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Introduction In the culture of South Asia, hijras or chakka in Kannada, khusra inPunjabi and kojja in Telugu are physiological males who have feminine gender identity, women’s clothing and other feminine gender roles. Hijras have a long recorded history in the Indian subcontinent, from the antiquity, as suggested by the Kama Sutra period onwards. This history features a number of well-known roles within subcontinental cultures, part gender-liminal, part spiritual and part survival. In South Asia, many hijras live in well-defined, organized, all-hijra communities, led by a guru.
These communities have sustained themselves over generations by “adopting” young boys who are rejected by, or flee their family of origin. Many work as prostitutes for survival. The word hijra is Urdu, derived from the Arabic root hjr in its sense of “leaving one’s tribe,” and has been borrowed into Hindi. The Indian usage has traditionally been translated into English as “eunuch” or “hermaphrodite,” where “the irregularity of the male genitalia is central to the definition. ” However, in general hijras are born with typically male physiology, only a few having been born with male intersexvariations.
Some Hijras undergo an initiation rite into the hijra community called nirwaan, which refers to the removal of penis, testicles andscrotum. Since the late 20th century, some hijra activists and Western non-government organizations (NGOs) have been lobbying for official recognition of the hijra as a kind of “third sex” or “third gender,” as neither man nor woman. In North India the goddess Bahuchara Mata is worshiped by Pavaiyaa . In South India, the goddess Renuka is believed to have the power to change one’s sex. Male devotees in female clothing are known as Jogappa.
They perform similar roles to hijra, such as dancing and singing at birth ceremonies and weddings. [9] The word kothi (or koti) is common across India, similar to the Kathoey of Thailand, although kothis are often distinguished from hijras. Kothis are regarded as feminine men or boys who take a feminine role in sex with men, but do not live in the kind of intentional communities that hijras usually live in. Additionally, not all kothis have undergone initiation rites or the body modification steps to become a hijra. [10] Local equivalents include durani (Kolkata), menaka (Cochin),[11] meti (Nepal), and zenana (Pakistan).
Hijra used to be translated in English as “eunuch” or “hermaphrodite,”[6] although LGBT historians or human rights activists have sought to include them as being transgender. [12] Gender and sexuality These identities have no exact match in the modern Western taxonomy of gender and sexual orientation,[12] and challenge Western ideas of sex and gender. [4] Most are born apparently male, but some may be intersex (with ambiguous genitalia). They are often perceived as a third sex, and most see themselves as neither men nor women.
However, some may see themselves (or be seen as)females,[13] feminine males or androgynes. Some, especially those who speak English and are influenced by international discourses around sexual minorities may identify as transgender ortranssexual women. Unlike some Western transsexual women, hijras generally do not attempt to pass as women. Reportedly, few have genital modifications, although some certainly do, and some consider nirwaan (“castrated”) hijras to be the “true” hijras. [6] A male who takes a “receptive” or feminine role in sex with a man will often identify as a kothi (or the local equivalent term).
While kothis are usually distinguished from hijras as a separate gender identity, they often dress as women and act in a feminine manner in public spaces, even using feminine language to refer to themselves and each other. The usual partners of hijras and kothis are masculine men, whose gender identity is as a “normal” male who penetrates. [14] These male partners are often married, and any relationships or sex with “kothis” or hijras are usually kept secret from the community at large. Some hijras may form relationships with men and even marry,[15] although their marriage is not usually recognized by law or religion.
Hijras and kothis often have a name for these masculine sexual or romantic partners; for example, panthi in Bangladesh, giriya in Delhi or sridhar in Cochin. [11] Social status and economic circumstances Most hijras live at the margins of society with very low status; the very word “hijra” is sometimes used in a derogatory manner. Few employment opportunities are available to hijras. Many get their income from performing at ceremonies, begging, or sex work—an occupation of eunuchs also recorded in premodern times. Violence against hijras, especially hijra sex orkers, is often brutal, and occurs in public spaces, police stations, prisons, and their homes. [16] As with transgender people in most of the world, they face extreme discrimination in health, housing, education, employment, immigration, law, and any bureaucracy that is unable to place them into male or female gender categories. [17] Beginning in 2006, hijras were engaged to accompany Patna city revenue officials to collect unpaid taxes, receiving a 4 percent commission. [18] Hijras are often encountered on streets, trains, and other public places demanding money from people.
