‘How could a psychiatrist have helped me out?’ Transgenders share struggle with mental health issues

Into the second year of the pandemic, most of us perhaps wake up every morning with a feeling of despair — a nonchalant acceptance of the fact that what we knew to be ‘normal’ pre-Covid, may take many more months to return.

To lose hope for a better, stable future may be something that many of us have encountered more than ever amid the pandemic; this feeling of hopelessness, however, has been a constant in the lives of the transgender community in India. Being shamed, abused or discriminated against is part of their lives; many have internalised such treatment as their destiny, a predetermined fate by virtue of their gender identity.

‘Who knows whether society will ever accept us…’

“When you don’t get the rights you deserve, you have to make do with what you have,” Kiran (name changed), a transgender from Delhi, tells indianexpress.com. She is among the transgenders we reached via Maanvika Foundation and Eti, which works with the most marginalised sections of society and is empowering transgenders to work with the LGBTQIA community impacted by differential challenges and especially Covid.

Currently working in a telephone company, Kiran says she can put up with occasional sneering as long she can earn a living. “Nobody wants to give us a job, at least this company employed me… Who knows whether society will ever accept us and if we will ever get our rights,” she remarks.

Kiran left home as a student of class 9 after some seniors, “who liked to dress up and do makeup” in the boy’s school she was enrolled in helped her understand who she was. Her parents refused to accept her. She dropped out of school and joined the kinnar community and thereafter began her journey of survival.

The memories from childhood still haunt, but there is not much one can do, she adds. “Yaad to aata hai par ab dheere dheere samhal gayi (I remember those days but I have gradually come to terms with it).”

“While my mother has finally accepted me and lives with me now, my father still disrespects me. Initially, my brothers assaulted me physically,” she recalls. “I went through all the abuse without being able to share it with anyone. I had no friends then. Nobody ever sat at my bench in school; I would sit all alone. Bahut akela feel hota tha (I used to feel lonely).”

Many transgenders found it difficult to access basic health services amid the pandemic. (representational, source: PTI/file)

Any significant trauma, especially if continuous, keeps returning, impacting the individual, says psychiatrist Dr Samir Parikh. “Naturally, the way you look at yourself changes, you begin to think that the world is an unjust place. There are flashbacks coupled with self-doubt,” he adds.

He explains that one of the most common mental health issues that transgenders suffer from is gender dysphoria, a sense of dissatisfaction felt because of the mismatch between their biological sex and gender identity. “It results in mood changes — one experiences low mood, impairment of functioning. It impacts their ability to trust someone or form meaningful relationships.”

In a country where belonging to the ‘other’ gender category is still taboo, transgenders battle for their self-respect on a daily basis. Shashank, a 33-year-old transgender who hails from a village in the North East, recalls how they would be dragged to the toilet, taunted or sexually assaulted in school. “Aisa lagta tha ya toh school chhodo ya apni jaan de do (I felt like I should either leave school or take my life),” Shashank, who recognised their identity in the eighth standard, shares. The Computer Applications graduate adds life was no different during college but they managed to finish the course only for their parents. Fortunately, their family is supportive to date.

The abuse and discrimination that started as a child continues even today, but there is only one difference, Shashank emphasises. “It is really difficult as a child when you are unaware of things and just coming to terms with hormonal changes in the body. The only difference is, now we have learned ways to protect ourselves. That said, kinnars are raped, much more than women, but there is nobody to even file a report.”

‘I got sick in the first wave but nobody even wanted to touch me’

The pandemic has only worsened the discrimination meted out against transgenders. After having lost their jobs during the lockdown, most of them have no money or food to sustain themselves. “Nobody has helped us,” Kiran says. Their usual sources of living — toli, badhai, sex work and begging — have also taken a hit.

Many were not even able to avail basic health services. “I got sick in the first wave but nobody even wanted to touch me. I had to rely on self-medication to get cured,” says Shashank, who has been unemployed for months now. “I did manage a stint at an NGO where the kinnar community was employed to make masks. That got over soon. I have been engaged in toli, badhai, sex work in the past, but I stopped doing those because I felt I deserved more as an educated individual.”

Neelam, a 46-year-old kinnar, echoes similar thoughts. “Bahut pareshan hoon main (I am really disturbed),” she says, adding she has been having sleepless nights and has been crying endlessly. “It is extremely disheartening and then you wish nobody ever gives birth to a person like me.” Her roommate Mahi, 32, adds they have been stopped from taking clients on the streets; there is no money to pay rent or buy grains.

‘How could a psychiatrist have helped me out of all the stress?’

Despite facing trauma, stress or anxiety on several levels, it looks like the community is far from getting mental health issues addressed. Shashank says they have heard about ‘depression’. “I suffered from it during the previous lockdown.”

For others, the idea of mental health is unknown. Naturally, consulting a mental health specialist has been out of question; the kinnars argue it would not solve their problems.

“How could a psychiatrist have helped me out of all the stress? If I have only Rs 10 in my pocket, only I will know how to survive in that much money — no doctor will be able to help,” says Shashank.

“Nobody understands us, nobody is concerned about our happiness. Who will we talk to? Apne haath mein hai kya? Uparwale ne jaise banaya! (Is it in our hands; it is God who has made us like this),” says Kiran. Neelam adds: “Many policemen, boys abuse us verbally, they threaten violence. We want to raise our voice but who is ready to listen? Half the time we are chased away.”

The solution to the perpetual distress faced by transgenders perhaps does not always lie in mental health consultations. Dr Parikh agrees: “Some amount of normalisation on distress is required through social support. That is the most common element of dealing with distress amid the pandemic.”

He adds, “A societal churning is required to overcome the stigma. We need to learn to accept without judgment.”