• Users Online: 1188
  • Home
  • Print this page
  • Email this page
Home About us Editorial board Ahead of print Current issue Search Archives Submit article Instructions Subscribe Contacts Login 

 Table of Contents  
Year : 2018  |  Volume : 34  |  Issue : 2  |  Page : 111-115

Resilience among transgender persons: Indian perspective

Department of Psychiatric Social Work, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India

Date of Web Publication29-Jun-2018

Correspondence Address:
Mr. Hasiruvalli Gangappa Virupaksha
Department of Psychiatric Social Work, National Institute of Mental Health and Neuro Sciences, Bengaluru - 560 029, Karnataka
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijsp.ijsp_25_17

Rights and Permissions

Introduction: Transgender persons are rejected from their families and communities; they are exploited, ridiculed, and discriminated at every aspect of the societal life due to their gender variant behavior and roles. They are at high risk for mental health problems and psychological distress. Materials and Methods: Sixty transgender persons recruited for the study through consecutive sampling method. Connor–Davidson Resilience Scale was administered. Results: Respondents have scored low (59.30 ± 15.02912) in the resilience scale, and this score is lower than any other population scored on this scale across the world. This suggests poor resilience status of the respondents. Residing at family of origin or in mainstream, having higher education status and being employed, are the factors associated with better resilience among transgender persons. Conclusion: The resilience among transgender persons need to be researched and explored further and need to be strengthened by identifying and enhancing the factors associated with better resilience level. Further, family acceptance, societal acceptance, mainstreaming to the education and employment sectors, and provision of health care and social services would bring changes in their lives.

Keywords: Mental health problems, psychological distress, resilience, transgender persons

How to cite this article:
Virupaksha HG, Muralidhar D. Resilience among transgender persons: Indian perspective. Indian J Soc Psychiatry 2018;34:111-5

How to cite this URL:
Virupaksha HG, Muralidhar D. Resilience among transgender persons: Indian perspective. Indian J Soc Psychiatry [serial online] 2018 [cited 2020 Feb 18];34:111-5. Available from: http://www.indjsp.org/text.asp?2018/34/2/111/235658

  Introduction Top

“Transgender” is a broad term for people whose gender identity, expression, or behavior is different from those typically associated with their assigned sex at birth.[1] Transgender persons are the one who exhibit the gender variant behavior and roles in the society.[2] In the Indian context, they are rejected by their families and society, undergo extreme stressful experiences due to gender dysphoria, undergo childhood sexual abuse, bullying and teasing, early discontinuation of schooling, lack of livelihood opportunities, forced marriage, being compelled to do sex work and begging for livelihood, financial and sexual exploitation by the partners, exploitation by police and public;[3],[4] they stay at slums with poor living conditions and they are ill-treated at health-care centers.[5],[6] Transgender persons are the most visible and exploited sexual minorities in India.[7] Further, the transgender persons are in high risk for developing psychological distress and mental health issues such as depression, substance abuse, suicidal tendencies, and conduct disorders.[3],[8] The literature has reported high rate of suicidal tendencies among transgender community which ranges from 32% to 50%[9],[10],[11],[12],[13] and the suicide rate is about 30%;[14] 26% of the transgender persons are at high risk for major depression, and 31% and 15% are at high risk for tobacco and alcohol abuse, respectively.[3] Hence, it is evident that transgender population is having poor mental health status.

Resilience is one's capacity to cope with adversity, stress, and other negative events as well as the capacity to avoid psychological problems while undergoing difficult circumstances;[15],[16] further resilience is a predictor of mental health status that specifically indicates self-esteem, perceived social support, emotion-oriented coping, and a sense of personal mastery.[17] Mental health and resilience are connected; resilience is viewed as a defense mechanism which enables people to thrive in the phase of adversity, and building resilience would result in good mental health status.[16],[18] High level of resilience is associated with lower level of mental health problems such as anxiety, depression, stress, obsessive-compulsive disorders, and so on.[19] Hence, above literature suggests that poor mental health means, transgender community has poor resilience.

However, some studies have demonstrated that in spite of having many hardships in their day-to-day life the transgender persons have overcome from these hardships by adopting certain positive coping strategies and personal qualities;[20] and there are certain protective factors such as support from the family members, staying in family of origin, optimism, having educated in higher level and having higher income and being employed in mainstream, having child-related concerns and being future oriented with personal goals,[8],[9],[21] these factors are helping them to develop resilience toward life.

In this regard, the current study tries to understand the resilience level of the transgender community in the Indian context.

