Abstract

This study aimed to study the social exclusion of transgender in Hazara Division of Khyber Pakhtunkhwa province of Pakistan. The study used qualitative research method in which data was collected through in-depth interviews with 25 respondents in the selected locales. The collected data was thematically analyzed and the results suggest that transgender face social exclusion which further exacerbates the vicious circle of discrimination, harassment, and violence from the broader society. It is concluded from the study that due to complex and debatable nature of the issue and the discriminative behavior of society toward transgender leads towards their sexual victimization, stigma, sexual abuse and violence. It is recommended that that the existing laws and policies regarding physical and sexual violence against transgender may be reassessed and to take concrete policy measures to ensure the mainstreaming of transgender in society.

Key Words

Transgender, Social Exclusion, Violence, Discrimination, Harassment

Introduction

The term transgender refers to the individuals whose gender identity is described as different from the socially defined identity of male and female. Transgender is a comprehensive term encompassing individuals whose gender identity, expression, or behavior diverges from societal expectations traditionally linked to the sex assigned to them at birth. Transgender is a term that encompasses individuals whose gender identity differs from the sex assigned to them at birth. Gender identity refers to an individual's deeply felt sense of being male, female, or a gender that does not fit within the traditional binary framework. It is an internal, personal understanding of one's own gender, which may or may not align with societal expectations or the physical characteristics associated with assigned sex. 

The concept of being transgender has been recognized across various cultures throughout history. However, the understanding and awareness of transgender identities have evolved over time. The American Psychological Association (APA) defines transgender as individuals whose gender identity is different from the sex they were assigned at birth. They note that transgender individuals may label themselves in various ways, such as transgender, trans, transgender man, transgender woman, or non-binary, among others (Davis & Wilson, 2016; American Psychological Association, 2023).

Further, the term is primarily employed to characterize individuals who transgress socially constructed gender boundaries. The term acknowledges individuals who do not align with the identification of their assigned sex. Many transgender individuals become aware of their gender identity as early as the age of five when typical signs begin to manifest. Transgender, commonly abbreviated as 'trans,' serves as an inclusive umbrella term encompassing a wide spectrum of gender identities that do not conform to the sex assigned to individuals at birth. In contrast, cisgender individuals identify with the gender assigned to them at birth, while transgender individuals experience a gender identity that deviates from their assigned sex (American Psychiatric Association, 2013).

Numerous global cultures have varying expressions for transgender including but not limited to Hijra or Kinar in India, Travesti in South America, Nadleehi in Navajo, and two-spirit in Native America, have historically acknowledged and represented transgender individuals, showcasing the rich diversity of gender identities across the world.  In Pakistan, the predominant terms used to refer to transgender individuals are 'Hijra,' 'Khwajasar,' and 'Murat,' collectively encompassing a wide spectrum of gender nonconformities. These terms include individuals who defy conventional societal norms related to gender, such as cross-dressers, homosexuals, bisexuals, true hermaphrodites, eunuchs, transsexuals, transvestites, genderqueer youth, drag queens, and those identifying as transgender (Abdullah et al.,2012; Agrawal, 2016; Shah et al., 2018, Ming, Hadi & Khan, 2018 Waheed, 2019; Kurian &  Manoj, 2021). 

Unfortunately, some families in Pakistan, as in other countries, may feel ashamed or dishonored when a first-born child is transgender (Ali et al., 2022). Society often resorts to stigmatizing labels such as shame, abnormality, whimsicality, or curses to characterize transgender individuals, overlooking the fundamental truth that they are equally human beings, deserving of respect and understanding, beyond the binary confines of male and female categorizations. Transgender individuals face social stigma, and they are usually ostracized by their families, relatives, and community. They endure additional challenges in managing the stress associated with their sexual orientation within our societal context (Jordan, 2000; Barboza, Dominguez & Chance, 2016; Ahmed, Yasin & Umair, 2014; Kurian &  Manoj, 2021). 

Literature Review

Extensive research worldwide has delved into the study of transgender identity emphasizing its unique characteristics and the ongoing struggle for equality, freedom of speech, and expression within the socioeconomic realm, encompassing various dimensions of exclusion. Various scholars have endeavored to define and elucidate the nature of the problem within their respective fields. 

