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Measuring the Psychological Morbidity among Eunuchs (Hijras) of Bahawalpur City.

Byline: Muhammad Saleem, Ejaz Hussain, Masood Nadeem and Aqeel Ahmad Khan


The aim of this study was to measure the psychological morbidity among eunuchs of Bahawalpur City by using GHQ-12. A sample of 316 eunuchs aged 20-50 years old completed the self administered questionnaire. In addition, reliability of GHQ-12 (Urdu) was measured using split-half and internal consistency method, for validity --forward-backward|| translation method was adopted. Finally, factor structure of the questionnaire was extracted by performing principle component analysis with oblique rotation solution. In all 316 eunuchs included in the study (Mean = 34 years, and Standard Deviation = 6.16). Using the Likert scale (0-3), the mean GHQ score was 11.1 (SD=10.5). The principle component analysis with oblique rotation solution indicated that GHQ-12 was a measure of psychological morbidity (59.5 %) with two factor analysis (F1, 57% and F2, 62%).The findings of the study showed that eunuchs of Bahawalpur City are facing moderate psychological morbidity.

Keywords: Psychological Morbidity, Eunuchs, Bed and Guard, Potential Usurpers, Psychological Aid


The word _eunuch' comes from a Greek compound of "bed" and "guard." Eunuchs had the responsibility of guarding the marriage bed. "They were qualified for that social function by being disqualified from a biological one.(Taylor, 2000). Eunuchs divided into two groups, those who castrate themselves voluntarily for religious reasons and those who are castrated by others either as a punishment or in order to create an individual who is significantly different from a whole man (Ringrose, 2007).

Eunuchs have no motive for wealth and no ambition for position, eunuchs would have no desire selling palace secrets or conniving with potential usurpers. Ideally the castrati would thus demonstrate absolute loyalty to his employer (--The Eunuchs||, 2003). Like other part of the world the attitude towards hijras in Pakistan is also very discriminatory and biased. They are also denied health and psychological or psychotherapeutic assistance. Victims of gender identity problem carry out castrations without any medical and psychological aid. They indulge in self-remedy including hormone taking without prescription, using silicone injections and at extreme auto-castrations. No one is there to understand them and find solution to their problems (Sharma, 2000; Talwar, 1999; Winter, 2002).

In Pakistan, eunuchs are facing troublesome in every respect; they are living below poverty line, no self respect, always being called with nick (insulting) names like _Khusra', _Zanana', _Mukhanus', _Chakka', _Morat' and _Hijra'. They live in isolated colonies and in slums most often. They are also being used as a cheap tool of sexual gratification. Eunuchs are lead by guru (teacher) who decides the fate of his chaila (student), they typically prefer to become wedding dancers. A small ruling, with strong social significance made its way into news headlines this week. Pakistan's Supreme Court wills to recognize the plight of eunuchs, or hijras. Unreliable census numbers suggest that there are at least 400 000 Pakistanis that identify as transgendered and they are subject to some of the fiercest persecution in the country.

Despite strong prejudice, this has been a neglected community from official eyes for as long as Pakistan has existed, donning this week's ruling, at least at a psychological level, as at least a symbolic attempt at integration.(Sana Malik, 2009).

Difficult as it is for ordinary citizens to get a response from state institutions, it is infinitely more grueling for a community which faces rejection, ridicule and physical abuse on a daily basis.(The Express Tribune, Nov,15,2010). The hijras are a religious community of men who dress and act like women and whose culture centers on the worship of Bahuchara Mata, one of the many versions of the Mother Goddess worshipped throughout India (Slijper, 1997). In some cultures they are considered as neither men nor women and not necessarily be considered as deviant as they occupy respectable social position (Bartlett, Vasey and Bukowski, 2000).

In Islam women are required to observe Pardah (veil) from male hermaphrodite. In Hadith (sayings of Prophet Muhammad, SAW), effeminate men are forbidden to enter upon women as they may have interest in women, notwithstanding without natural sexual prowess. Prophet Muhammad (SAW) forbade the entry of an effeminate man in his household, since He (SAW) had heard him relishing the description of physical features of a woman. The narration exhibited amply the effeminate man's interest in the women (Sahi Bukhari, 1986, p. 119; Sunnan-e-Ibne Maja, 1983, p. 533).

Our understandings of eunuchs' problems (psychological or physical) facilitate them to solve their psychological and financial problems of hijras and make their life comfortable and productive for society at large (Jami, n.d.). Large people do not like to interact with them. Preliminary results of my research (N= 295) show that 50% of individual meet/ see them once in a year, 28% meet/see them once in a month, 12% meet/see once in a week while 6% related seeing/meeting every day, while 2% did not see/meet them in their life. Talking about them in the family is not taken in good stead (Jami, n.d.).