  Materials and Methods Top

The study adopted descriptive research method and 60 respondents who identify themselves as “transgender persons” (male to female), aged 18 and above recruited for the study. The respondents were contacted through a local nongovernment organization (NGO), which is working for the rights of the sexual minorities in the southern part of India. The first 60 transgender persons who signed written informed consent were recruited for the study and those who refused to participate were excluded from the study. Data collected through interview method; the sociodemographic data sheet and the Connor-Davidson Resilience Scale (CD-RISC)[22] were administered to collect data. CD-RISC consists of 25 items and evaluated with five-point Likert scale ranging from 0 to 4; not true at all – 0, rarely true – 1, sometimes true – 2, often true – 3, and true nearly all of the time – 4; these ratings range with the score of 0–100 and the higher score reflect greater resilience. The scale has been widely used across the globe including India;[23] this has been administered among all categories of people such as general population, people suffering from mental health problems, and medical problems. Since the CD-RISC has achieved notable reliability and validity [24],[25],[26] in a variety of population and has been used in the Indian population, the author used this scale for the current study.

Descriptive statistics are performed to describe the sociodemographic details and level of resilience, and Chi-square test was performed to find out the differences in the level of resilience based on different sociodemographic variables.

  Results Top

[Table 1] depicts that the majority of the respondents belong to middle age group (28.27 ± 6.804); they (93.3%) speak more than one language, most of them are fluent in speaking Kannada, Tamil, Telugu, and Hindi languages; half of the respondents belong to neighborhood states other than Karnataka. Majority of the respondents are educated in primary (26.7%) and high school (46.7%) level. The majority (71.7%) of the respondents are staying in transgender community (Hammaams and Slums), 8.3% of them are staying in their family of origin and 20% of them are in rented houses in the mainstream of the society. The majority of the respondents (86.6%) are dependent on sex work or begging or both for their livelihood and only 13.3% of the respondents are earning their livelihoods by working in NGOs, working as cooks and priests in temple. Their average income per day is 382.83 ± 203.720 which is ranged 140–1500. Those who are “Gurus” (Guru is the status of mother achieved by a senior transgender person; the status is achieved when a senior transgender person receives newly joined transgender person as her Chela, that is, daughter; a transgender person who wants to join transgender community is welcomed only when he/she becomes Chela to a senior transgender person; the Chela has to serve the Guru and offer certain portion her daily earnings to her Guru and the Guru is the care taker of the Chela) (four Gurus participated this study and three Gurus refused to participate) and those who are doing sex work along with begging are earning/1000–1500 every day. The majority (73.3%) of the respondents are using/abusing substances such as tobacco and alcohol.
Table 1: Sociodemographic characteristics of transgender persons (n=60)

Click here to view

[Table 2] depicts the resilience score (59.30 ± 15.02912) among respondents. The scale evaluates the resilience on the aspects such as availability of secure and close relationship, being able to adapt to changes of life, coping, sense of humor in life, having goals and making efforts toward the same, making decisions, sense of purpose, and so on. The score shows that the respondents have poor resilience as a whole because this level of the score is lesser than any other group of population scored across the world except for the population of earthquake survivors and clinical population such as persons with anxiety disorder and PTSD.
Table 2: Level of resilience among transgender persons

Click here to view

[Table 3] depicts that the transgender persons who have higher education, occupied in the mainstream and who are staying in the family of origin and staying in the mainstream of the society have a better level of resilience compared to their counterparts. However, majority of the respondents have not been accepted from their families, and they are staying in Hammamms (a public bathing facility run by transgender persons) and slums; and majority of them have discontinued their education at school level and are dependent on begging and sex work for their livelihood; because they ran away from home, there is no one to support them and to survive, they have opted begging and sex work.
Table 3: Differences in the level of resilience among transgender persons based on the selected sociodemographic variables

Click here to view

  Discussion Top

The current study replicates that the transgender persons are away from their families; this may be because of nonacceptance by the family members and their society and also the transgender persons want to avoid the encounters with their family members and other known people. Further, they have discontinued their education in the primary level or high school level and are dependent on sex work or begging or both for their livelihood. These findings have been supported by the previous literature.[27] To supplement their survival in the different places as part of the migration, transgender persons have learned multiple languages. Since no lessor gives his/her house for rent, the transgender persons have to take shelter at Hammams (a public bathing facility usually run by transgender community) or at slums; usually, many transgender persons reside under the single roof. Hence, their living condition is very poor. This result has been corroborated by other studies.[5],[6] Further, the transgender persons are prone for use and abuse of substances. It has been reflected in the current study as well as in the previous studies.[3],[4],[28] The study found that the transgender community has a lower level of resilience. It shows that the transgender persons perceive no support from family members and other sources; they feel inferior, less competent, and unable to cope with the difficult situations of everyday life; they also feel that they have nothing much to feel happy or satisfied about themselves. Overall, it indicates poor mental health status and psychological well-being in the transgender community. These results are supported by the previous literature.[3],[4],[5],[6],[17],[27],[28]

