Background: Transgender lives embody resilience, creativity, and joy, extending beyond narratives of struggle. While pride and authenticity enrich these experiences, transgender individuals in India, particularly women, continue to face marginalization in education, employment, health care, and public life. Despite legal recognition, occupational participation that is essential for health and inclusion still remains underexplored and is often constrained by stigma, family rejection, economic insecurity, and environmental discrimination. Objectives: To explore the occupational participation of women who identify as transgender in Coimbatore, Tamil Nadu, India. Study Design: A qualitative phenomenological study. Methods: A qualitative phenomenological study involved seven consenting self-identified transwomen without comorbidities, aged 18–60 years, selected through purposive and snowball sampling. Data were collected through telephonic semi-structured interviews in Tamil, the participants familiar language, using an interview guide based on the Person–Environment–Occupation–Performance model. Sociodemographic details were also collected. Interviews were audio-recorded, transcribed verbatim, translated into English, and thematically analyzed using Braun and Clarke’s six-phase method. Ethical approval was obtained from the Institution. The study adhered to the principles of the Declaration of Helsinki. Results: Ten major themes emerged: (1) perception of work, (2) work as a survival strategy, (3) absence of rest days, (4) lack of employment opportunities, (5) self-expression through grooming, (6) emotional instability, (7) leisure participation, (8) community discrimination, (9) educational disruption, and (10) financial hardship. Despite educational qualifications, most participants were engaged in informal or stigmatized occupations. While participants demonstrated resilience and identity affirmation through grooming and leisure, systemic and societal barriers significantly restricted their occupational engagement. Conclusion: Transgender women in India face systemic challenges that hinder occupational participation due to exclusion and discrimination. Despite these barriers, they exhibit strong motivation and adaptability. Occupational therapists must adopt inclusive, gender-affirming, and justice-oriented approaches to support this marginalized group. The study advocates for culturally responsive interventions and inclusive policy frameworks to promote occupational justice.
Guhashree et al. (Tue,) studied this question.