Assessment of psychological morbidity in different populations is in fashion now days like --Psychological morbidity, sources of stress and coping strategies among undergraduate medical students of Nepal (Sreeramareddy, et al. 2007).|| and --Increased postwar symptoms and psychological morbidity among U.S. Navy Gulf War veterans (Gray, 1999). and --Suicide probability and psychological morbidity secondary to HIV infection: a control stud (Grassi, Mondardini, Pavanati, Sighinolfi, Serra, and Ghinelli,2001).

The above scenario reflects the miserable plight of eunuchs living as minority in Pakistan. In the light of above mentioned stressors there is possibility eunuchs are facing some psychological problems like social dysfunction and psychological distress. According to Goldberg and William (1988) minor psychological disorders may lead to severe psychiatric problems.

Here is strong need to explore the level of distress and social dysfunction among eunuchs of Bahawalpur so that they may be remedied earlier.


The sample size was 316 participants (eunuch) selected by snowball sampling. Before taking sample it was surveyed that total population of eunuchs was 1500, located in different colonies / slums of Bahawalpur. GHQ-12 (A self administered tool) was used after translating it from English into Urdu by using standard --Forward-Backward|| method. Finally after pilot testing GHQ-12 was administered to a sample (n=316) of eunuchs aged 20-50 years old, (Mean-34, SD-6.15). In addition each respondent was asked to complete a short questionnaire by selecting option 0-3 (Likert Scale).

Reliability of the GHQ-12 (Urdu) was measured by using split-half and internal consistency method. Furthermore, the factor structure of questionnaire was extracted by performing principle component analysis (F1, F2) using oblique factor solution. The study used likert scale (0, 1, 2, and 3) rather than Goldberg's original scoring method (Bi- Modal, 0, 0, 1, 1).


In total 316 eunuchs aged 20-50 years included in the study. The descriptive findings are presented in table 1.0. The mean age of the respondent was 34 years and standard deviation was 6.16. Most of eunuchs were Unemployed (86%), Beautician (06%), Tailor (05%), and Chef (03%). By using the Likert scale (0-3) the mean GHQ score was found to be 11.1 and SD 10.5. Most of eunuchs (60%) were observed illiterate, primary pass (28%) matriculation (11%) and intermediate (01%).

Table-1. The Characteristics of Eunuchs and Their Descriptive Findings

###(N= 316)


Age (group)




###Mean (SD)###34 (6.15)

Gender###Third Gender

###(n=3 16)

Educational level

(n =128)




Employment status

(n =316)





###(Wedding Dancers)

GHQ Score

###Mean (SD)###11.1 (10.5)

###Range###0-36 (Likert

###Scale, 0,1,2,3)

Reliability of the GHQ-12 was measured using split-half and internal consistency method. The validity of GHQ-12 (Urdu) was found satisfactory in pilot testing. The principle component analysis with oblique rotation solution was performed and to distinct factors (F1 = Psychological Distress, 57% and F2 = Social Dysfunction, 62%) were calculated on the basis of data in sample.

Table-2: Factor Structure of The GHQ-12 Using Oblique Rotation Solution

GHQ-12 Items###Factor 1###Factor 2

###(Psychological Distress)###(Social Dysfunction)

1. Able to concentrate###0.76(240)

2. Lost much sleep###0.83(262)

3. Playing useful part###0.41(130)



GHQ-12 is a well reputed research tool for the measurement of psychological morbidity (psychological distress and social dysfunction). However, it does not meet the criteria of standard psychological diagnosis. In general findings of this research exhibits promising results and were comparable with other researches available in the field of psychology.

It is commented that GHQ-12 was basically designed as a independent screening measure for psychological problems but it has a multidimensional structure, So it is suitable for the measurement of psychological morbidity. We used the likert scale method and the result showed that this method appears to be fruitful. The eunuchs who scored above the mean show an indication of psychological distress and social dysfunction due to poor self esteem, low confidence, worthlessness and biased attitude of general public toward them.

However 316 eunuchs were a selected sample from Bahawalpur and thus it cannot be generalized to whole population of the eunuchs in Pakistan.


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Author:Saleem, Muhammad; Hussain, Ejaz; Nadeem, Masood; Khan, Aqeel Ahmad
Publication:Journal of Educational Research
Article Type:Report
Geographic Code:9PAKI
Date:Jun 30, 2011
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