The history of transgender individuals is vast and complex, with diverse cultural, social, and historical contexts worldwide. Transgender identities have historical roots dating back to ancient civilizations. Various cultures across the globe have recognized and acknowledged gender diversity. For instance, in many indigenous cultures, such as the Native American Two-Spirit tradition and the Hijra community in South Asia, individuals outside the traditional gender binary held respected and often revered roles within their societies (Roscoe, 1991). During the colonial era, Western colonization significantly impacted the perception of gender diversity in many regions. Colonial powers imposed Western gender norms and often criminalized non-conforming gender identities. In countries like India, colonial-era laws categorized Hijras and other gender-diverse communities as criminal tribes, leading to their marginalization and stigmatization (Reddy, 2005). The modern era witnessed significant strides in legal recognition and social acceptance for transgender individuals. Landmark legal decisions, such as the Stonewall riots in 1969 in the United States, catalyzed the LGBTQ+ rights movement globally, advocating for equality and recognition for transgender individuals (Carter, 2004). In recent years, several countries have made progress in recognizing the rights of transgender individuals. Legal changes, such as recognizing a third gender category in official documents and anti-discrimination laws, have aimed to provide legal protection and social recognition (Winter, 2018).

In the Subcontinent, Hijras trace their cultural heritage back to the Khawaja Sara of the Mughal era, when Mughal rulers would employ them to attend to their harems. This historical legacy persisted for numerous years, with Hijras being invited to participate in singing and dancing during various events and festivals. However, the traditional role of Hijras in Pakistan has witnessed a decline over time. These individuals were commonly present at childbirth or marriage sites, engaging in activities such as dancing, singing, and seeking alms. Their roles have altered over time, and many of them now work in sex work, dancing, and begging (Hossain, 2017). This difficulty thus comes from the notion of gender, which lays on an individual the task of being just one of the two binary genders, male or female (Cowan, 2005; Hird, 2002; Tolentino, 2000; Van Borsel, De Cuypere, Van den Berghe, 2001). However, the way the transgender community feels in Pakistan is the complete opposite compared to the Western countries, where activism has been able to achieve certain rights over the years. Unlike other countries, Hijras in Pakistan have been discriminated against for a long time and have difficulty getting employment and education thus necessitating response from academicians, researchers, and policymakers. 

Social marginalization of the transgender population is reflected in various spheres including health, education, employment, and other basic human rights. They lack access to essential opportunities and resources needed for their daily lives (Grant et al., 2011). Such discrimination and social exclusion of transgender leads to further issues including joblessness, homelessness, and widespread poverty (James et al., 2016). Additionally, such social conditions also have detrimental effects on mental health as the majority of transgender people experience anxiety, sadness, and suicidal ideation because of the rejection and stigma they routinely receive from society (Testa et al., 2014).  Social exclusion is a major cause of psychological distress, anxiety, and depression among marginalized communities (Kessler et al., 2010). Economic inequality and access to work opportunities lead to financial instability and increasing poverty (Marmot, 2004). Social exclusion affects access to healthcare services, and this is largely a key factor in the disparities in health outcomes among transgender (Adler & Stewart, 2010).

Material and Methods

The objective of this study was to explore the lived experiences of transgender and to develop a deeper understanding of social exclusion, discrimination, and victimization. In order to achieve the desired objectives of the study, a qualitative methodological approach was used within which data was collected from the study participants through in-depth interviewing. A diverse range of 25 transgender volunteers was selected through snowball sampling to ensure a range of ages, gender identities, socioeconomic statuses, and residence locations. Individual interviews provided participants with a venue to state their own views, feelings, and experiences. The data was analyzed through the primary method of thematic analysis, which allowed the discovery of recurrent themes and patterns. Further insight was sought into the lives of transgender men and women residing in segregated areas in the locales of Mansehra, Abbottabad, and Haripur. 

The research conducted used and followed ethical guidelines by getting informed consent, maintaining the confidentiality of participants, and obtaining permission from the institutional review board. The research design was guided by the existing theories and methodologies of qualitative research under specific theories (Braun & Clarke, 2006; Creswell & Poth, 2017; Smith, Flowers, & Larkin, 2009; Yin, 2018). 

