Following the divine: an ethnographic study of structural violence among transgender jogappas in South India

Abstract Newly proposed legislation that aims to protect the well-being of transgender people in India offers hope of greater recognition of human rights and improved access to entitlements for these marginalised groups. However, social welfare and health institutions have a long way to go in translating proposed legislation into policies that can concretely address the social suffering of transgender people. Drawing on ethnographic field research in northern Karnataka among a highly understudied transgender group known as the jogappas, we describe the effects of overlapping forms of structural violence surrounding education, subsistence, family life and attempts to access social and health services. Findings reveal how social inequities are implicated in the emergence of transgender subjectivities along the road to becoming a jogappa. Our findings alert policy makers to the diverse needs of transgender people in India, which continually evolve while rooted in moral histories of religiosity.


Introduction
In April 2014, the Supreme Court of India declared that the social liberties of an individual must be protected irrespective of their gender identity, self-expression and decision to undergo surgical (sex-reassignment) intervention. This landmark ruling, aimed at granting transgender communities fuller citizenship rights, was taken up by numerous Indian states including Karnataka, which initiated social welfare schemes for the transgender community. More recently, the proposed Transgender Persons (Protection of Rights) Bill (2016) aims to further address the widespread violence and social discrimination transgender people encounter in India. However, the programmes emanating from this new legislation have been confined to problematic incentive schemes that offer meagre pensions and only small stipends for microfinancing (i.e. loans to transgender people to start their own small businesses). Such financial compensations do little to address the root of structural realities that underpin the marginality and social status of transgender people. Furthermore, as evidenced by protests over the definition of transgender and the requirement for mandatory medical verification in the Bill (Abraham 2017), social welfare and health institutions have a long way to go towards translating the proposed legislation into policies and interventions that can effectively address the everyday struggles of transgender people in India.
Although transgender people occupy an important focus in recent parliamentary arenas, popular news media and public health discourse throughout South Asia (Hossain 2017;Khan 2017;Ganju and Saggurti 2017), scholars have long attempted to represent the lived realities of transgender people in this region, especially 'male bodied' hijra as 'one of the most iconic and popular examples of this so-called third gender' (Hossain 2017(Hossain , 1419; also see Nanda 1990). This rich body of scholarship raises important questions about how the 'third gender' has come to be reified in contemporary political and legal discourse (Hossain 2017). Although strongly contested in the scholarly literature (e.g. Cohen 1995;Reddy 2005), the very notion of third gender has been construed narrowly in emergent political discourses as a 'progressive legal achievement', one that ties the citizenship legitimacy of transgender people to notions of disability and anatomical defect (i.e. genital excision) (Hossain 2012). This portrayal of transgender people in the new legislation inadvertently denies recognition of the wider gender fluidity, ambiguity and diversity that exists within transgender communities across South Asia, especially ignoring those who neither identify with hijra communities nor undergo anatomical modifications (Hossain 2012).
Drawing upon extensive ethnographic field research in northern Karnataka, South India, this paper describes the intense 'social suffering' (Das et al. 2001) of an understudied transgender group known as the jogappas. We conceive of social suffering as wrought by a convergence of social and structural forces that profoundly disrupt a sense of collective social positionality, giving rise to affective states of anguish, sorrow and distress. This perspective is not intended to negate the resilience, resourcefulness and ability of jogappas to cope with the social suffering they face in their daily livesindeed, their lives as ascetics are enmeshed in a rich tapestry of ritualised meanings and vibrant economic exchanges and social interactions that play out within the realm of religiosity (Bradford 1983). Instead, by focusing on the effects of overlapping forms of discrimination as they reverberate through the lived experiences of gender nonconformity, we reveal the emergence of transgender subjectivities as inextricably intertwined with frustrated attempts to earn a livelihood and access social and health services and thereby alert policy makers to the diverse and structurally embedded needs of transgender people.

