIV/ Sero-surveillance measures for Transgenders. Unsurprisingly, no clear directions have been given for the mental well being of trans persons.

What can healthcare professionals do?

There has been no detailed study yet on the prevalence of mental illnesses among trans persons in India and their experiences with Mental Health Professionals (MHPs). But agencies which have worked with the community have pointed to the high prevalence and lack of a holistic approach towards mental health. Psychiatric disorders ranging from alcohol abuse and dependence to depressive spectrum disorders are some of the common disorders seen in the trans population in India. Trans persons face additional problems when, in some cases, they are able to access MHPs, owing to the lack of gender awareness and sensitisation of these professionals. Mental health professionals can play a supporting role as educators or advocates in the client’s school or workplace. They can provide resources and counselling to families and help them understand and accept transgenders.

How can civic society play a role?

As long as the society remains the same, government initiatives will do little towards the upliftment of transgenders. As long as the narrow-mindedness of persons and a lack of acceptance persists, inequality will exist and people will continue to be ostracised. A complete mental revolution is, therefore, the key to a better society. As in the case with other areas of social progress, change begins at the grassroots level. Awareness programs are the need of the hour. These will help progressive ideas to percolate into the community and reduce adverse life outcomes for trans persons. The Indian LGBTQ community has always had to live under tense conditions, without access to many basic rights. The trend has been changing lately, with the constant awareness and empowerment of the trans community in India. With hundreds of trans activists from across India participating in the event, this year’s Hijra Habba discussed strategies to strengthen transgender empowerment and tackle key issues specifically related to barriers to their access of health services and legal recognition. One of the biggest achievements of the event was building an understanding on the Transgender Persons (Protection of Rights) Bill 2016, which was recently approved by the Union Cabinet under the Chairmanship of Prime Minister Narendra Modi. India is one of the countries that recognises trans persons as the third gender, and if the government and society continue to take positive steps for the community, it can create support systems that provide for the better mental well being of trans persons.

Feature Image Credit: H Heyerlein on Unsplash

Anoushka Thakkar is a Research Associate (Mental Health) at One Future Collective.