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Background <p>Transgender individuals in Pakistan, often referred to as “hijra” or “khawaja sira,” have historically held significant social roles as royal advisors, guardians, and military commanders. However, British colonial laws, such as the Criminal Tribes Act of 1871, led to their stigmatization, systemic discrimination, social exclusion, and economic deprivation.</p> Methods <p>This conceptual paper examines the historical and current status of sexual variants in Pakistan. Transgender individuals continue to face discrimination and social oppression, with high rates of mental health disorders, including depression, anxiety, and suicidality. The lack of legal protection, family support, and access to healthcare exacerbates these issues. Despite legal advancements, such as the Transgender Persons (Protection of Rights) Act of 2018, policy implementation remains inconsistent. Also, sexual variant people (e.g., LGB + , including lesbian, gay, and bisexual persons) continue to experience high levels of discrimination and social exclusion.</p> Conclusions <p>While legal measures have been introduced to recognize and protect transgenders and sexual variants’ rights, significant gaps persist in their mental health support and resource accessibility. The Mental Health Ordinance of 2001 failed to include transgender individuals, underscoring the absence of a comprehensive mental health policy. The Supreme Court ruling of 2009 and subsequent legal reforms, including identity card issuance and specialized educational institutions, represent progress but remain inadequate.</p> Policy Implications <p>Despite legal recognition, transgender and LGB + individuals in Pakistan continue to encounter systemic barriers to healthcare, employment, and education. Strengthening mental health services, bridging policy implementation gaps, reducing societal stigma as well as increasing research on sexual variants’ well-being are critical for their inclusion. Collaborative efforts between the government, civil society, and advocacy groups are necessary to ensure tangible improvements.</p>

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Mental Health of Sexual Variant People in Pakistan

  • 期刊论文

  • 发表日期：

    2025年9月12日

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  • Rameez Ali Mahesar,
  • Razia Anjum,
  • Sheikh Shoib,
  • Antonio Ventriglio

摘要

Background

Transgender individuals in Pakistan, often referred to as “hijra” or “khawaja sira,” have historically held significant social roles as royal advisors, guardians, and military commanders. However, British colonial laws, such as the Criminal Tribes Act of 1871, led to their stigmatization, systemic discrimination, social exclusion, and economic deprivation.

Methods

This conceptual paper examines the historical and current status of sexual variants in Pakistan. Transgender individuals continue to face discrimination and social oppression, with high rates of mental health disorders, including depression, anxiety, and suicidality. The lack of legal protection, family support, and access to healthcare exacerbates these issues. Despite legal advancements, such as the Transgender Persons (Protection of Rights) Act of 2018, policy implementation remains inconsistent. Also, sexual variant people (e.g., LGB + , including lesbian, gay, and bisexual persons) continue to experience high levels of discrimination and social exclusion.

Conclusions

While legal measures have been introduced to recognize and protect transgenders and sexual variants’ rights, significant gaps persist in their mental health support and resource accessibility. The Mental Health Ordinance of 2001 failed to include transgender individuals, underscoring the absence of a comprehensive mental health policy. The Supreme Court ruling of 2009 and subsequent legal reforms, including identity card issuance and specialized educational institutions, represent progress but remain inadequate.

Policy Implications

Despite legal recognition, transgender and LGB + individuals in Pakistan continue to encounter systemic barriers to healthcare, employment, and education. Strengthening mental health services, bridging policy implementation gaps, reducing societal stigma as well as increasing research on sexual variants’ well-being are critical for their inclusion. Collaborative efforts between the government, civil society, and advocacy groups are necessary to ensure tangible improvements.