If refused, the hijra may attempt to embarrass the man into giving money, using obscene gestures, profane language, and even sexual advances. [citation needed] In India for example, threatening to open their private parts in front of the man if he does not donate something. Hijras also perform religious ceremonies at weddings and at the birth of male babies, involving music, singing, and sexually suggestive dancing. These are intended to bring good luck and fertility. Although hijras are most often uninvited, the host usually pays the hijras a fee.
Many fear the hijras’ curse if they are not appeased, bringing bad luck or infertility, but for the fee they receive, they can bless goodwill and fortune on to the newly born. Hijras are said to be able to do this because, since they do not engage in sexual activities, they accumulate their sexual energy which they can use to either bestow a boon or a bane. Hijras can also come as an invitee to one’s home, and their wages can be very high for the services they perform. Supposedly, they can give insight into future events as well bestow blessings for health.
Hijras that perform these services can make a very good living if they work for the upper classes. History The ancient Kama Sutra mentions the performance of fellatio by feminine people of a third sex (tritiya prakriti). [19] This passage has been variously interpreted as referring to men who desired other men, so-called eunuchs (“those disguised as males, and those that are disguised as females”[20]), male and female transvestites (“the male takes on the appearance of a female and the female takes on the appearance of the male”),[21] or two kinds of biological males, one dressed as a woman, the other as a man. 22] During the era of the British Raj, authorities attempted to eradicate hijras, whom they saw as “a breach of public decency. “[23] Anti-hijra laws were repealed; but a law outlawing castration, a central part of the hijra community, was left intact, though rarely enforced. Also during British rule in India they were placed under Criminal Tribes Act 1871 and labelled a “criminal tribe,” hence subjected to compulsory registration, strict monitoring and stigmatized for a long time, after independence however they were denotified in 1952, though the century old stigma continues.
Recently campaigns have emerged with the intent of protecting the hijras from persecution. Raheed Patel, known locally in the hijra community as Pineapple Andy Kaid has been quite active in this quest and the push to recognize marriage amongst the hijra. A hijra polygamist himself, Mr. Kaid has lobbied in earnest for the hijra cause. [24] [edit]In religion The Indian transgender hijras or Aravanis ritually marry the Hindu godAravan and then mourn his ritual death (seen) in an 18-day festival in Koovagam, India. In Hindu contexts, hijras belong to a special caste.
They are usually devotees of the mother goddess Bahuchara Mata, Lord Shiva or both. Hijra culture draws upon the traditions of several religions. [edit]Hijras and Bahuchara Mata Bahuchara Mata is a Hindu goddess with two unrelated stories both associated with transgender behavior. One story is that she appeared in the avatar of a princess who castrated her husband because he would run in the woods and act like a woman rather than have sex with her. Another story is that a man tried to rape her so she cursed him with impotence.
When the man begged her forgiveness to have the curse removed, she relented only after he agreed to run in the woods and act like a woman. The primary temple to this goddess is Gujarat[25] and it is a place of pilgrimage for hijras, who see Bahucahara Mata as a patroness. [edit]Hijras and Lord Shiva One of the forms of Lord Shiva is a merging with Parvati where together they are Ardhanari, a god that is half Shiva and Half Parvati. Ardhanari is especially worshipped in North India and has special significance as a patron of hijras, who identify with the gender ambiguity. 25] [edit]Hijras in Ramayana In some versions of the Ramayana,[26] when Rama leaves Ayodhya for his 14-year exile, a crowd of his subjects follow him into the forest because of their devotion to him. Soon Rama notices this, and gathers them to tell them not to mourn, and that all the “men and women” of his kingdom should return to their places in Ayodhya. Rama then leaves and has adventures for 14 years. When he returns to Ayodhya, he finds that the hijras, being neither men nor women, have not moved from the place where he gave his speech.
Impressed with their devotion, Rama grants hijras the boon to confer blessings on people during auspicious inaugural occasions like childbirth and weddings. This boon is the origin of badhai in which hijras sing, dance, and give blessings. [27] [edit]Hijras in the Mahabharata In the Mahabharata, before the Kurukshetra War, Ahiravan offers his lifeblood to goddess Kali to ensure the victory of the Pandavas, and Kali agrees to grant him power. On the night before the battle, Aravan expresses a desire to get married before he dies.
