Size estimation and vulnerability assessment of transgender people in Manipur, North-east India: A cross-sectional study.

Context: Transgender people commonly faced stigma which has been linked to violence, abuse, and discrimination, often forcing them to remain hidden.

Objectives: This study plans to estimate the size of the transgender population and to assess the vulnerability and risk of transgender people in the society.

Methods: This cross-sectional study was conducted among 171 transwomen aged 18 years and above residing in two districts in Manipur recruited using the respondent-driven sampling (RDS) method. Interviews were conducted using a semistructured questionnaire, and the multiplier method was applied for the size estimation. Descriptive statistics were generated. Ethical approval for the study was obtained from the institutional ethics committee.

Results: The mean ± SD age of realization of their sexual identity and age of expressing gender identity was 9.06 ± 2.9 and 17.3 ± 2.7 year, respectively. The reported network size was found to be 40.37 ± 38.7, and the estimated size of the transgender population was found to be 2201 (95% CI 1987.6-2403.1). Most of the respondents (157, 91.8%) had 'Ever experienced harassment due to their sexual identity', with the majority (138, 87.9%) reporting 'verbal abuse', while (108, 63.1%) reported 'sexual abuse' and 43.9% of them said they had a 'psychological effect' due to the abuse.

Conclusion: The majority of the respondents had faced some form of harassment or abuse due to their gender identity, leading to the psychological effect on them. There is an urgent need for developing a comprehensive measure focusing on mainstreaming the transgender persons by creating an enabling environment for their holistic development.