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Original Research

Barriers faced by trans men (female to male transgender persons) in gender transitioning in Pakistan

, MS, , PhD & , PhD
Pages 233-264 | Received 08 Aug 2022, Accepted 25 Nov 2022, Published online: 27 Jan 2023

References

  • Aghabikloo, A., Bahrami, M., Saberi, S. M., & Emamhadi, M. A. (2012). Gender identity disorders in Iran; request for sex reassignment surgery. International Journal of Medical Toxicology and Forensic Medicine, 2(4), 128–134.
  • Ahmad, Z. (2011). O2-S6. 06 Sexual practices of transgender community in Pakistan. Sexually Transmitted Infections, 87(Suppl 1), A68–A69. https://doi.org/10.1136/sextrans-2011-050109.102
  • Ahmer, Z., Yasir, S., & Tariq, H. (2021). Knowledge and attitudes regarding transgender and intersex individuals among medical students and health care providers of Karachi, Pakistan. Liaquat National Journal of Primary Care, 3(1), 3–7. https://doi.org/10.37184/lnjpc.2707-3521.3.4
  • Aitken, M., Steensma, T. D., Blanchard, R., VanderLaan, D. P., Wood, H., Fuentes, A., Spegg, C., Wasserman, L., Ames, M., Fitzsimmons, C. L., Leef, J. H., Lishak, V., Reim, E., Takagi, A., Vinik, J., Wreford, J., Cohen-Kettenis, P. T., de Vries, A. L. C., Kreukels, B. P. C., & Zucker, K. J. (2015). Evidence for an altered sex ratio in clinic‐referred adolescents with gender dysphoria. The Journal of Sexual Medicine, 12(3), 756–763. https://doi.org/10.1111/jsm.12817
  • Akbar, A. (2016). Transgender Alisha succumbs to wounds at Peshawar hospital. DAWN. https://www.dawn.com/news/1260559.
  • Akhtar, H., Badshah, Y., Akhtar, S., Kanwal, N., Akhtar, M. N., Zaidi, N. U. S. S., & Qadri, I. (2012). Prevalence of human immunodeficiency virus infection among transgender men in Rawalpindi (Pakistan). Virology Journal, 9(1), 229–229. https://doi.org/10.1186/1743-422x-9-229
  • Akhtar, M., & Bilour, N. (2020). State of mental health among transgender individuals in Pakistan: Psychological resilience and self-esteem. Community Mental Health Journal, 56(4), 626–634. https://doi.org/10.1007/s10597-019-00522-5
  • Altaf, A., Zahidie, A., & Agha, A. (2012). Comparing risk factors of HIV among hijra sex workers in Larkana and other cities of Pakistan: An analytical cross sectional study. BMC Public Health, 12(1), 279–279. https://doi.org/10.1186/1471-2458-12-279
  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Press.
  • Ashwal, J. E. (2017). Lived experiences of gender identity and expression within the South African transgender community [Master’s thesis, University of the Witwatersrand].
  • Atnas, C., Milton, M., & Archer, S. (2015). Making the decision to change–the experiences of trans men. Counselling Psychology Review, 30(1), 33–42.
  • Bariola, E., Lyons, A., Leonard, W., Pitts, M., Badcock, P., & Couch, M. (2015). Demographic and psychosocial factors associated with psychological distress and resilience among transgender individuals. American Journal of Public Health, 105(10), 2108–2116. https://doi.org/10.2105/ajph.2015.302763
  • Barr, S. M., Budge, S. L., & Adelson, J. L. (2016). Transgender community belongingness as a mediator between strength of transgender identity and well-being. Journal of Counseling Psychology, 63(1), 87–97. https://doi.org/10.1037/cou0000127
  • Beek, T. F., Kreukels, B. P., Cohen‐Kettenis, P. T., & Steensma, T. D. (2015). Partial treatment requests and underlying motives of applicants for gender affirming interventions. The Journal of Sexual Medicine, 12(11), 2201–2205. https://doi.org/10.1111/jsm.13033
  • Bowling, J., Blekfeld-Sztraky, D., Simmons, M., Dodge, B., Sundarraman, V., Lakshmi, B., Dharuman, S. D., & Herbenick, D. (2020). Definitions of sex and intimacy among gender and sexual minoritised groups in urban India. Culture, Health & Sexuality, 22(5), 520–534. https://doi.org/10.1080/13691058.2019.1614670
  • Braz, C. (2019). Lives on hold? Itineraries in access by trans men to health services in Brazil and Argentina. Cadernos de Saúde Pública, 35. https://doi.org/10.1590/0102-311xer110518
  • Brown, G. R., & Jones, K. T. (2015). Incidence of breast cancer in a cohort of 5,135 transgender veterans. Breast Cancer Research and Treatment, 149(1), 191–198. https://doi.org/10.1007/s10549-014-3213-2
  • Campbell, M. M., Fresán, A., Addinall, R. M., Böhmke, W., Grobler, G. P., Marais, A., Wilson, D., Stein, D. J., Reed, G. M., & Robles, R. (2018). Experiences of gender incongruence and the relationship between social exclusion, psychological distress, and dysfunction among South African transgender adults: A field-study for ICD-11. Annals of Clinical Psychiatry : Official Journal of the American Academy of Clinical Psychiatrists, 30(3), 168–174.
