Mental health and gender transitioning among hijra individuals: a qualitative approach using the minority stress model

Abstract

This study used the minority stress model to explore experiences of gender transitioning among hijra (trans woman) individuals in Mumbai, India. It used a qualitative life history calendar approach to examine transitioning as a critical life experience in a chronological manner. Twenty hijra-identified persons were recruited using purposive snowball sampling and interviewed at a community-based organisation. Data were analysed using thematic analysis. Participants reported diverse experiences living as hijra and shared perspectives on transitioning. Most participants identified to undergo transitioning at their own will. Many cited biological families as a factor that restricted or delayed transitioning, while gharana (congregation of hijras) and gurus were listed as sources of support. Participants also differed in the reasons given for transitioning, expectations, types of practices, and issues of access and support. Transitioning was described as an integral part of their experiences as hijra and developing a congruent self. Implications of the study include the need to engage communities in determining their needs and social support, provide holistic transitioning services at public hospitals, and develop technical and cultural sensitivity training for health professionals.

Keywords:

• Gender transitioning
• hijra
• India
• transgender
• minority stress

Acknowledgements

We thank Vivek Anand, Alpana Dange and Shruta Mengle Rawat from The Humsafar Trust, Mumbai for their support and assistance in carrying out the research activities. We also thank research participants for sharing their stories and strength with us.

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1 Badhai refers to give blessings by dancing at auspicious occasions like weddings, birth ceremonies, or openings of new businesses; manghti refers to begging for alms and blessings in trains, at crossroads or in other public spaces; pan refers to commercial sex work.

2 This study was based on the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, which used the term “gender identity disorder”; the current fifth edition uses the term “gender dysphoria” to describe the distress that might be present in the context of incongruence between sex assigned at birth and gender identity.

3 Dai nirvana refers to the traditional method of removing entire male external genitalia by an experienced hijra-identified person called a dai maa. The dai maa has no medical training; however, it is believed that she operates with the power of the Mata (Mother Goddess Bahuchara). The procedure also involves elaborate worship rituals for the blessing of the goddess for successful transition.