The respondents of the study consist of 25 purposively selected transgender persons in the selected locales of the Hazara division. More precisely, the selected respondents were interviewed residing in the selected locales of Haripur (Mochi Bazar, Loharan Bazar, Darband Adda), Abbottabad (Chuggian, Mandian, and Link Road), and Mansehra (Oghi Bazar, Pano Road). It is important to understand the routine life of transgender youth in the Hazara division and compare their life with another transgender across Pakistan. The snowball sampling technique was used in the study for interviewing transgender population. 




Data Analysis

The collected data was secured in the form of field notes which were subsequently analysed through thematic analysis. Initially, the narrative of study participants was examined repeatedly to develop familiarity with the data. The data was analyzed using Braun and Clarke's six-step mode (2006) while extracting a total of four major themes. The extracted themes include social exclusion, discrimination and social stigma, social victimization, and sexual abuse. 

Results and Discussion

The gathered data was recorded as field notes using the local language. Taking into consideration the nature of the study, the interview guide was structured around several themes, featuring open-ended questions. The deliberate use of open-ended questions aimed to delve deeper into the realities explored in this research. Thematic analysis, a widely utilized qualitative research approach, serves as the foundation for deriving themes from the collected data. Thematic analysis is a qualitative research method that involves identifying and analyzing patterns or themes within a dataset. When examining the exclusion and inclusion of transgender individuals, several key themes emerged. Here are some potential themes that were explored through thematic analysis:




Social Exclusion

Examination of the lives of transgender folks in the setting of social rejection exposes a few repeating examples, most of which draw to light the different difficulties faced by this gathering. To them, it seems to be persistent discrimination experienced by such individuals, which is in many instances recounted based on the very fact of their gender identity leading to marginalization, violence, and excluding other sorts of shaming. The need for education and awareness is imperative for society, which should be initiated in removing stereotypes and developing empathy towards paving a path to breaking the deep-rooted biases causing social isolation. A Respondent said:

"Through my early years at school, I was socially excluded because people didn't understand or accept my gender identity, and would be born into a gender that didn't fit my gender identity. As a result, being isolated and bullied, it was difficult to feel part of somewhere. Fortunately, I settled into a supportive transgender community that offered a lot of folks to connect with who went through similar experiences, and it changed everything. Another plus side to the inclusive work environment has been that it has helped me feel more belonging because I feel affirmed and accepted when my employers validate my gender ideologies."

The study of social exclusion from transgender's perspective presents a wide and difficult field that involves the issue of discrimination and marginalization and the necessity of inclusive legal frameworks and communities. By this analysis, the challenge facing transgender individuals is ongoing and it is a call for the whole society to make structural changes in how they live as a society to create an inclusive and fairer society. Another respondent added:

"I don't have to hide my gender identity from my parents, brothers, sisters, cousins, or other people in my family. They know that this is me and that it isn't a choice"




Discrimination and Social Stigma

Speaking with transgender people on stigma and prejudice uncovers a tapestry of interwoven themes that highlight the significant influence of cultural biases on their lives. Interviewees' narratives consistently told of their personal experiences with discrimination including very subtle instances of exclusion and violence to blatant abuse. These stories chronicle experiences of bias in a range of different environments including the workplace, healthcare systems, and school, making the case that the full panoply of anti-discrimination legislation is needed right away. In conversations with transgender people about stigma and prejudice, you learn the complexity of themes that surround them. Discrimination pervades in all its manifestations – verbal harassment, micro-aggression, and basic hang-ups in the social system – making it the theme that features prominently in discussions around the topic (Grant et al., 2011). In this, those opposing the legislation could not ignore the fact that making the law does not keep transgender individuals safe but rather enforces their complete inclusion in society by enacting robust anti-discrimination legislation to protect them (James et al., 2016). 

One of the respondents narrated regarding discrimination:

I have been discriminated against in my place of work, and I have few ways of making a proper complaint about it. What's depressing is that there isn't a specific law that bars discrimination based on gender identity. The police are horrible people, particularly the officers with lower ranks. They abuse their authority. And they use that because we are vulnerable and if anything happens because of their attitude, no one is going to go there for FIR. They handle us like animals which of course is something no one can stand even the slightest.

The above narratives of one of the participants indicate the institutional responses regarding the questions of discrimination against transgender. It is evident that being a helpless individual, transgender are victimized by persons in power and position. The conversation further explores discriminatory views, ingrained gender stereotypes, transgender identity, and the complex dynamics of deeply embedded institutional structure.