  • Carlson, K. J., Irwin, J. A., Dowdall, J. R., Figy, S., C., & Amoura, N. J. (2021). Integrated comprehensive care for transcare and gender diverse clinic patients: An assessment of physical, mental, and social needs. Cureus, 13(12), e20544.https://doi.org/10.7759/cureus.20544
  • Carrara, S., Hernandez, J. D. G., Uziel, A. P., Conceição, G. M. S. D., Panjo, H., Baldanzi, A. C. D. O., … Giami, A. (2019). Body construction and health itineraries: A survey among travestis and trans people in Rio de Janeiro, Brazil. Cadernos de Saude Publica, 35, e00110618. https://doi.org/10.1590/0102-311xer110618
  • Chen, R., Zhu, X., Wright, L., Drescher, J., Gao, Y., Wu, L., Ying, X., Qi, J., Chen, C., Xi, Y., Ji, L., Zhao, H., Ou, J., & Broome, M. R. (2019). Suicidal ideation and attempted suicide amongst Chinese transgender persons: National population study. Journal of Affective Disorders, 245, 1126–1134. https://doi.org/10.1016/j.jad.2018.12.011
  • Cheung, A. S., Ooi, O., Leemaqz, S., Cundill, P., Silberstein, N., Bretherton, I., Thrower, E., Locke, P., Grossmann, M., & Zajac, J. D. (2018). Sociodemographic and clinical characteristics of transgender adults in Australia. Transgender Health, 3(1), 229–238. https://doi.org/10.1089/trgh.2018.0019
  • Colebunders, B., De Cuypere, G., & Monstrey, S. (2015). New criteria for sex reassignment surgery: WPATH standards of care, Version 7. Revisited. International Journal of Transgenderism, 16(4), 222–233. https://doi.org/10.1080/15532739.2015.1081086
  • Coleman, E., Bockting, W., Botzer, M., Cohen-Kettenis, P., DeCuypere, G., Feldman, J., Fraser, L., Green, J., Knudson, G., Meyer, W. J., Monstrey, S., Adler, R. K., Brown, G. R., Devor, A. H., Ehrbar, R., Ettner, R., Eyler, E., Garofalo, R., Karasic, D. H., … Zucker, K. (2012). Standards of care for the health of transsexual, transgender, and gender-nonconforming people, version 7. International Journal of Transgenderism, 13(4), 165–232. https://doi.org/10.1080/15532739.2011.700873
  • Condat, A., Mendes, N., Drouineaud, V., Gründler, N., Lagrange, C., Chiland, C., Wolf, J.-P., Ansermet, F., & Cohen, D. (2018). Biotechnologies that empower transgender persons to self-actualize as individuals, partners, spouses, and parents are defining new ways to conceive a child: Psychological considerations and ethical issues. Philosophy, Ethics, and Humanities in Medicine: PEHM, 13(1), 1–11. https://doi.org/10.1186/s13010-018-0054-3
  • Corbin, J. M., & Strauss, A. (2011). Grounded theory methodology. In Handbook of qualitative research (Vol. 273, p. 285).