No woman was willing to marry a man doomed to die in a few hours, so Krishna assumes the form of a beautiful woman called Mohini and marries him. In South India, hijras claim Aravan as their progenitor and call themselves “aravanis. “[27] In Tamil Nadu each year in April and May, hijras celebrate an eighteen-day religious festival. The aravani temple is located in the village Koovagam in the Ulundurpet taluk in Villupuram district, and is devoted to the deity Koothandavar, who is identified with Aravan. During the festival, the aravanis reenact a story of the wedding of Lord Krishna and Lord Aravan, followed by Aravan’s subsequent sacrifice.
They then mourn Aravan’s death through ritualistic dances and by breaking their bangles. An annual beauty pageant is also held, as well as various health and HIV or AIDS seminars. Hijras from all over the country travel to this festival. A personal experience of the hijras in this festival is shown in the documentary India’s Ladyboys, by BBC Three and also on the television series Tabooon the National Geographic Channel. [edit]In films and literature This section does not cite any references or sources. Please help improve this section by adding citations to reliable sources.
Unsourced material may be challenged and removed. (December 2009) Hijras have been on screen in Indian cinema since its inception, historically as comic relief. A notable turning point occurred in 1974 when real hijras appeared in a song and dance sequence inKunwaara Baap (“The Unmarried Father”). There are also hijras in the Hindi movie Amar Akbar Anthony (1977). They accompany one of the heroes, Akbar (Rishi Kapoor), in a song entitled “Tayyab Ali Pyar Ka Dushman” (“Tayyab Ali, the Enemy of Love”). One of the first sympathetic portrayals was in Mani Ratnam’s Bombay (1995). 997’s Tamanna starred male actor Paresh Rawal in a central role as Tiku, a hijra who raises a young orphan. Pooja Bhatt produced and also starred in the movie, with her father Mahesh Bhatt co-writing and directing. A hijra (played by Raghubir Yadav), has taken to profession in introducing the widows of Varanasi, another group of down-trodden outcasts, to prostitution (the film resulted in high controversy). There is a brief appearance in the 2004Gurinder Chadha film Bride & Prejudice, with hijras singing to a bride-to-be in the marketplace.
There’s also a loose reference in Deepha Mehta’s Bollywood/Hollywood in the guise of Rocky or Rokini. Deepa Mehta’s Water also features a hijra character by the name of Gulabi. In the 2000 Tamil film, Appu directed by Vasanth, the antagonist is a hijra. The film features the hijra running a brothel and the role is played by Prakash Raj. This was a remake of the Hindi filmSadak, in which the character of the brothel owner was famously played by Sadashiv Amrapurkar, with the name (in the movie) “Maharani. ” In 2005, a fiction feature film titled Shabnam Mausi was made on the life of a eunuch politician of the same name (see Shabnam Mausi).
It was directed by Yogesh Bharadwaj, and the title role was played by Ashutosh Rana. In Soorma Bhopali, Jagdeep encounters a troupe of hijras on his arrival in Bombay. The leader of this pack is also played by Jagdeep himself. In Anil Kapoor’s Nayak, Johnny Lever, who plays the role of the hero’s assistant, gets beaten up by hijras, when he is caught calling them “hijra” (he is in habit of calling almost everyone who bothers him by this pejorative and no one cares much, except this once ironically, as the addressees are literally what he is calling them. ) The 1992 film Immaculate Conception by Jamil
Dehlavi is based upon the culture-clash between a western Jewish couple seeking fertility at a Karachi shrine known to be blessed by a sufi-fakircalled Gulab Shah and the group of Pakistani eunuchs who guard it. One of the main characters in Khushwant Singh’s novel Delhi, Bhagmati is a hijra. She makes a living as a semi-prostitute, and is quite wanted in diplomatic circles of the city. The novel Bombay Ice by Leslie Forbes features an important subplot involving the main character’s investigation of the deaths of several hijra sex workers. The novel City of Djinns by William Dalrymple also features a chapter on hijras.
Vijay TV’s Ippadikku Rose, a Tamil show conducted by postgraduate educated transgender Rose is a very successfully running program that discusses various issues faced by youth in Tamil Nadu, where she also gives her own experiences. In addition to numerous other themes, the 2008 movie Welcome to Sajjanpur by Shyam Benegal explores the role of hijras in Indian society. In the 2009 Brazilian soap opera Caminho das Indias (Portuguese for “The way to India”) hijras are shown in some occasions, especially at weddings and other ceremonies where they are paid for their blessing.
