REGULAR ARTICLE Overview of Quality of Life of Older Lesbians and Trans Women in India A. Mani International Rough Set Society 9/1B, Jatin Bagchi Road, Kolkata-700029, India Email: [email protected] Web: http://www.logicamani.in ARTICLE HISTORY Compiled August 3, 2019 ABSTRACT It is well-known that lesbians, trans and queer women face considerable discrimination, exclu- sion, stigmatization, and abuse in India. That is over and above the misogyny and discrimination faced by women in the patriarchal country. LGBTQIA people were also criminalized by law till recently. In spite of all the oppression and discrimination, lesbians and trans women have always existed in the country. A number of small sample studies with limited focus have been conducted by academic bodies, NGOs, and few state transgender boards over the past few years. Some of these studies provide direct or indirect insight into the quality of life of older trans women and lesbians (QOLO). In this research, these studies are reviewed in detail from a QOLO perspective, and a number of critical conclusions are arrived at by the present author. Further, an enhanced version of QOL (and QOLO) for lesbians is also proposed by her. It is hoped that this research would be useful for motivating interdisciplinary work in a relatively neglected area. KEYWORDS Lesbians, Trans Women, Indigenous Cultural Identities, Discrimination, Stigmatization, Aging, WHOQOL, Quality Of Life, India 1. Introduction Beyond the genderism, transphobia, opposition to inclusive sex education, and stigmatization of same-sex relationships perpetrated by patriarchy, the Indian legal system has had followed colonial era laws on homosexuality, adultery, and gender discrimination till recently. Legal recognition of trans identities was ensured through the NALSA judgment in the year 2014 (see Mani (2014b), Orinam (2014)) and homosexuality was decriminalized as recently as in 2018. Apart from recognizing the right to self identify one’s gender, the judgment also called for a number of measures for ending the discrimination and social isolation of gender diverse people. It may be noted that gender diverse people within indigenous cultural/professional communities have historically been the most visible part of the LGBTQIA population in India because of global initiatives on AIDS eradication. It should be noted that no laws based on the NALSA judgment are in place as of this writing, and same sex marriages are not recognized by the courts (see Orinam(2019)). Naturally, all this has affected the state of studies on the LGBTQ population in the country. About 30% of India’s population is aged over 45 years, 15% above 55 years, and women have a life-expectancy of 70:3 years (UNFPA(2017)). There are 29 states and 7 union territories in India. Of these, only the states of Kerala, Tamil Nadu, and West Bengal have dedicated trans boards for the empowerment of trans people and indigenous gender/cultural/professional identities. These boards are expected to facilitate processing of identity documents, provide housing, healthcare, vocational training, and placement at the very least. A few subjective accounts of and fewer quantitative accounts about the lives of lesbians in India are available. Both lesbians and trans women are perceived as socially deviant women in India. Upper class and older members of both classes are typically closeted (a person is closeted if and only if their gender identity or sexual orientation is not common knowledge in the person’s social and professional circles), while lower class trans women are more visible due to ostracization. Because trans women face transphobia in addition, it makes sense to study both classes in parallel. The second section is devoted to older lesbians, related QOL challenges, and an enhanced version of QOL for the study of Indian lesbians is also proposed by the present author. The proposal is intended to change the direction of subjective approaches to the subject in relation to the question; How can subjective accounts be improved for the purposes of mining data relating to QOL? Data on LGBTQ population has never been collected in census and no large sample studies on the well-being of lesbians and trans women have been conducted because of this state-of- affairs. This is all the more alarming because the number of people aged above 60 years is expected to increase by 50% in the next five years UNFPA-Team (2017). A number of small sample studies on people of indigenous cultures aged between 15 and 65 years (including some 2 trans women), have been conducted by academic research groups, NGOs, and trans welfare boards. The aim of this overview is to critically examine these for insight into the state of older lesbians and trans women in the country. The present study is constrained by the availability or otherwise of such studies, their limitations, future prospects and not by demographic bias. Fur- ther, while researchers do have theoretical understandings of the states (on the basis of existing narratives) in which older lesbians and trans women exist, it is not possible to connect related frameworks with available work on QOL because the latter suffer from too many deficiencies. A strong conclusion of this paper is that the geriatric age for trans women should be taken to be 40. Directions for future studies have also been proposed on the basis of the main conclusions of this study. 