  • Costa, A. B., da Rosa Filho, H. T., Pase, P. F., Fontanari, A. M. V., Catelan, R. F., Mueller, A., Cardoso, D., Soll, B., Schwarz, K., Schneider, M. A., Gagliotti, D. A. M., Saadeh, A., Lobato, M. I. R., Nardi, H. C., & Koller, S. H. (2018). Healthcare needs of and access barriers for Brazilian transgender and gender diverse people. Journal of Immigrant and Minority Health, 20(1), 115–123. https://doi.org/10.1007/s10903-016-0527-7
  • Cruz, T. M. (2014). Assessing access to care for transgender and gender nonconforming people: A consideration of diversity in combating discrimination. Social Science & Medicine (1982), 110, 65–73. https://doi.org/10.1016/j.socscimed.2014.03.032
  • da Silva Barreto, M., Simon, B. S., Marquete, V. F., de Souza, R. R., Girardon-Perlini, N. M. O., & Marcon, S. S. (2021). Theoretical sampling process in a Straussian Grounded Theory study. Revista da Escola de Enfermagem da USP, 55, 1–9. https://doi.org/10.1590/1980-220x-reeusp-2021-0212
  • De Vries, A. L., McGuire, J. K., Steensma, T. D., Wagenaar, E. C., Doreleijers, T. A., & Cohen-Kettenis, P. T. (2014). Young adult psychological outcome after puberty suppression and gender reassignment. Pediatrics, 134(4), 696–704. https://doi.org/10.1542/peds.2013-2958
  • Deogracias, J. J., Johnson, L. L., Meyer-Bahlburg, H. F., Kessler, S. J., Schober, J. M., & Zucker, K. J. (2007). The gender identity/gender dysphoria questionnaire for adolescents and adults. Journal of Sex Research, 44(4), 370–379. https://doi.org/10.1080/00224490701586730
  • Dunham, Y., & Olson, K. R. (2016). Beyond discrete categories: Studying multiracial, intersex, and transgender children will strengthen basic developmental science. Journal of Cognition and Development, 17(4), 642–665. https://doi.org/10.1080/15248372.2016.1195388
  • Emerton, R. (2004). Neither here nor there: The current status of transsexual and other transgender persons under Hong Kong law. Hong Kong LJ, 34, 245.
  • Emerton, R. (2006). Finding a voice, fighting for rights: The emergence of the transgender movement in Hong Kong. Inter-Asia Cultural Studies, 7(2), 243–269. https://doi.org/10.1080/14649370600673896
  • Garg, G., Elshimy, G., & Marwaha, R. (2018). Gender dysphoria. http://creativecommons.org/licenses/by/4.0/
  • Gooren, L. J., Sungkaew, T., Giltay, E. J., & Guadamuz, T. E. (2015). Cross-sex hormone use, functional health and mental well-being among transgender men (Toms) and Transgender Women (Kathoeys) in Thailand. Culture, Health & Sexuality, 17(1), 92–103. https://doi.org/10.1080/13691058.2014.950982
  • Gordon, D., & Pratama, M. P. (2017). Mapping discrimination experienced by Indonesian trans* FtM persons. Journal of Homosexuality, 64(9), 1283–1303. https://doi.org/10.1080/00918369.2016.1244446
  • Hembree, W. C., Cohen-Kettenis, P., Delemarre-van de Waal, H. A., Gooren, L. J., Meyer, W. J., Spack, N. P., Tangpricha, V., & Montori, V. M. (2009). Endocrine treatment of transsexual persons: An Endocrine Society clinical practice guideline. The Journal of Clinical Endocrinology and Metabolism, 94(9), 3132–3154. https://doi.org/10.1210/jc.2009-0345
  • Hessou, S., Ahanhanzo, Y. G., Kpozèhouen, A., Yadouleton, T., Sodoloufo, O., Capo-Chichi, V., Doussoh, B., Gnahoui-David, B., Biaou, A., & Azandjèmè, C. (2019). Trans-identity in Benin: Fact or fiction? Social response and consequences. Universal Journal of Public Health, 7(4), 179–185. https://doi.org/10.13189/ujph.2019.070404
  • Higgins, A., Sharek, D., & Glacken, M. (2016). Building resilience in the face of adversity: Navigation processes used by older lesbian, gay, bisexual and transgender adults living in Ireland. Journal of Clinical Nursing, 25(23–24), 3652–3664. https://doi.org/10.1111/jocn.13288
  • Holmberg, M., Arver, S., & Dhejne, C. (2019). Supporting sexuality and improving sexual function in transgender persons. Nature Reviews. Urology, 16(2), 121–139. https://doi.org/10.1038/s41585-018-0108-8
  • Hossain, A. (2020). Hijras in South Asia: Rethinking the dominant representations. The SAGE Handbook of Global Sexualities, 1, 404–421. https://doi.org/10.4135/9781529714364.n19
  • Hunt, J., Bristowe, K., Chidyamatare, S., & Harding, R. (2017). ‘They will be afraid to touch you’: LGBTI people and sex workers’ experiences of accessing healthcare in Zimbabwe—an in-depth qualitative study. BMJ Global Health, 2(2), e000168. https://doi.org/10.1136/bmjgh-2016-000168
