Mental health and gender congruence among transgenders in chennai

National mental health survey of India conducted from 2015 to 2016 found mental health problems are more in 30-49 or over 60 age people. Low income is the reason and people are in urban areas are most affected. Transgenders are most vulnerable population in terms of getting mental health problems compared to non transgender people. Most of the studies conducted on transgenders found the same. Chance of getting mental health was higher in transgenders than cisgenders peers (Becerra-Culqui TA, Liu Y, Nash R, et al., 2018a). The word ‘’transgender” is an umbrella term used to refer to people whose gender identity and natal sex differ (Stein. E. 2012). Study conducted on Transgender and Non-gender conforming (TGN) youth found that they are having huge risk of getting mental health problems such as suicidality, self-harm, clinically significant depressive symptoms, moderate self-esteem and resiliency (Katz- Wise. L. S, et al., 2017). But in recent days transgenders are treated well by society. In a way it is helped those transgender in availing education, employment and etc. The same reflected in academics, science and most importantly individuals’ opinions are changed. The reason behind this change due to awareness about transgenders and inclusiveness to society getting higher and in turn these improvements will lead to increase in the acceptance of transgender by non-transgenders and it will be gate opener for transgender to access the societal features such as health care access, employment and etc. In psychology, it is considered to be a mental disorder as a state in which a person’s feels significant distress. Though many of the transgenders do not feel their gender as distressing, so being or identifying as transgender is not constitute as mental disorder. But to express their self to society they need to mutilate their body in terms of surgery in order to gain the power of sex roles.

Mental health in other terms described as subjective well-being which constitutes three domains: emotional well-being, psychological well-being and social well-being (Keyes 2002). Those well-beings needed for a people to function optimal in personal and social life. Many studies explored the importance of subjective well-being for cisgenders. But there are limited studies available regarding the transgenders subjective well-being/mental health. According to WHO (2014) Mental health is defined as a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community. So it is obvious that, transgenders need to be at a state where they can realize their potential, dealing stresses, work fruitfully and able to contribute to the society where they belonging rather than facing discrimination, unable to express their genuine self and avoidance by society and etc to achieve a fully functional mental health/subjective well-being.

Various factors are determining the mental health of transgenders. Study conducted on Australian gay men revealed that they were psychologically healthier if they were employed, getting higher income, if they were in a relationship, received social support, had many close friends, felt connected to gay community, among all these social support is the most important factors. ( Lyons, Pitts and Grierson, 2013). When they are stigmatized and branded as transgender, it is important to know whether transgenders are allowed to stay with their family otherwise they might forced to run away from family. Staying with their community or staying alone is the only choice left to them. It is significant to aware with whom transgender living happily i. e. with family or community or alone and its reason behind. The result of this will surely have strong message for society. Most transgender stay hidden in society and they have to make more effort to appear indistinguishable from cisgenders people. (Dean. et al., 2000).

In transgenders, both appearance and gender identity are the vital part in gender congruence. On appearance concerns, transsexuals are forced into surgery because of un acceptance by society. It is normally expected that gender incongruence among transgender is high which can be described as a condition where someone convinced that their true gender is different from the one indicated by their body or one that has been assigned to them. The term congruence has been used to describe this genuine and authentic expression of the self (Rogers, 1959). So we can understand the term transgender congruence as the degree to which transgender individuals feel genuine, authentic, and comfortable within their external appearance/presence and accept their genuine identity rather than the socially prescribed identity (Kozee et al., 2012a). In research point of view, we should understand the degree to which transgender people feel congruence between their external presentation and internal self. Kozee explained three important elements needed for the consideration of transgender congruence, they are Self-image, self-reflection and self-expression.

This study is aims at finding the correlation between the mental health and gender congruence. Research suggested that transgender person’s identity must be affirmed for the emotional wellbeing of the individual. A study conducted on transgenders and gender non-conforming (TNNC) youth suggested that they requires instant evaluation and implementation of clinical, social, and educational gender identity support (Becerra-Culqui TA, et al, 2018b). Mental health practitioner role is valuable role on assisting transgenders in exploring and affirming their gender identity, whether this is to be on an individual, interpersonal or social/community level. The creation of positive identity support is crucial to neglect many mental health issues that are associated being transgender. (Nuttbrock, Rosenblum & Blumenstein, 2002a). On the whole understanding the correlation between the mental health and the gender congruence will bring the new perspective to mental health among transgenders.