Another respondent answered.

Our families expect sons from us, and we are not capable of this. We typically take flights from our families whenever we're given a choice. That's when we are old enough to think of other options. Sometimes our own relatives escape the suffering and abuse that others inflict upon them. I ran away from home, because of the constant taunting I was getting when I was fifteen.




Sexual Victimization

During conversations with transgender individuals, it was highlighted repeatedly that they are experiencing and facing high incidences of sexual victimization in various places. There is a general understanding that people with other sexual orientations and gender identities may not experience the discrimination that the transgender community experiences on a daily basis in their lives (James et al., 2016; Reisner et al., 2015). The most highlighted and reported issue was that of sexual victimization of transgender individuals by the larger public as a result these individuals are feeling at a higher risk everywhere.  Moreover, they are really at more risk of kinds of s sexual violence, different kinds of sexual violence—everything from harassment, to assault, to partner violence. It addresses how critical it is to adopt a comprehensive approach to tackling the specific risk factors and to provide transgender survivor-specific support services. Respondent said:

Once, the verbal abuse went so far as to turn to physical abuse. What this incident did to me was make me realize I couldn't do anything to protect myself or simply make the pain go away, and that's something that a lot of transgender are experiencing on a daily basis. They diminish our ability to move without fear, erode our sense of safety, they impact our mental well-being. This should not become the norm, yet for far too many among us sexual victimization is a burden we live with every day, the fear that hangs with us wherever we go. And we need to come together and speak out for transformation because together our actions can address these challenges.

As suggested by the above narrative, one of the permanent and salient features of transgender life is that of sexual victimization. They are living in constant fear of being sexually assaulted anywhere. Such feelings of constant fear restrict their mobility and also lead to psychological distress. Furthermore, such instances are routinely occurring but usually go without proper reporting, actions, and follow-ups.  There is a great deal of reluctance in reporting on the part of the transgender as they anticipate further victimization and exploitation (Grant et al., 2011; Stotzer, 2009). This underscores the need for establishing a safe and supportive mechanism for reporting and the establishment of an environment that will allow the survivors to speak freely without fear of reprisal.

Another Respondent said that:

Once I suffered verbal harassment in public on the basis of my gender identity. It got worse and worse till I was physically attacked. Those words made me feel exposed and violated, forced into experiencing the horrible thing — the awful thing — a lot of us must live with.

Anxiety, sadness, and post-traumatic stress disorder (PTSD) are significantly more common in transgender survivors of sexual abuse compared with peers (Testa et al., 2012). Sexual victimization of transgender people reveals a reality that is disturbing in part because of heightened vulnerability to victimization, poor underreporting of victimizations, intersecting complications, and burdensome mental health consequences. To get on top of this situation, we need to take a holistic view and be conscientious, accounting for the special problems encountered by transgender people. A slogan you can use to highlight the importance of trauma-informed mental healthcare and support services tailored to the experience of transgender survivors. Another respondent narrates:

I have had experiences with prejudice, judgment, and even healthcare professionals unwilling to be open with a conversation about transgender health-related issues. Unfortunately, these have become scenarios in which transgender health issues are not comprehended. 




Sexual Abuse and Violence

Underreporting is a big issue as a consequence many transgender individuals are not comfortable disclosing that they are victims of sexual victimization. In response, the fear of further exploitation, discrimination, disbelief, or reprisal often results in silence, and attention must be paid to the development of safe and supportive reporting mechanisms and the 'climate' in which survivors feel safe to speak out (Grant et al., 2011; Stotzer, 2009). A respondent narrated as

As a transgender, I have experienced unwelcome sexual advances and sexual harassment in public places. For many of us, it is the constant fear of being the target of sexual assault, and verbal abuse, discrimination, or doubts that prevents us from even reporting those incidents. Unfortunately, we have an unfortunate inclination to remain silent out of fear of being blamed, or not being believed, which only keeps that cycle of discrimination and harassment going.