In the TV comedy Outsourced (2011), a hijra is hired by Charlie as a stripper for Rajiv’s “bachelor party”, much to Rajiv’s utter horror. Vol – I , ISSUE – VI [ July 2011 ] : Research Paper Author : DR. SRIDEVI SIVAKAMI PL [ AVINASHILINGAM UNIVERSITY FOR WOMEN, COIMBATORE ] VEENA K. V [ ANNA ADARSH COLLEGE FOR WOMEN, CHENNAI ] Article : SOCIAL EXCLUSION HAVE A NEGATIVE IMPACT ON THE HEALTH OF TRANSGENDER ABSTRACT Transgender is a general term applied to a variety of individuals, behaviors and groups involving tendencies to vary from culturally conventional gender roles.
Male to female and female to male are the two gender identities which have been widely noted in the transgender literature. The study aims at unraveling the nutritional status of the selected transgenders. One hundred and twenty transgenders from the age group of 20-70 years were selected from the locale by using convenience sampling method. A detailed interview schedule was used to collect their demographic profile, lifestyle patterns, psychological aspects and assessment of nutritional status by adopting standardized procedure.
Statistical analysis was applied to find the significance of their nutritional status based on the type of their type of activity. Transgender face more psychological problems and social exclusion is one of the most important one. Social exclusion is the failure of the society to provide certain individuals and groups with those rights and benefits normally available to its members such as employment, adequate housing, health care, education, training etc. they face exclusion starting from their family member’s to the problems faced within their own community.
Emotional changes have an impact on the food consumption pattern and hence they lack nutrients subjected to rejection, racism and lack of medical health care. INTRODUCTION Transgender designate a person whose identity does not conform unambiguously to conventional nations of male or female gender roles but combines or moves between these. People who were assigned a sex usually at birth and based on their genitals but who feel that this is a false or incomplete description of themselves (USI LGBT campaign, 2007). MTF and FTM are the two gender identities which have been widely noted in the transgender literature (Xavier, 2000).
Transgender is a relatively rare condition, but is increasingly encountered in our modern society. In the world, the transgenders are estimated to be six hundred crores. There are roughly one million Hijra in India, representing approximately one in every four hundred post pubertal persons born male. The transgender population in Tamil Nadu would be roughly about sixty thousands. Transgender people are likely to experience some form of victimization as a result of his/her identity or gender expression. They face a unique set of emotional health issues.
Both social exclusion and discrimination have a negative impact on the health of these individuals (Lee, 2000). The prevalence of mental health problems and other co-occurring health issues in the transgender community reaches near epidemic levels. Due to a complex network of socio-economic and cultural forces, the transgender community is highly vulnerable to a host of psychological problems including depression, bipolar affective disorders, post traumatic stress disorders (PT&D), alienation and suicidality in addition to multiple health problems including drug and alcohol abuse, HIV/AIDS & STD.
This distress is referred to as a gender dysphoria and may manifest as depression or inability to work and form healthy relationships with others. A psychological condition is considered a mental disorder only if it causes distress and disability. Gender dysphoria is a diagnosis recognized by the American Psychiatric Association of severe distress and discomfort caused by the conflict between one’s gender identity and one’s sex at birth (Brown and Rounsley, 1996). Family members and friends are not able to understand or accommodate the transition process resulting in the ending up at times (Pfafflin and Jung, 2003).
With this back drop, the present study was undertaken with the following objectives To; 1. Study the socio economic status of the selected transgenders people. 2. Unraveling the impact of social exclusion on their health. 3. Find out the life style pattern of selected transgenders people MATERIALS AND METHODS Subjects were selected by convenience sampling method for the research. Investigator selected 120 subjects from the age group of 20 -70 years , from Coimbatore city, Tamil nadu. Conduct of the study
The main endeavor is to study their socio-economic status, life style pattern, dietary pattern and medical conditions were assessed based on their psychological status. The reason for them leaving their family, eating late hours and problems within their community were also assessed. Assessment of nutritional status of the community is one of the first steps in the formation of any public health strategy to combat malnutrition. So the investigator assessed the status of the selected transgenders by adopting standardized procedure like anthropometric measurements, body mass index and waist hip ratio.
