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Living in the shadows of the traditional sex-gender schema- viz. the male and female are the Hijras or the Third Genders of India. Because of their unique physiological attributes and personal preferences they transcend the gender binary, therefore in the process, establishing an identity that goes beyond the conventional delimitation of the so called normal sex/gender framework. This however creates negative repercussions for the third gender community as organizations like the medical healthcare or a psychiatric clinic fails to sympathize with their problems and ailments. Quite clearly, it is a result of improper sensitization and lack of awareness with respect to the third gender, their culture, sexual orientations and anatomical configurations. The paper explores the many sexual maladies (HIV, genital ulcer disease, genital wart to name a few) affecting the marginalized community of India, its possible prevention and the adoption of feasible solutions to ameliorate them. Because of cultural and religious obligations their genitalia is subject to much torture as they are compelled to undergo castration to prove their authenticity. Consequently, they may suffer from physical and psychological side-effects like infection, pus formation, decrease in energy, decline in memory and concentration etc. Also, there appears to be an acute shortage of medical personnel, clinical institutions and psychiatric aid to specifically cater to the needs of third gender community therefore making them reluctant to avail services provided by the The recent Supreme Court ruling, 2014 may have entitled them to a third gender categorization but the hegemonic heterosexual Indian society inundated with values of patriarchy and male potency still needs to accommodate them fully as one of the ?normal? sex/gender categorization. Until this is realized, the third gender will continue to lead marginal lives without any social support or welfare systems. As a result, there is a marked increase in mental health problems like depression and also the possibility of suicide cannot be ruled out. Recent social problems like rape and molestation can produce disturbing effects on the psychological health of the hijras as they are most vulnerable to sexual assaults and forced intercourse because of their effeminacy, impotency and a lack of working social agencies/law/police forces at place to redress their grievances. The paper also examines culture and its repercussions on the health of the hijras, the adverse effects of castration, psychological trauma and the subsequent results of hetero-normative puritanism.
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