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Azhar Study on Gender Nonconformity Stigma in Pakistan Featured in Anniversary Collection

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The Graduate School of Social Service congratulates Associate Professor Sameena Azhar, Ph.D., whose research was highlighted in the journal Cambridge Prisms Global Mental Health as one of 10 noteworthy articles in its 10th anniversary special collection.

The article, “‘I would prefer to be dead than to live this way’: Lived experiences of stigma and discrimination against khwaja sira in Swat, Pakistan,” was published in April 2024. Co-authors on the study include GSS alumni Maria Mercedes Guzman Herrera, GSS ’23, and Riya Lerner, GSS ’24. 

Title: "Lived Experiences of Stigma and Discrimination Against Khwaja Sira in Swat, Pakistan"The image is a visual representation of stigma faced by khwaja sira individuals in Swat, Pakistan, divided into three sections: Internalized Stigma, Perceived Stigma, and Enacted Stigma. Internalized Stigma: The first panel shows a person in traditional clothing looking into a mirror, reflecting a distressed expression. The accompanying quote reads, "I would prefer to be dead than to live this way." Perceived Stigma: The second panel depicts a person sitting with their head in their hands, surrounded by numerous eyes symbolizing judgment. The quote states, "People in society think of me as something dirty and vulgar." Enacted Stigma: The third panel features a person standing with their back turned to a mosque in the distance. The quote reads, "I can't go to the mosque. People in the community will not allow me to participate in the Eid prayer." Each panel visually illustrates a different dimension of stigma: internalized (self-directed feelings of shame), perceived (awareness of societal judgment), and enacted (direct exclusion from social and religious spaces). The background is a muted purple color, with bold black-and-white illustrations emphasizing the emotional weight of the experiences.

A graphical abstract designed for the article.

Khwaja Sira identify as third-gendered people and have historically suffered social marginalization. However, their lived experiences of stigma and discrimination in the Swat Valley of Khyber Pakhtunkhwa, Pakistan, have unfortunately not been fully studied. Azhar and her team saw this gap in the research and acted. 

The authors interviewed 45 khwaja sira in Mingora, Swat, Khyber Pakhtunkhwa to better understand their experiences of gender-nonconformity stigma and discrimination in various social contexts.

The article identified three dimensions of gender-nonconformity stigma impacting khwaja sira in Swat, Pakistan: 

  • Internalized stigma – namely feelings of shame and embarrassment
  • Perceived stigma – namely opinions others had of khwaja sira regarding lack of employability or engagement in sex work
  • Enacted stigma – namely exclusion from families, in educational settings, in religious spaces, and in healthcare settings.

Azhar and her team hope their findings will inform future social intervention and community practice engagements with khwaja sira communities in Pakistan.

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