Dietary survey was carried out to collect data on dietary history and dietary intake of the selected transgenders. The data on dietary history intake included information with regard to meal pattern, food habits; frequency of consumption of fruits, vegetables, green leafy vegetables, fleshy foods and preserved foods was collected. The food consumption pattern of the transgenders at the time of survey was collected using 24 hour recall method, over three consecutive days. Using the collected data, their nutrient intake was calculated. Biochemical parameters namely fasting and post prandial blood glucose level and the blood pressure ere analyzed and found the persons at risk for life style diseases and were recorded. Statistical analysis of the data included mean and standard deviation of the transgender was calculated and t test was applied to find the significance of their nutritional status based on the type of their activity in comparison to the Recommended Dietary Allowances. RESULTS AND DISCUSSION SOCIO – ECONOMIC PROFILE OF THE SELECTED TRANSGENDERS The demographic and socio-economic background revealed the following: 1. Education status of the selected transgenders TABLE – I Education status of the selected transgenders Educational statusNumberPercentage
Primary and high school6756 Higher secondary school2218 College level3025 Illiterate11 With regards to the educational status of the transgender community 56 percent of them have only primary and middle school education and 18 percent have higher secondary education. The researcher found that these subjects were avoided by their classmates and teachers and hence they hesitated to go to school after they recognized the abnormal changes in them. Twenty five percent of them obtained their degrees through distance education and only one among the selected transgenders was illiterate. 2.
Income level of the selected transgenders TABLE – II Income status of the selected transgenders Income level (HUDCO Classification)NumberPercentage Low income7764 Middle income3428 High income98 Based on the HUDCO (2004) classification 64 percent of them belonged to the low income group, 28 percent of them belonged to middle income group and eight percent of them belonged to high income group. As a result of victimization these people face a lot of problems in their work area and hence they don’t stay a long way in the job.
They have a few opportunities and their work and talent are never accepted in the work area. PSYCHOLOGICAL ASSESSMENT 1. Relationship of the transgenders with their family While assessing the family details of transgenders community 37percent lived with their own family, 39 percent had problems with a particular member in the family and only 23 percent do not have any contact with the family members. They stayed alone or along with other transgenders. 2. Reasons for leaving their own family Table III explains the reason for transgenders left their family. TABLE III Reasons for Transgenders Leaving Their Family
ProblemsNumberPercent Not accepted2520 Hindrance in marriage for brothers and sisters1815 Ill-treated2218 Live freely and happily3933 Feel embarrassed1210 Among the selected 120 subjects, most of the subjects came out of the family after they recognized themselves as a transgenders. Thirty three percent came out of their family as they could live their life freely and happily, 20 percent were not accepted in the family, 15 percent left home as they were the cause of hindrance in the marriage of brothers and sisters, 18 percent of them were ill treated and only 10 percent felt embarrassed and left home. . Problems within the transgender community Table VI explains the problems faced within the transgender community. TABLE VI Problems within the Community ProblemsNumberPercent Misunderstanding76 Distribution in collection of money32 Jealousy54 It was clear from the above table that six percent of the problems arise due to misunderstanding among themselves, four percent due to jealousy and two percent due to confusion in the distribution of collection of money. LIFE STYLE AND DIETARY PATTERN OF THE SELECTED TRANSGENDERS 1. Exercising pattern
While assessing the exercise pattern of transgenders, 17 percent of them had the habit of performing exercise. Among them 13 percent had the habit of walking daily whereas only three percent of them performed yoga daily. 2. Smoking and alcohol habits TABLE V Smoking and alcohol consumption pattern of the selected transgenders TypeFrequencyNo. per day DailyWeeklyRarely5 Cigarette14–924 Beedi2–2– Gudka1711973 Pan parag214112312 Beetel leaves with tobacco6-4-1- Beer167961115 Brandy547124- Whisky547853 Wine433325 It was clear from the table that only 16 of them had the habit of smoking.
It was alarming to see that 14 of them smoked cigarettes daily; and two of them smoked beedi. Out of the selected subjects, 45 of them had chewing habits. Twenty six subjects were pan parag users. Seventeen subjects chewed gudka daily and six subjects chewed beetel leaves with tobacco. Fifty four of the subjects had the habit of consuming alcohol. Sixteen of the selected subjects drank beer, four percent consumed wine daily. 3. Dietary Pattern of the Selected Transgenders Almost all transgenders (92%) were non-vegetarians.
The green leafy vegetable consumption patterns among the selected transgenders were according to doctor’s recommendation. Iron rich foods like manathakali, amaranth and fenugreek leaves was consumed by most of the selected subjects. All the vegetables were consumed in rotation without monotonous usage of vegetables. Beans were consumed frequently followed by cabbage, beetroot, carrot, bitter gourd and brinjal. The consumption patterns of fruits among the selected subjects were found that banana was the most common fruit consumed by the transgenders.