Further, the current study has identified few factors such as higher level of education, employment (other than sex work and begging), and living in the family of origin, and in the mainstream of the society has led the transgender persons to develop a better level of resilience. This indicates the transgender persons are in dire need of family acceptance and family living, social inclusion, education, and livelihood opportunities in the mainstream. These factors would really strengthen their resilience toward life and bring down their psychological distress and promote good mental health in the community. These findings also supported by the previous literature.[8],[21]

Although the current study throws light on resilience level and some of the implications to improve the resilience level and promote mental health of the transgender community (in a metropolitan city of southern part of India), the results cannot be generalized. The results of this study should be interpreted with the knowledge of the geographical area, smaller sample size, and all the respondents of this study were contacted through an NGO which is working for the transgender community in the locality. In other words, the respondents are the members of the NGO and are receiving services as well. Hence, they may not represent the transgender community as a whole; there are huge numbers of transgender persons who do not visit the NGO or have not registered or not in regular contact with the NGO, and their resilience level may be lower than this or vice versa. However, the transgender community is one of the difficult to reach populations and the researcher requires help of some agency or an agent who facilitates the contact with this community for research. Hence, the researcher had to contact them through Sangama, a NGO working for rights of sexual minorities in the southern part of India. This population is hardly studied, especially in the Indian context; there is a dire need of more research studies on this population to understand the unique culture, needs, and issues and respond accordingly.

  Conclusion Top

The study indicates a lower level of resilience among transgender persons which further reflects poor mental health status of the community. There is huge scope for research in exploring and understanding the unique mental health and psychological aspects of the transgender community in the Indian context. In spite of various hardships in day-to-day life, the transgender community has a tremendous amount of resilience which needs to be explored further and strengthened. Moreover, the factors (protective factors such as acceptance, social support, education, employment, health-care services, and social inclusion) which facilitate them to develop resilience toward life have to be identified and enhanced further. In this regard, the mental health professionals, social workers, and the society as a whole have a great responsibility to respond to this and initiate appropriate interventions.


The authors are very much grateful to the staff of Sangama and its various Drop-in Centers who facilitated the contacts with the respondents. The authors are also thankful to all the transgender persons who spared their time and participated in this study.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.

