KARACHI: Having spent her life as a social outcast for more than 15 years, Sajid Hussain, a transgender now known as Laila, today finds no reason to live any longer in the largely conservative society.

She says she believes even her death will not grieve her family and it is for this reason that she has collected money for her burial and wants to entrust it to someone who will use it in accordance with her will.

“I even thought of having narban (getting castrated) a few months ago so that I could attain a better status in my community. But my sangat (close friends) convinced me that it’s a major sin and I shouldn’t spoil the life hereafter,” she says impassively.

Belonging to a small village in Bhawalpur district, Laila grew up working as a domestic help. According to her, her long interaction with women and biological deficiencies made her feel like one of them.

“I was the eldest among my siblings and started working at an early age since my father was not interested in supporting the family. He had a bad temper and used to beat my mother and the children at home.

“If my father had accepted me the way I was or had told me with love that what I was doing was wrong, I would have felt embarrassed on being a heejrah (transvestite). But that never happened and my life was ruined,” she laments.

An abusive relationship with a man further let her down and the desire to live on died somewhere, Laila says, adding that the only thing that can give a meaning to her life now is a respectable job such as nursing elderly people or that of a babysitter.

And, this is what her mother, Raheema, also wants her to do.

Raheema never objected to Laila’s behaviour as according to the former everyone accepted her the way she was.

“A doctor told me that your son lacked male prowess. Everyone called him a heejrah and I accepted it,” she said.

Zahoor, also known as Shazia, Laila’s friend with whom she spends her entire day, has somewhat a happier life. “This is all because of my parents who loved me too much despite my way of life that society looks down upon.”

Recalling his childhood, Zahoor says that people used to tease and call him heejrah that hurt him a lot. Although he went to school and studied up to Class VI, he could not learn anything, except writing his name, because the headmaster of his school used to send him to his home to work, he recalls.

Zahoor claims his parents helped him get married twice. His first wife died, he says, adding that his second wife married him of her own choice and still loves him.

“The fact that I have children is a proof that I am a complete man, biologically, though my heart is of a woman. I never went out with my wife as it makes me feel embarrassed,” he says, admitting that he also had relationship with other men.

While Zahoor/Shazia lives in Karachi where he earns an income by seeking alms at shrines, his family is settled in Sargodha.

Explaining the reason for living separate from the family, he says that people would make his children’s life hell by teasing about their father.

“I don’t want to trouble them and know the truth. They know that their father is different and earns money by dancing in functions, but they don’t know that I beg. Besides, I am concerned that urban life could spoil them,” he says.

The heejrah community

Members of the heejrah community say that though discrimination and stigma affect them at every level, it is even more painful when they are denied education and health facilities that limit their chances to live a better life.

The Supreme Court’s orders for their welfare and recognition last year was a ray of hope, they recall.

Recent interviews with a number of transgender persons and individuals working with non-governmental organisations providing health and social services to the community show that the community comprises many different people who joined the group for different reasons.

A vast majority is perceived to have masculine bodies who take on feminine appearance to earn money through begging, have drugs and free sexual life. Perhaps it is for this reason that the number of transgender persons has dramatically increased over the past 10 to 15 years.

Most transsexuals grow breasts with the help of hormonal injections while some of those with abnormal genitals even go for a medical operation to get their reproductive organs removed. The treatment is said to be carried out in highly unhygienic conditions and at times causes death.

Then, there are transgender persons suffering from a psychological disorder believing that they belonged to the wrong gender.

Only a very small number of people are actually born with a condition called intersex — a group of conditions that occur when there is a discrepancy between the appearance of external genitalia and internal reproductive organs.

“Only people with intersex condition deserve employment opportunities by the government. In fact they should be given the status of a special person and offered privileges as in the case of special persons. A majority of those in the transgender community are of those who want to have a free life and enjoy drugs and sex,” says Mirza Aleem Baig, heading the Gender and Reproductive Health Forum.

Mr Baig doesn’t accept the psychological reason for being a transgender in most cases and says that a medical board can help identify what he calls ‘the true transgender’.

He also believes that government efforts will be futile unless the media created awareness among the public about the issues affecting the transgender community.

“Though a majority is there for fun, it doesn’t mean that we won’t make a beginning to improve their lives. It is also important for parents to keep an eye on their children, their behaviour and people they hang on with,” he says, adding that the community is also a high risk group for the human immunodeficiency virus.

Dr Saleem Azam, running Pakistan Society, an NGO working to support vulnerable sections of society, including drug addicts and sex workers, agrees that public awareness and availability of medical support can help save many families.

“A huge majority of transvestites looks for ‘clients’ in the garb of seeking alms. But I do believe most suffer from psychological disorders. Having said that, their increasing number also indicates an increasing demand for them and should serve as a worrying sign for society,” he says.

Heejrahs, he says, are exploited by their gurus, who share their earned money and in turn provide ‘protection’ to them.

Gender identity a human right

Apart from the reservation that a majority of the community members are not genuine cases of transgender, or intersex, there are medical experts who contend that it’s beyond common logic to lie about one’s gender identity to become part of a highly marginalised segment of society.

“It’s a very complex issue. It’s not easy to become a heejrah and survive in [largely conservative] society. They are deprived of opportunities for a better life and face huge problems such as police harassment and high risk of infections on a daily basis only because of discrimination on account of their identity.

“We also came to know during a study that they are paid very low for sex. Besides, it’s also an issue of human rights,” says Dr Syed Hamid Ali, a virologist working with the Aga Khan University and Hospital.

Dr Ali had the opportunity to have a peak into the lives of community members during his research on the prevalence of HIV / Acquired Immune Deficiency Syndrome.

Prof Dr Raza-ur-Reham, head of the psychiatric department, Civil Hospital Karachi, says transgender phenomenon is an established psychological disorder and has various symptoms.

“Some affected individuals are sexually satisfied by just wearing women’s clothes while others do not like their bodies and feel that they are caged in someone else’s body.

“No examples exist in Pakistan in which a complete man was turned into a woman or vice versa, though cases exist in which some defects in reproductive organs were rectified. Abroad, such procedures are done after a long counselling process and also involve multiple plastic surgeries,” he adds.

No local study on intersex

Replying to questions regarding intersex, Dr Khadija Nuzhat Humayun, a paediatric endocrinologist working with the AKUH, says that there can be multiple reasons, including chromosomal and endocrinal abnormalities, for the condition to occur. “It can also be hereditary. Brain and behaviour, both, are affected by biological changes and also on account of social circumstances.

“Not all cases could be rectified while there is no 100 per cent guarantee in cases which are helped. Besides, the patient needs lifelong medication,” she explains, adding that it is difficult to say about the exact ratio of children born with intersex condition because no local study exists on the subject while the studies by western countries vary.

All experts agree that parents should seek immediate medical or psychological intervention if they see any abnormality in genitalia, late or early onset of puberty or if the child’s behaviour doesn’t conform to their gender identified at birth.

“If we isolate them, they will have no option but to become part of the heejrah community and turn to begging for their entire life. Parents need counselling so that their child can attain education and seek a better future.”