THE IMPACT OF PERCEIVED SOCIAL STIGMA ON THE MENTAL HEALTH OF TRANSGENDERS IN PAKISTAN: THE MEDIATING ROLE OF PSYCHOLOGICAL RESILIENCE

Abstract

The social stigma, rejection and discrimination experienced by transgender (khwaja sira) people in Pakistan is widespread and puts them at a higher risk of psychological issues. The present study was based on Minority Stress Theory and the psychological mediation theory, which was based on perceived social stigma and mental health of transgender people in Pakistan, and to test the mediating role of psychological resilience between perceived social stigma and mental health. The study used a cross sectional correlational design and the sample consisted of 250 self-identified transgender persons (aged 18-54) who were selected from Lahore using purposive sampling and snowball sampling technique through community gatekeepers. Participants filled out a demographic form and the following scales: the Connor-Davidson Resilience Scale (CD-RISC-25), and Depression, Anxiety and Stress Scale (DASS-21), which included 14 items for perceived transgender stigma (enacted and felt normative stigma). Perceived social stigma was significantly and positively correlated with mental health problems (r = .69, p < .01) and significantly and negatively correlated with psychological resilience (r = −.53, p < .01) after application of the Pearson correlation analysis. The model accounted for 59% of the variance in mental health problems and the mediation analysis, using Hayes' PROCESS macro (Model 4) with 5,000 bootstrap samples, revealed that the relationship between perceived social stigma and mental health problems was significantly and partially mediated by psychological resilience (indirect effect = 0.76, 95% Boot CI [0.52, 1.04]). The results indicated a direct impact of stigma on the mental health of transgender people and that stigma also diminishes psychological resilience, and that alongside structural interventions to reduce stigma towards the khwaja sira community in Pakistan, there is need for mental health intervention that focuses on psychological resilience and is culturally responsive to the transgender community.