  References Top

Transgender Terminology. National Centre for Transgender Equality; 2014. Available from: http://www.transequality.org/issues/resources/transgender-terminology. [Last accessed 2018 Apr 16].  Back to cited text no. 1
Peoples Union for Civil Liberties-Karnataka. Human Rights Violations Against the Trnasgdender Community – A Study of Kothi and Hijra Sexworkers in Bangalore, India. Bangalore: Peoples Union for Civil Liberties, Karnataka; 2003.  Back to cited text no. 2
Budania SK. Rapid Assessment of Mental Health Needs and Planning of Mental Health Services for the Transgender (Hijras) Community. Bangalore: National Institute of Mental Health and Neuro Sciences (NIMHANS); 2012.  Back to cited text no. 3
Sridevi SP, Veena KV. Social exclusion have a negative impact on the health of the transgender. Indian Streams Res J 2011;1:1-4.  Back to cited text no. 4
Karthik L, Joseph V. A Study on General Welbeing of Male to Female Transgenders Living in Chennai; 2010. Available from: https://www.medindia.net/news/healthwatch/Mental-Health-Concerns-of-Transgender-Population-Living-in-Chennai-South-India-A-Study-78981-1.htm. [Last accessed 2018 Apr 16].  Back to cited text no. 5
Chakrapani V, Newman PA, Shunmugam M, McLuckie A, Melwin F. Structural violence against Kothi-identified men who have sex with men in Chennai, India: A qualitative investigation. AIDS Educ Prev 2007;19:346-64.  Back to cited text no. 6
Peoples Union for Civil Liberties-Karnataka, editor. Human Rights Violations Against Sexuality Minorities in India. Bangalore, Sangama: Peoples Union for Civil Liberties-Karnataka; 2001.  Back to cited text no. 7
Mustanski B, Liu RT. A longitudinal study of predictors of suicide attempts among lesbian, gay, bisexual, and transgender youth. Arch Sex Behav 2013;42:437-48.  Back to cited text no. 8
NCTE. Preventing Transgender Suicide Washington: National Center for Transgender Equality; 2010. Available from: http://www.transequality.org/PDFs/NCTE_Suicide_Prevention.pdf. [Last accessed 2018 Apr 16].  Back to cited text no. 9
Clements-Nolle K, Marx R, Katz M. Attempted suicide among transgender persons: The influence of gender-based discrimination and victimization. J Homosex 2006;51:53-69.  Back to cited text no. 10
DiStefano AS. Suicidality and self-harm among sexual minorities in Japan. Qual Health Res 2008;18:1429-41.  Back to cited text no. 11
Testa RJ, Sciacca LM, Wang F, Hendricks ML, Goldblum P, Bradford J, et al. Effects of violence on transgender people. Prof Psychol Res Pract 2012;43:452.  Back to cited text no. 12
Rosenstreich G. LGBTI People Mental Health and Suicide. Australian J Psychosocial Rehabilitation 2011:16-9.  Back to cited text no. 13
Transgender Suicide Rates Continue to Rise. The Soft Copy – An IIJNM Web Publication; 2012. Available from: http://www.thesoftcopy.in/archive/softcopy_2012_13/06_12_12_romana_suicide.html. [Last accessed 2018 Apr 16].  Back to cited text no. 14
Lutha SS, Cicchetti D. The construct of resilience: Implications for interventions and social policies. Dev Psychopathol 2000;12:857-85.  Back to cited text no. 15
Luthar SS, Cicchetti D, Becker B. The construct of resilience: A critical evaluation and guidelines for future work. Child Dev 2000;71:543-62.  Back to cited text no. 16
Grossman AH, D'augelli AR, Frank JA. Aspects of psychological resilience among transgender youth. J LGBT Youth 2011;8:103-15.  Back to cited text no. 17
Davydov DM, Stewart R, Ritchie K, Chaudieu I. Resilience and mental health. Clin Psychol Rev 2010;30:479-95.  Back to cited text no. 18
Hjemdal O, Vogel PA, Solem S, Hagen K, Stiles TC. The relationship between resilience and levels of anxiety, depression, and obsessive-compulsive symptoms in adolescents. Clin Psychol Psychother 2011;18:314-21.  Back to cited text no. 19
White MG. Resiliency Factors among Transgender People of Color [Dissertation, Dissertation Abstract]. East Eisenhower Parkway, Ann Arbor, MI, ProQuest Information & Learning (US): The University of Wisconsin-Milwaukee; 2014.  Back to cited text no. 20
Moody C, Smith NG. Suicide protective factors among trans adults. Arch Sex Behav 2013;42:739-52.  Back to cited text no. 21
Connor KM, Davidson JR. Development of a new resilience scale: The Connor-Davidson Resilience Scale (CD-RISC). Depress Anxiety 2003;18:76-82.  Back to cited text no. 22
Singh S, Deshmukh P, Ungratwar A, Subramanyam AA, Kamath R. Does resilience affect illness perception and well-being in the elderly? J Geriatr Ment Health 2014;1:94.  Back to cited text no. 23
  [Full text]  
Libretto S, editor Psychometric Properties of Connor-Davidson Resilience Scale in a Sample of Military Active Duty Service Members. 142nd APHA Annual Meeting and Exposition (November 15-November 19, 2014). APHA; 2014.  Back to cited text no. 24
Sarubin N, Gutt D, Giegling I, Buehner M, Hilbert S, Kraehenmann O, et al. First analysis of the 10-and 25-item german version of the connor-davidson resilience scale (CD-RISC) regarding psychometric properties and components. Zeitschrift Fur Gesundheitspsychologie 2015;23:112-22.  Back to cited text no. 25
Crespo M, Fernandez-Lansac V, Soberon C. Spanish version of the Connor-Davidson Resilience Scale (CD-RISC) for chronic stress situations. Behav Psychol Psicol Conductual 2014;22:219-38.  Back to cited text no. 26
Abdullah MA, Basharat Z, Kamal B, Sattar NY, Hassan ZF, Jan AD, et al. Is social exclusion pushing the Pakistani Hijras (Transgenders) towards commercial sex work? A qualitative study. BMC Int Health Hum Rights 2012;12:32.  Back to cited text no. 27
Mental Health Concerns of Transgender Population Living in Chennai, South India – A Study. Med India; 2011. Available from: http://www.medindia.net/news/healthwatch/mental-health-concerns-of-transgender-population- living-in-chennai-south-india-a-study-78981-1.htm. [Last accessed 2018 Apr 16].  Back to cited text no. 28


  [Table 1], [Table 2], [Table 3]


Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
Access Statistics
Email Alert *
Add to My List *
* Registration required (free)

  In this article
Materials and Me...
Article Tables

 Article Access Statistics
    PDF Downloaded379    
    Comments [Add]    

Recommend this journal