  • Irshad, U., Hashmi, A. M., & Aamer, I. (2020). Between a rock and a hard place–gender dysphoria and comorbid depression in a young, low-income. Cureus, 12(9). https://doi.org/10.7759/cureus.10205
  • Jami, H., & Kamal, A. (2015). Measuring attitudes toward Hijras in Pakistan: Gender and religiosity in perspective. Pakistan Journal of Psychological Research, 30(1), 151–187. https://doi.org/10.1037/t55832-000
  • Keenan, H. B. (2006). “They call me ‘umfowethu’”: Transgender men and female masculinity in South Africa. Reconciliation and Development.
  • Keuroghlian, A. S., Mujugira, A., & Mayer, K. H. (2021). Healthcare worker training to improve quality of care for sexual and gender minority people in sub‐Saharan Africa: Learning from efforts in Uganda. Journal of the International AIDS Society, 24(S3), e25728. https://doi.org/10.1002/jia2.25728
  • Khan, A. (2019). An update on HIV in transgenders of Pakistan. Asian Pacific Journal of Tropical Medicine, 12, 21–21.
  • King, M. E., Winter, S., & Webster, B. (2009). Contact reduces transprejudice: A study on attitudes towards transgenderism and transgender civil rights in Hong Kong. International Journal of Sexual Health, 21(1), 17–34. https://doi.org/10.1080/19317610802434609
  • Lobato, M. I., Soll, B. M., Brandelli Costa, A., Saadeh, A., Gagliotti, D. A. M., Fresán, A., Reed, G., & Robles, R. (2019). Psychological distress among transgender people in Brazil: Frequency, intensity and social causation–an ICD-11 field study. Revista Brasileira de Psiquiatria (Sao Paulo, Brazil : 1999), 41(4), 310–315. https://doi.org/10.1590/1516-4446-2018-0052
  • Logie, C. H., Alschech, J., Guta, A., Ghabrial, M. A., Mothopeng, T., Ranotsi, A., & Baral, S. D. (2019). Experiences and perceptions of social constraints and social change among lesbian, gay, bisexual and transgender persons in Lesotho. Culture, Health & Sexuality, 21(5), 559–574. https://doi.org/10.1080/13691058.2018.1498539
  • Ma, J. L. C. (1999). Social work practice with transsexuals in Hong Kong who apply for sex reassignment surgery. Social Work in Health Care, 29(2), 85–103. https://doi.org/10.1300/J010v29n02_05
  • Mackie, V. (2001). The trans-sexual citizen: Queering sameness and difference. Australian Feminist Studies, 16(35), 185–192. https://doi.org/10.1080/08164640120076023
  • Manzoor, I., Khan, Z. H., Tariq, R., & Shahzad, R. (2022). Health problems & barriers to healthcare services for the transgender community in Lahore, Pakistan. Pakistan Journal of Medical Sciences, 38(1), 138–144. https://doi.org/10.12669/pjms.38.1.4375
  • Mavhandu-Mudzusi, A. H., & Sandy, P. T. (2015). Religion-related stigma and discrimination experienced by lesbian, gay, bisexual and transgender students at a South African rural-based university. Culture, Health & Sexuality, 17(8), 1049–1056. https://doi.org/10.1080/13691058.2015.1015614
  • Mazaheri Meybodi, A., Hajebi, A., & Ghanbari Jolfaei, A. (2014). Psychiatric axis I comorbidities among patients with gender dysphoria. Psychiatry Journal, 2014, 971814. https://doi.org/10.1155/2014/971814
  • McCallion, S., Smith, S., Kyle, H., Shaikh, M. G., Wilkinson, G., & Kyriakou, A. (2021). An appraisal of current service delivery and future models of care for young people with gender dysphoria. European Journal of Pediatrics, 180(9), 2969–2976. https://doi.org/10.1007/s00431-021-04075-2
  • Meerwijk, E. L., & Sevelius, J. M. (2017). Transgender population size in the United States: A meta-regression of population-based probability samples. American Journal of Public Health, 107(2), e1–e8. https://doi.org/10.2105/AJPH.2016.303578
  • Minor Peters, M. (2016). ‘They wrote “gay” on her file’: Transgender Ugandans in HIV prevention and treatment. Culture, Health & Sexuality, 18(1), 84–98. https://doi.org/10.1080/13691058.2015.1060359
  • Monstrey, S., Selvaggi, G., Ceulemans, P., Van Landuyt, K., Bowman, C., Blondeel, P., Hamdi, M., & De Cuypere, G. (2008). Chest-wall contouring surgery in female-to-male transsexuals: A new algorithm. Plastic and Reconstructive Surgery, 121(3), 849–859. https://doi.org/10.1097/01.prs.0000299921.15447.b2
  • Najafipour, M., & Najafipour, F. (2018). Transsexualism in Iran. International Journal of Scientific and Engineering Research, 9(1), 158–161.
