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Mental illnesses and related vulnerabilities in the Hijra community: A cross-sectional study from India.

Authors
  • Sartaj, Deepak1
  • Krishnan, Vijay2
  • Rao, Ravindra1
  • Ambekar, Atul1
  • Dhingra, Neeraj3
  • Sharan, Pratap1
  • 1 Department of Psychiatry, AIIMS New Delhi, New Delhi, India. , (India)
  • 2 Department of Psychiatry, AIIMS Rishikesh, Rishikesh, Uttarakhand, India. , (India)
  • 3 National AIDS Control Organisation, New Delhi, India. , (India)
Type
Published Article
Journal
The International journal of social psychiatry
Publication Date
May 01, 2021
Volume
67
Issue
3
Pages
290–297
Identifiers
DOI: 10.1177/0020764020950775
PMID: 32815441
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

The Hijra community is a cultural and gender grouping in South Asia broadly similar to western transgender communities, but with literature suggesting some differences in gender experience and patterns of psychosocial adversity. The present study aims to describe patterns of mental illness and psychoactive substance use in Hijra subjects and study their association with gender experience and psychosocial adversity. Fifty self-identified Hijras availing HIV-prevention services in New Delhi, India, were interviewed. Data on mental disorders, psychoactive substance use, quality of life, discrimination, empowerment, violence and gender identity were assessed using structured instruments. Subjects were mostly in their mid-twenties, and had joined the Hijra community in their mid-teens. More subjects (46%) were involved in begging than in traditional Hijra roles (38%). Sex work was reported by 28% subjects. The rates of lifetime mental illness was 38%, most commonly alcohol abuse (26%); others had anxiety or depressive disorders (8% each), somatoform disorders (6%) and bulimia nervosa (n = 1). Disempowerment was mostly experienced in domains of autonomy and community participation; 52% had experienced sexual or psychological violence. Discrimination was attributed to gender (100%), appearance (28%) or sexual orientation (28%). There were negative correlations between the physical domain of WHO-QOL and physical violence and depression scores; and between discrimination and WHO-QOL environmental, physical and psychological domains. This Hijra group showed high rates of mental disorder and substance involvement, related to QOL domains and experiences of discrimination and disempowerment.

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