1.1. Background This subsection is intended to clarify the terminology and concepts of sex, gender and sexuality used in this paper. From a modern scientific perspective, the sex (or biological sex) of a person is best seen as a tuple of parameters corresponding to hormonal, brain, clinical, chromosomal, and physical sex, epigenetics and more. Gender is plural term that refers to gender identity, ex- pression and gender as a social construct. Serano (2016) clarifies much on these. It is important to distinguish between the terms in any rational discourse. It is a fact that modern biology is yet to properly adapt itself to these advances in terminology as evidenced by textbooks stuck in some concept clinical/anatomical sex (Melmed et al. (2012) is an example of such a book) and genderism. Further trans-inclusive guidelines as in Coleman et al. (2011) are not part of the core training of the medical community (including doctors, nurses, administrators, trainers and ayahs) in India. People belonging to indigenous cultural and professional identities (that include gender diverse people), henceforth referred to as Indcpgids, are less understood because of myths and disinformation (see Dutta (2013)). An example of a poorly informed article is Kalra (2012) – wherein the author assumes that all Hijras are eunuchs (a common myth). Indcpgids such as Hijra, Thirunangai, Kinnar, and Kothi (that are based on culture, class, caste, sexuality and gender) do not necessarily fall under concepts of gender identity. The socially ostracized Hijra community, that has its own language, rituals, rules and occupational preferences, consists of castrated males, binary/non-binary trans women, intersex people, cis men and even cis women. Kothis are groups of lower class gay men that may indulge in occasional cross-dressing. A thirunangai, on the other hand may be a trans woman or a trans gender person or even a 3 woman with congenital adrenal hyperplasia, belonging to lower socioeconomic classes. A number of studies, originating in India, use the term transgender to refer to people of all Indcpgids. This is very problematic and will be referred to as the sloppy gender problem. The percentage of trans women among these Indcpgids is not uniformly high. Gender identity of a person is the person’s innate sense of gender and is intrinsic to the person in question. Studies show that it is strongly influenced by prenatal development. It has been shown to be hardwired modulo different assumptions and connections with genetics are also known. There are studies that also relate gender identity to brain structure, hormones in brain, and other modern biological markers of sex (see Diamond (2006); Reed and Diamond (2016); Spizzirri et al. (2018) for example). If a person identifies as a woman or as a transgender woman and if she was assigned a different gender at birth, then the person is a trans woman – in the former case she is said to be identifying on the binary. Only when people are assigned wrong gender at birth, and have sufficient dysphoria do they seem to express the incoherence with their gender identity. According to Mani (2014a) sufficiency of dysphoria can be characterized in terms of possible attribute sets. Even in 2019, trans persons do not enjoy equal legal protection from sexual and physical violence in India. Further, they have lower life expectancy in India — the average is much less than 56.2 years (the figure for Tamil Nadu). This suggests that any trans person aged over 40 should be evaluated from a geriatric perspective. In the Indian context, Indcpgids form the most visible and inhumanly discriminated group within LGBTQIA. Most lesbians remain closeted because of the generally oppressive, homophobic, and patriarchal Indian society. The 2011 census, estimated the total population of Indcpgids (recognized as communities) at 0.49 Million. This figure is known to be a bad underestimate for reasons such as inherent defects in the estimation procedure, lack of gender sensitivity in design, vagueness of the category used and hostile survey environment. Binary identified trans people were also excluded in the census by design. There are studies on the health of trans women in particular and trans persons in general, but these are not directly related to their QOL. 1.2. QOL: WHOQOL-BREF QOL is an inexact concept that may vary over time, and depend on previous instances of assessment.