  • Nanda, S. (1999). The Hijras of India: Neither man nor woman. Wadsworth.
  • Nanda, S. (2014). Gender diversity: Crosscultural Variations. Waveland Press.
  • Nemoto, T., Teh, Y. K., Troki, K., de Guzman, R., & Iwamoto, M. (2018). Sociocultural context of sex work among makdispnyah (transgender women) in Kuala Lumpur, Malaysia. In L. Nuttbrock (Ed.), Transgender sex work and society (pp. 288–315). Columbia University press.
  • Nguyen, T. Q., Bandeen-Roche, K., Masyn, K. E., German, D., Nguyen, Y. H., Vu, L. K.-C., & Knowlton, A. R. (2015). Negative family treatment of sexual minority women and trans men in Vietnam: Latent classes and their predictors. Journal of GLBT Family Studies, 11(3), 205–228. https://doi.org/10.1080/1550428X.2014.964443
  • Nisar, M. A. (2018). (Un) Becoming a man: Legal consciousness of the third gender category in Pakistan. Gender & Society, 32(1), 59–81. https://doi.org/10.1177/0891243217740097
  • Norris, M., & Borneskog, C. (2022). The cisnormative blindspot explained: healthcare experiences of trans men and non-binary persons and the accessibility to inclusive. Sexual & Reproductive Healthcare, 32, 100733. https://doi.org/10.1016/j.srhc.2022.100733
  • Nowaskie, D. Z., Fogel, R. S., & Fogel, J. M. (2019). Impact on patient satisfaction and importance of medical intake and office staff in a multidisciplinary, one-stop shop transgender program in Indianapolis, Indiana. Journal of Multidisciplinary Healthcare, 12, 665–673. https://doi.org/10.2147/jmdh.s216969
  • Ojanen, T. T., Burford, J., Juntrasook, A., Kongsup, A., Assatarakul, T., & Chaiyajit, N. (2019). Intersections of LGBTI exclusion and discrimination in Thailand: The role of socio-economic status. Sexuality Research and Social Policy, 16(4), 529–542. https://doi.org/10.1007/s13178-018-0361-x
  • Olson-Kennedy, J., Chan, Y.-M., Garofalo, R., Spack, N., Chen, D., Clark, L., Ehrensaft, D., Hidalgo, M., Tishelman, A., & Rosenthal, S. (2019). Impact of early medical treatment for transgender youth: Protocol for the longitudinal, observational trans youth care study. JMIR Research Protocols, 8(7), e14434. https://doi.org/10.2196/14434
  • Ottosson, D. (2006). LGBT world legal wrap up survey. ILGA.
