Addiction among transgender and gender-diverse individuals in India: A spatial respondent driven sampling study

Keywords: Addiction, alcohol, transgender, respondent-driven sampling, India
Session Type: Virtual Paper Abstract
Day: Tuesday
Session Start / End Time: 3/1/2022 11:20 AM (Eastern Time (US & Canada)) - 3/1/2022 12:40 PM (Eastern Time (US & Canada))
Room: Virtual 17

Abstract

Transgender and gender diverse (TGD) individuals in India are simultaneously visible for their cultural practices and invisible in terms of their lack of recognition and basic rights. A long history of abuse, violence, discrimination, and economic marginalization rooted in a rigid heteronormative society, has resulted in tremendous health crises among the TGD communities. One such crisis is addiction. Few existing studies indicate that TGD individuals are more likely to use illegal substances and to continue heavy drinking into later life. The hard-to-reach nature of their communities and lack of adequate research makes it difficult to determine the extent of their substance misuse disorders for health intervention.
To address this, we have two objectives. First, understand the opportunities and challenges of using the Respondent-Driven Sampling (RDS) approach, proven to be an effective recruitment method for hard-to-reach populations; not applied to the TGD population of India before. Second, assess the behavior of substance misuse and the extent of associated negative health outcomes among TGD individuals in Kolkata, India. Data on TGD individuals aged 18+ (n = 108) were obtained from SHAKTHI-II, a spatial RDS survey (2019–2020).
Our results indicated that the TGD community was almost closed, with a transwoman as the ‘super-seed’, connected to several TGD individuals, hidden in the subsequent layers of seeds (n=11), peer-I (n=33), and peer-II (n=63). The self-reported gender identities tended to shift from the westernized transgender to Hijra or Kothi and their substance misuse with mainly alcohol and tobacco increased as we penetrated in their communities.