Police officers’ accounts of moral distress in encounters with khwaja sira and trans women in Pakistan: Possible implications for transgender health

Background In Pakistan, khwaja sira and trans women are protected on paper by the Transgender Persons (Protection of Rights) Act 2018, yet earlier studies report that they are still policed as suspects. Little is known about how the officers make sense of their own role. This study asks police officers about encounters with khwaja sira and trans women before any arrest or custody. Their accounts are used only to learn about institutional practice as the officers describe it. The safety, health, and rights of khwaja sira and trans women remain the main concern.Methods We used Interpretative Phenomenological Analysis (IPA). Seven serving police officers (five men, two women; 4–25 years of service) from Punjab and Khyber Pakhtunkhwa gave single in-depth interviews about specific encounters with people they read as khwaja sira or trans women. Recruitment ran through the lead author, a criminologist and former police officer. Cases were analyzed idiographically before group experiential themes were developed across the set. Moral distress was the main lens, with street-level bureaucracy and moral injury as secondary lenses.Results Four group experiential themes were developed: (1) the trans woman or khwaja sira person was read as a policing problem before any offense; (2) a gap between the law and what the local police station (thana) expects; (3) the conflict felt in the officer’s body; and (4) discretion used, at personal cost, to protect a person informally. Officers described being asked to act against people who had committed no offense, and linked their distress to bodily symptoms.Conclusions In these seven officers’ accounts, distress appeared where they felt unable to act as the 2018 Act requires. This is the officers’ view, not evidence of how common this is or of what happened to the people policed. No health outcomes were measured. The accounts point to possible mechanisms that earlier research links to transgender health, and these need testing with khwaja sira and trans women.