Sexual assault, emotional violence, verbal abuse, bullying, and social exclusion from mainstream society are the issues reported by the study participants. One of the serious issues reported by the study participants is that of physical and sexual assaults in public places with no consequences for the perpetrators. In such circumstances, transgender are unable to properly report the incidents because of the fear of further exploitation, victimization, and abuse. Furthermore, the emotional, social, and physical abuses experienced by transgender are creating huge psychological issues, mental problems, and serious health outcomes. Further, they are discriminated against at school and they feel isolated until they find support either from the transgender community or accepting businesses. Now, the need for societal education is growing to debunk the myths and to bring forward a more inclusive society. Through conversations with transgender people, I have learned that there are many different forms of discrimination, like systemic biases, verbal abuse, and microaggressions. Participants underscored the pressing need for the passage of anti-discrimination laws to protect transgender rights in a range of areas such as healthcare, employment, and education.

It also studied disparities in legal safeguards available to transgender people. Transgender people are left 'exposed and at risk' from discrimination from different institutions but most particularly from law enforcement agencies. The economic marginalization of families from our study was a big issue, such as job discrimination and inability to access healthcare because of lack of proper financial assistance and support. The problems of most transgender people are always multifaceted, so it becomes imperative to use holistic approaches to tackle these problems, especially because of income differences and limited economic opportunities. Dialogues provide insight into healthcare disparities, like bias, lacking cultural awareness, and barriers to reaching gender-affirming care. Transgender healthcare services should be provided around mental health care addressing mental health that society stigmatizes. The transgender community was identified to have an alarming pattern of sexual victimization: harassment, assault, and violence within intimate relationships. Because of concerns about discrimination, underreporting has occurred, and programs dedicated to tailored support services and inclusive reporting are still needed. Transgender people face bias in the workplace, educational settings, and the criminal justice system. Inclusive policies and reforms are important to remove systemic obstacles. These challenges include discriminatory practices, lack of inclusiveness, and prejudiced treatment. One obstacle that was highlighted was that sexual victimization was underreported because of the fear of discrimination or not being believed. The problem highlights the need for survivor-centeredness and secure reporting, as well as addressing the problem of increased vulnerabilities, intersectional complexities, and mental health implications.

There are a huge number of challenges that transgender people experience, permeating around many areas of their lives. Thematic analysis has illuminated the challenges that are facing these substance users, including family dynamics, social exclusion, discrimination, legal protections, economic marginalization, healthcare disparities, sexual victimization, and institutional discrimination. The narratives therefore strongly advocate for structural reforms including legislation, education, and public awareness initiatives, to promote inclusiveness and ease the barriers to social integration faced by the transgender population.

Conclusion

It is concluded from the study that transgender are facing serious social, psychological, and physical abuses in their daily lives. People who identify as third gender, transgender in Pakistan experience deep alienation and marginalization as they are socially and economically alienated in every sphere of life.  Transgender people are sometimes viewed as a curse by families and society because they were born with sexual deformities and feminine conduct. As a result, they face many challenges in many spheres of their lives. They are shut out of important facets of life, like the house, school, job, healthcare, identity, get-togethers with family, property, and social and cultural activities. They turn to prostitution, dancing, and public begging as a means of surviving the mistreatment and torture they experience in every aspect of their lives. They suffer from the limited government support and legal rights they are entitled to, when others don't even have to think about them. It is because of their marginalized position and the discrimination they face in public spheres, that they are seen negatively by society and even their own family that they engage in sex work. Findings uncover the widespread social marginalization and biases that transgender individuals face daily. Marginalization amplifies their economic and social vulnerability and hurts their access to important services including health, education, and decent job opportunities. Legislative reforms, public awareness campaigns, and policy adjustments are all ways to address these systemic issues. 

Recommendations

It is recommended that policymakers and policy influencers should come forward to advocate the rights of the transgender community, especially for better educational opportunities, decent work, and job opportunities. There must be some technical and vocational training programs to train and support transgender people to provide them with the skill set necessary for decent jobs and sustainable employment. Furthermore, there is a need to address the housing and healthcare requirements for fostering a supportive environment for the transgender population. Public harassment is an expression that receives severe action, and law enforcement is doing it, and transgender has been animosity growing. The government should proactively create a safe and supportive environment for transgender employees by increasing awareness and sensitization with the workforce about the special needs and the wellbeing of this community. Like any other person, transgender humans should be treated with rights and respect. Society needs to acknowledge their social existence and they must be considered as a complete person.  Furthermore, religious leaders and scholars must come forward to educate the common masses regarding the place and identity of transgender in their respective locales. 

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