Among them 44 percent consumed banana daily as it is of low cost and easily available. The next preferred fruit next to banana was apple followed by grapes, sweet lime and orange. The consumption pattern of non-vegetarians among selected transgenders showed that 32 percent of selected transgenders consumed egg daily and one each consumed beef and chicken daily. Forty percent of selected transgenders consumed fish weekly Fish consumption was recommended by the doctors as they reduced the chances of cardiac problems. 4. Snacking pattern
The transgenders community is still not recognized in the society and they are abused; ill treated which reflects on their eating habits. It was found that 28 percent had the habit of eating while they were too disappointed or sad and showed their anger on food. Seventy two percent do not eat when they are emotionally disturbed. NUTRITIONAL ASSESSMENT OF THE SELECTED TRANSGENDERS 1. Body Mass Index (BMI )of the selected transgenders TABLE VI Body Mass Index (BMI) of the selected transgenders BMI classificationNumberPercentage Underweight3032
Among the selected subjects 15 percent were underweight, 63 percent normal, 20 percent overweight and 12 percent obese. The reasons for the overweight and obese was observed as they consumed hormonal tablets as a process of transition for the development of secondary sex organs and also used anabolic substances to reduce the impact of psychological distress. Ninety percent of the selected transgenders had low WHR (less than 0. 9) and they were at lower risk of life style diseases. The common disease conditions seen among the selected subjects were diabetics, overweight, obesity and hypertension. . Personal history of diseases among transgenders Table VII reveals the diseases among the selected transgenders TABLE VII DISEASES THAT ARE COMMON AMONG THE SELECTED SUBJECTS (N=120) Disease Condition Underweight (No)Ideal weight (No)Overweight (No)Obese (No) Diabetes1-12 Blood pressure-792 HIV112- The above table clearly explains the disease conditions among the selected subjects. Of the three diabetic subjects one was overweight and two of the selected subjects were obese. All the selected diabetic subjects were non insulin dependent Diabetes Mellitus.
Transgenders taking estrogen may be at increased risk for type II diabetes, particularly those with family history of diabetes or other risk factors (Barrett et al. , 2002). Nine of the selected transgenders from the overweight and two from the obese category had elevated blood pressure, where as only seven of ideal weight subjects reported to be hypertensive. The HIV awareness program was found to be effective as only four out of 120 transgender subjects reported with HIV, where each of them were underweight and normal weight respectively and only two were obese.
The transgender population appears to have an inappropriately high rate of HIV/AIDS. Reported HIV rated from studies in US range from 20-35 percent among MTF spectrum with 2-4 percent among FTM (Lindley et al. , 2003). SUMMARY AND CONCLUSION The results of the present study conclude that the transgenders are not considered as a part of the society. Thus they are underprivileged and lack the basic infrastructure to lead a happy living in the present changing world. They are very few occupational choices and are at times forced to do obs against their interest and satisfaction. Since, they lack both education and occupation; they have poor health conditions leading to various diseases and complications. The prevalent diseases identified among them are blood pressure, underweight, overweight, obese, diabetic and HIV. They undergo lots of psychological stress resulting from discrimination and ill treatment in the society. It does take time for them to adjust to various changes and their relationships in the society. BIBLIOGRAPHY 1. American Psychiatric Association, (2000). Diagnostic and Statistical.
Manual of Mental Disorders 4th Edition – DSM IV-TR, American Psychiatric Association Press , P. 56 2. Barrett , C. B,(2002). Expanding research infrastructure for lesbian health , Arm. J. Public health, 93:Pp 1129-1132. 3. Brown, M. L. and Rounsley, C. A, (1996). True selves: Understanding Transsexualism – For families, friends, co-workers and Helping Professional Jossey – Bas, P144. 4. HUDCO, (2004). Housing finance publishing division, Patiala House, New Delhi, P. 232 5. Lee. R,(2000) , Health care problems of lesbians, gay, bisexual transgender patients, Western Journal of Medicine, Pp56-58. . Lindley . L. Nicholscon, T. J. Kerby, M. B. , Sler, N ,(2003). HIV/ STI associated risk behaviors among self-identified lesbian, gay, bisexual and transgenders colleges students in United States, AIDS Education and Prevention, 15, R. 413-429. 7. Pfafflin F. , Jung, (2003) . In sex Reassignment: Thirty years of International Follow Up Studies: A comprehensive Review 1961-1991 from the Electronic Book Collection of the International Journal of Transgenderism Retrieved on 2007-09-06 8. Xavier, J. M, (2000). The Washington transgender needs assessment survey. Retrieved Jan. 12, Pp121-122.