  • Parameshwaran, V., Cockbain, B. C., Hillyard, M., & Price, J. R. (2017). Is the lack of specific lesbian, gay, bisexual, transgender and queer/questioning (LGBTQ) health care education in medical school a cause for concern? Evidence from a survey of knowledge and practice among UK medical students. Journal of Homosexuality, 64(3), 367–381. https://doi.org/10.1080/00918369.2016.1190218
  • Perez-Brumer, A., Silva-Santisteban, A., Salazar, X., Vilela, J., & Reisner, S. L. (2020). In search of “my true self”: Transmasculine gender identity processes, stigma, and mental health in Peru. https://doi.org/10.1037/0000159-002
  • Polat, A., Yuksel, S., Discigil, A. G., & Meteris, H. (2005). Family attitudes towards transgendered people in Turkey. Experience from a Secular Islamic Country. International Journal of Psychiatry in Medicine, 35(4), 383–393. https://doi.org/10.2190/bhly-k1ml-jdcb-h04w
  • Pollock, L., & Eyre, S. L. (2012). Growth into manhood: Identity development among female-to-male transgender youth. Culture, Health & Sexuality, 14(2), 209–222. https://doi.org/10.1080/13691058.2011.636072
  • Puckett, J. A., Cleary, P., Rossman, K., Mustanski, B., & Newcomb, M. E. (2018). Barriers to gender-affirming care for transgender and gender nonconforming individuals. Sexuality Research & Social Policy : Journal of NSRC : SR & SP, 15(1), 48–59. https://doi.org/10.1007/s13178-017-0295-8
  • Redding, J., A. (2019). The Pakistan Transgender Persons (Protection of Rights) Act of 2018 and its impact on the law of gender in Pakistan. Australian Journal of Asian Law, 20, 103. https://doi.org/10.2139/ssrn.3339759
  • Rehman, S. (2019). Factors involved in perceived Barriers among doctors in providing healthcare to transgender persons: A mixed method approach [Unpublished M.Phil thesis]. Quaid-i-Azam University.
  • Riggs, D. W., Ansara, G. Y., & Treharne, G. J. (2015). An evidence‐based model for understanding the mental health experiences of transgender Australians. Australian Psychologist, 50(1), 32–39. https://doi.org/10.1111/ap.12088
  • Roberts, C. E. (2020). Emotional experiences of transgender individuals undergoing medical transitioning [Doctoral dissertation, Northcentral University].
  • Rocon, P. C., Rodrigues, A., Zamboni, J., & Pedrini, M. D. (2016). Difficulties experienced by trans people in accessing the Unified Health System. Ciencia & Saude Coletiva, 21(8), 2517–2526. https://doi.org/10.1590/1413-81232015218.14362015
  • Russell, S. T., & Fish, J. N. (2016). Mental health in lesbian, gay, bisexual, and transgender (LGBT) youth. Annual Review of Clinical Psychology, 12, 465–487. https://doi.org/10.1146/annurev-clinpsy-021815-093153
  • Sanyal, D., & Majumder, A. (2016). Presentation of gender dysphoria: A perspective from Eastern India. Indian Journal of Endocrinology and Metabolism, 20(1), 129–133. https://doi.org/10.4103/2230-8210.172247
  • Scheim, A., Kacholia, V., Logie, C., Chakrapani, V., Ranade, K., & Gupta, S. (2020). Health of transgender men in low-income and middle-income countries: A scoping review. BMJ Global Health, 5(11), e003471. https://doi.org/10.1136/bmjgh-2020-003471
  • Semlyen, J., & Kunasegaran, K. (2016). Understanding barriers to cervical screening uptake in trans men: An exploratory qualitative analysis. The Lancet, 388, S104. https://doi.org/10.1016/S0140-6736(16)32340-6
  • Sequeira, G. M., Chakraborti, C., & Panunti, B. A. (2012). Integrating lesbian, gay, bisexual, and transgender (LGBT) content into undergraduate medical school curricula: A qualitative study. The Ochsner Journal, 12(4), 379–382.
  • Shah, C., Merchant, R., Mahajan, S., & Nevatia, S. (2015). No outlaws in the gender galaxy. Zubaan.
  • Shirdel-Havar, E., Steensma, T. D., Cohen-Kettenis, P. T., & Kreukels, B. P. (2019). Psychological symptoms and body image in individuals with gender dysphoria: A comparison between Iranian and Dutch clinics. The International Journal of Transgenderism, 20(1), 108–117. https://doi.org/10.1080/15532739.2018.1444529
  • Stevens, M. (2012). Transgender access to sexual health services in South Africa: Findings from a key informant survey. Gender Dynamix.
