Victimization Experiences of men who have sex with

INTRODUCTION Men who have sex with men, transgender women and hijra (MTH) are often

REVIEW OF LITERATURE : GLOBAL SCENARIO REVIEW OF LITERATURE Minority stress theory hypothesizes three

REVIEW OF LITERATURE Multiple studies across the world have shown increased rates of depression,

REVIEW OF LITERATURE Victimization has been one of the outcome of various studies however,

METHODOLOGY REFLECTIONS Research Approach: Constructivist Grounded Theory Study Sites: Kalol, Gujarat and Udaipur, Rajasthan

METHODOLOGY REFLECTIONS Sampling Data technique: Theoretical sampling analysis: Data was coded using Charmaz’s constructivist

RESULTS REFLECTIONS High frequency of harassment and violence (89%), particularly from male sex partners,

RESULTS REFLECTIONS MTH who were victim of violence (73%) were more engaged in frequent

CONCLUSION REFLECTIONS Victimization heightens health risks, hinder MTH victims from seeking legal recourse, and

RECOMMENDATIONS Existing interventions with MTH communities can focus on : - addressing mental health

RECOMMENDATIONS Addressing mental health issues requires gender sensitive approach. In the heteronormative society, mental

RECOMMENDATIONS Quantitative study on bigger sample is warranted to generate robust evidence Future studies

THANK YOU! 2 Nyvad! For more information on the study, please email: drapurvakumar@gmail. com

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Victimization: Experiences of men who have sex with men, transgender women and hijra (MTH) from Gujarat and Rajasthan Apurvakumar Pandya, Ph. D Health Psychologist & Scientist D, Indian Institute of Public Health Gandhinagar Editorial Board Member, Indian Institute of Sexology Bhubaneshwar

INTRODUCTION Men who have sex with men, transgender women and hijra (MTH) are often victimized on the basis of sexual orientation, gender identities, and behaviours. Mental health-related classification systems (ICD & DSM) do not deem homosexuality, transgenderism as a disorder. However, MTH continues to be stigmatized due to which they experience chronic stress.

REVIEW OF LITERATURE : GLOBAL SCENARIO REVIEW OF LITERATURE Minority stress theory hypothesizes three processes that compromise the psychological well-being of non -heterosexual individuals: (1) institutionalized discrimination and directly experienced prejudices, (2) expectation of victimization/rejection and the efforts to avert them, and (3) internalization of stigma (internalized homophobia).

REVIEW OF LITERATURE Multiple studies across the world have shown increased rates of depression, anxiety disorders, alcohol use, suicidal ideation and attempts, and suicides as well as other comorbid psychiatric disorders. A significant number of LGBT members end up homeless; are more likely to attempt suicide. The LGBT community has elevated rates of poverty, food insecurity, and joblessness compared to the general population.

REVIEW OF LITERATURE Victimization has been one of the outcome of various studies however, it has not studied exclusively. In India, a paucity of literature on the prevalence and the emotional problems faced by MTH, primarily due to lack of generation of systematic data. Effects of victimization has not received attention by Indian researchers.

METHODOLOGY REFLECTIONS Research Approach: Constructivist Grounded Theory Study Sites: Kalol, Gujarat and Udaipur, Rajasthan Sample size: 15 in-depth interviews (IDIs) & a focus group interview (FGIs)in each site (30 IDIs & 2 FGIs)

METHODOLOGY REFLECTIONS Sampling Data technique: Theoretical sampling analysis: Data was coded using Charmaz’s constructivist Grounded Theory

RESULTS REFLECTIONS High frequency of harassment and violence (89%), particularly from male sex partners, family members, and police. Such experiences negatively impact not only their sexual health but also affect their mental health adversely. 92% of participants who experienced harassment and violence shared mental health problems. Only 14% of them were aware of mental health services. And only 4% (out of 14%) accessed mental health services

RESULTS REFLECTIONS MTH who were victim of violence (73%) were more engaged in frequent transactional sex and high-risk sexual behaviours. Compliance to regular HIV tests and STI check-up was found to be low. Only 53% had underwent HIV test in last six months and STI screening. Out of total 22% were living with HIV. Both physical violence and psychological/verbal violence were also associated with self-harm, suicidal ideation, and increased use of alcohol.

CONCLUSION REFLECTIONS Victimization heightens health risks, hinder MTH victims from seeking legal recourse, and accessing sexual and mental health services, which is a concern.

RECOMMENDATIONS Existing interventions with MTH communities can focus on : - addressing mental health well-being providing legal and social protection services in addition General orientation of public healthcare providers on MTH population/LGBTQ issues

RECOMMENDATIONS Addressing mental health issues requires gender sensitive approach. In the heteronormative society, mental health professionals need to be oriented on Affirmative LGBTQ Counselling and Psychotherapy

RECOMMENDATIONS Quantitative study on bigger sample is warranted to generate robust evidence Future studies can identify the effects violence has on - health risk behaviours (including HIV risk behaviours) and - mental health of MTH living with and without HIV. - A systematic review of global literature would be useful

THANK YOU! 2 Nyvad! For more information on the study, please email: drapurvakumar@gmail. com