New Delhi- In recent years, the transgender community in India has gained visibility. However, the experiences of transmen have been understudied. A research study titled "Our Health Matters: Indian Trans Men and Transmasculine Health Study," conducted by the Transgender Welfare Equity and Empowerment Trust and the Transmen Collective, was released in October 2023. This study highlighted many of the issues faced by transmasculine individuals. Transmasculine is a broader term that refers to individuals who were assigned female at birth but may identify as men, trans, non-binary, or another term.

The study was conducted in two stages. In 2021, transmasculine peer researchers conducted detailed qualitative interviews via video conferences or telephone calls in Hindi or Marathi with 40 transmasculine individuals residing in 10 different states. Subsequently, from November 2022 to January 2023, quantitative survey data were gathered from 377 transmasculine individuals aged 18 and above.

Impact on Mental Health

The study found very high levels of depression, anxiety, and suicide risk within the community. "About one-third of participants had moderate or severe depression symptoms, while 45% had moderate or severe anxiety symptoms. Almost half (44%) had ever seriously considered suicide, and one-quarter had done so in the last year. Over a third of participants (36%) had ever attempted suicide, and 16% had done so in the past year."

However, various factors can help with mental health struggles. The study found that "suicidal thoughts, depression, and anxiety were less common among transmasculine people who were employed, had supportive parents, belonged to in-person trans groups, or had accessed transition-related healthcare. These results suggest opportunities to intervene to prevent suicide and improve mental health among transmasculine people."

An unfortunate fact is that many mental health practitioners might end up being more harmful than helpful to the community. Conversion therapy and other unscientific methods have been prevalent in society. That's why it is important for health practitioners to undergo sensitivity training.

Access to Basic Healthcare

Comprehensive healthcare for transmasculine people includes both general preventive care and transition-related or gender-affirmative care (i.e., hormones and surgery). Some - but not all - trans people require transition-related medical care to reduce gender dysphoria (distress related to the difference between one's gender identity and physical characteristics). For those who need it, transition-related care is essential for mental well-being and is recommended by the World Professional Association for Transgender Health and other professional bodies.

The report highlights the importance of accessible healthcare for everyone. "Focusing on general healthcare, we found that only 46% of participants had a regular doctor. Promisingly, of participants who did have a regular doctor, 64% said that the doctor was mostly or very knowledgeable about trans issues. On the other hand, many participants lacked access to comfortable and knowledgeable doctors: one-third of participants had avoided healthcare in the past year because they feared being mistreated."

The study further stated, "Regarding transition-related healthcare, about 1 in 4 participants had completed all the transition-related care they needed, while the majority were either in the process of completing this care (28%) or waiting to begin (36%). Only 11% were not planning to seek care or were unsure whether they would. Just over half (56%) had ever taken hormones as part of their transition, of whom the vast majority (93%) were still taking hormones at the time of the survey. Of those who had ever taken hormones, 19% had been denied a prescription for hormones, and 18% first took hormones without a prescription."

Negative Experiences with the Administration

Transmasculine individuals face challenges in obtaining gender recognition for welfare schemes. According to this study, only 14% of participants had changed the gender listed on all their identity documents (ID), while 28% had changed it on some documents. Over half (54%) wanted to change the gender on their ID but had not been able to do so. Of those who had tried to change the gender on their ID, 91% had at least one negative experience.

A transgender identification card is required for community members to access welfare benefits. In 2023, the Ministry of Social Justice and Empowerment launched SMILE (Support for Marginalized Individuals for Livelihood and Enterprise), a welfare scheme designed to provide skill development, educational opportunities, shelter housing, and health services for trans people. The survey was conducted within a year after the program's launch. At that time, only 30% of transmasculine participants had ever heard of the scheme, of whom only 8% had applied and actually received the help they requested. This shows a lack of initiative from all sides in providing awareness about the existing help that the community can look forward to.

Transphobia from Society

Transmasculine individuals often face physical or emotional abuse due to societal perceptions of feminine behaviour. The study highlighted this grim reality. "70% of participants reported experiencing at least one form of violence, with verbal harassment (42%) being the most common. Of those who faced physical or sexual violence (or threats of the same), 61% said it happened because they are trans or non-binary, and 58% had disclosed that violence to anyone else."

The report further discussed how the community may disengage from social situations. Whether due to their own negative experiences or awareness of the experiences of their peers, transmasculine individuals may limit their activities to avoid mistreatment. In the past year alone, over 1 in 3 participants had avoided family events and public restrooms, while about 1 in 5 had avoided public transportation, public spaces in general, or school/work.

A 26-year-old respondent based in Maharashtra was quoted as saying, "I avoid going in public. Avoid means not going to the mall. Where people have to enter with security checks, like standing in the female queue. I feel uncomfortable with that."

Natal Family’s Support

Natal family refers to the family one was born in. Queer people often do not have the privilege of being supported by their birth parents. This can lead to severe physical and well as emotional distress.

This study states that out of all the participants, fewer than one-third had support from their parents. One respondent said, ““The world can say, ‘if you don’t get support from your family, then why should we support you?’. The world can start from family. If your parents are with you, then it isn’t an issue whether friends, girlfriends, or boyfriends are with ‘you or not.”

When ones’ family does not show up, they turn to their chosen family. “Support from within the transmasculine community can be vitally important, particularly for those who may not have strong support from their families. Most participants belonged to online trans groups while less than one-third belonged to in-person groups. There was high interest in either online (53%) or in-person (59%) support programs for transmasculine people.” A participant from Tamil Nadu remarked about the support they found within the community, “Yes, we get full support from the trans community. When there is no one for us they stand for us. They are like our family, and we get full support from them. Mental support is important, and they take care of us.”

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