  • Stojanovski, K., King, E. J., Bondikjova, V., Brooks, D. K., & Mihajlov, A. (2019). ‘Until we have laws… everything is useless!’: Intersectionality, self-identified needs and inequity among sexual and gender minorities in Macedonia. Culture, Health & Sexuality, 21(10), 1192–1207. https://doi.org/10.1080/13691058.2018.1551574
  • Strauss, A., & Corbin, J. (1998). Basics of qualitative research techniques (pp. 1–312). Sage publications.
  • Sultana, A., & Kalyani, M. K. (2012). Femaling males: Anthropological analysis of the transgender community in Pakistan. The Journal of Humanities and Social Sciences, 20(1), 93.
  • Syali, M., & Jhamb, V. (2022). Mishandling the issue of gender dysphoria in India-an analysis of the transgender persons (Protection of Rights) Act, 2019. International Journal of Human Rights and Constitutional Studies, 9(1), 31–38. https://doi.org/10.1504/IJHRCS.2022.119450
  • Tagliamento, G., & Paiva, V. (2016). Trans-specific health care: Challenges in the context of new policies for transgender people. Journal of Homosexuality, 63(11), 1556–1572. https://doi.org/10.1080/00918369.2016.1223359
  • Turan, Ş., Aksoy Poyraz, C., İnce, E., Sakallı Kani, A., Emül, H. M., & Duran, A. (2015). Sociodemographic and clinical characteristics of transsexual individuals who applied to a psychiatry clinic for sex reassignment surgery. Turk Psikiyatri Dergisi = Turkish Journal of Psychiatry, 26(3), 153–160.
  • Usman, A., Khan, A. H., Bashir, Q., Amjad, A., & Amjad, U. (2018). Pushed to the margins: Post-diagnosis experiences of Hijra (transgender) sex workers living with HIV infection. Pakistan Journal of Psychological Research, 33(1), 15–34.
  • van de Grift, T. C., Cohen-Kettenis, P. T., Steensma, T. D., De Cuypere, G., Richter-Appelt, H., Haraldsen, I. R. H., Dikmans, R. E. G., Cerwenka, S. C., & Kreukels, B. P. C. (2016). Body satisfaction and physical appearance in gender dysphoria. Archives of Sexual Behavior, 45(3), 575–585. https://doi.org/10.1007/s10508-015-0614-1
  • World Health Organization. (2013). Regional assessment of HIV STI and other health needs of transgender people in Asia and the Pacific. WHO Regional Office for the Western Pacific.
  • World Health Organization. (2019). International statistical classification of diseases and related health problems (11th ed.). https://icd.who.int/
  • World Professional Association for Transgender Health. (2012). Standards of care for the health of transsexual, transgender, and gender nonconforming people [7th Version].
  • Yılmaz, V., & Göçmen, İ. (2016). Denied citizens of Turkey: Experiences of discrimination among LGBT individuals in employment, housing and health care. Gender, Work & Organization, 23(5), 470–488. https://doi.org/10.1111/gwao.12122
  • Yüksel, S., Kulaksizoğlu, I. B., Türksoy, N., & Sahin, D. (2000). Group psychotherapy with female-to-male transsexuals in Turkey. Archives of Sexual Behavior, 29(3), 279–290. https://doi.org/10.1023/a:1001967514549
  • Zengin, A. (2014). Sex for law, sex for psychiatry: Pre-sex reassignment surgical psychotherapy in Turkey. Anthropologica, 56(1), 55–68.
  • Zhu, X., Gao, Y., Gillespie, A., Xin, Y., Qi, J., Ou, J., Zhong, S., Peng, K., Tan, T., Wang, C., & Chen, R. (2019). Health care and mental wellbeing in the transgender and gender-diverse Chinese population. The Lancet. Diabetes & Endocrinology, 7(5), 339–341. https://doi.org/10.1016/S2213-8587(19)30079-8
  • Zucker, K. J. (2017). Epidemiology of gender dysphoria and transgender identity. Sexual Health, 14(5), 404–411. https://doi.org/10.1071/sh17067
  • Zucker, K. J., Mitchell, J. N., Bradley, S. J., Tkachuk, J., Cantor, J. M., & Allin, S. M. (2006). The recalled childhood gender identity/gender role questionnaire: Psychometric properties. Sex Roles, 54(7–8), 469–483. https://doi.org/10.1007/s11199-006-9019-x

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