Jogappas: a lesser known transgender group in India
In recent times, depictions of jogappas have come to feature prominently in popular print media, where they are portrayed as 'exotic-beings', lost in time, steeped in poverty and hyper-marginalised (see for example Aneka 2014). Yet only partial accounts of the lives of jogappas can be found in larger anthropological studies focusing on other cultural groups in India. For instance, Reddy (2005, 67-71) mentions her encounters with jogappas in a Goddess 'Yellamma' temple located in Hyderabad. Reddy (2005, 70) distinguishes jogappas from hijras, her main focus of ethnographic inquiry, by referring to the central importance of goddess possession in their narrative claims of identity and respectability. Anthropologists have also drawn subtle cultural nuances that set the appearance of jogappas apart from hijras in everyday life. For instance, while hijras use subversive body language (such as the loud clapping of hands) or bodily modifications (like genital excision) to assert their identities (Ramberg 2014;Reddy 2005;Zimman and Hall 2009), jogappas use bodily adornment like muttu (a red and white beaded necklace symbolising their marriage to Yellamma), 1 and they rhetorically oppose body modification, on the grounds of religiosity. At the same time, Ramberg (2014) and Reddy (2005) point to the structural conditions that foster 'crossovers' between hijra and jogappa communities. Some of their study participants assumed dual identities depending on the context and needi.e. they engaged in commercial sex work as a hijra in cities but, upon returning to their native villages, resumed leading religious rituals as a jogappa. Bradford (1983) offers the only dedicated ethnographic study of jogappas. Through a structuralist framework, he ties the jogappas' system of belief to a symbolic universe surrounding the Goddess Yellamma in Northern Karnataka. Bradford (1983, 310, 312) casts jogappas as 'erotic ascetics' who 'blatantly' display their female sexuality in public, while targeting 'all men' as potential partners. However, a noticeable gap in the literature exists with respect to how these cultural belief systems and erotic transgressions have been impacted by the HIV epidemic. What does it mean to be an 'erotic ascetic' amid HIV-related sexual stigma?
Religiosity indeed plays a central role in the lives of jogappas, like the devadasis or jogatis in the region, who are similarly 'tied with the muttu', signifying their marriage to Yellamma. Devadasi women hold a conflicted social position where, on the one hand, their engagement in sex work makes their sexuality polluted and threatening to society; and on the other, it is their sexuality that is integral to certain rituals that help maintain a moral balance and removes evil in the society (Orchard 2007). Similar to devadasis, jogappas too are highly stigmatised for their gender nonconformity and yet revered for their divine association with Yellamma. However, as Ramberg (2014, 210) notes in her ethnographic study of devadasis, while jogappas may be revered for their ascetic life, this does not necessarily translate into greater access to citizenship entitlements. Unlike devadasis, who disrupt conventional arrangements of patriarchal privilege as females who are 'treated as sons in their families' and eventually permitted, like men, to 'inherit land, pass their name to their children, and roam villages' (Ramberg 2014, 35, 210), jogappas are treated as daughters and thereby denied these entitlements accorded to men. To what extent do the very deprivations and discriminations encountered in becoming a jogappa furnish the conditions out of which transgender subjectivities emerge?

Theoretical framework
The theoretical framework of this study is based on the concept of structural violence, a term coined by Johan Galtung (1969, 168) to emphasise how various policies and institutions may inhibit individuals and groups from reaching their potential. As further defined and popularised by Farmer (2005, 8), structural violence refers to 'a host of offensives against human dignity: extreme and relative poverty, social inequalities ranging from racism to gender inequality, and the more spectacular forms of violence'. These 'offensives' that harm people are often embedded in longstanding social structures, institutions and practices that make them seem normal, ordinary and often invisible (Farmer 2005, 8). As Galtung (1969, 173) notes, 'Personal violence shows … structural violence is silent … [and] may be seen as about as natural as the air around us'.
This notion of indirect, ordinary violence can help us better understand how myriad inequities take shape in the daily lives of transgender people as they attempt to access social and health services. Akhil Gupta (2012) reveals how bureaucratic systems serving India's poor enact forms of structural violence via the seemingly mundane route of documenting practices that normalise their oppression. Similarly, transgender groups regularly face disqualifications as citizens in institutional contexts at moments when their gender cannot be readily identified and placed in administrative documents. Although administrative concessions in India, at the time of our research, allow transgender people to choose whether to designate their gender as a man, woman or transgender, transgender people continue to endure fall-out from the very administrative requirement that citizens be assigned a gender to receive vital services. This quieter, 'ordinary' form of violence exemplifies what Das et al. (2001, 1) refer to as 'the slow erosion of communities through the soft knife of policies that severely disrupt the life worlds of people'.
Globally, transgender women suffer a disproportionate burden of HIV infection (Baral et al. 2013). Although the last decade has seen a flurry of public health attention placed on the sexual health of transgender people in India, with respect to HIV there is a dearth of studies concerned with the overlapping social oppressions that underlie their vulnerability (for notable exception see Ganju and Saggurti 2017). Chakrapani et al. (2007), however, illuminate the interlocking forms of structural violence encountered by kothis (feminine-acting men who have sex with men), showing how discriminatory practices may occur beyond the awareness of individuals, emerging at the level of social institutions such as the family, the community and the health and legal system.

Fieldwork and data collection
The authors initiated a collaboration with the jogappa community for HIV prevention research in 2009 which, over time and with continued association, led to an in-depth ethnographic exploration in 2013. Access to the jogappa community was initially gained though a community-based organisation (CBO) in Belgaum, known as Sweekar Sangha, which was run by and for men who have sex with men and transgender communities in the field of HIV. Members of Sweekar initially facilitated the first author's rapport building with the jogappa community as it would have been challenging for an outside researcher to gain access to the intimate social spaces that jogappas inhabited. At the same time, being a gender nonconforming Indian-born 'male' person permitted the first author to build a level of rapport with jogappas that offered a vital window into the workings of structural violence. Furthermore, this also helped in overcoming a methodological obstacle identified by Ramberg (2014, 201) that is, the reluctance of jogappas to discuss their sexual relationships with men.
Over time, the first author was able to interact with more than 80 jogappas in small groups, across six towns and villages in three districts of Northern Karnataka (Belgaum, Bagalkot and Bijapur). The first author was invited by the jogappas to join them for celebrations and rituals like the jatra (festival) and jagran (extended religious performance and blessing), that were a major source of their income, as well as welcomed into their households which established a reciprocal relationship of offering food and small gifts.
With time, some jogappas became actively engaged in the study and assisted in the development of the interview guide, helped recruit study participants, as well as helped conduct and translate interviews that had to be conducted in the local language (Kannada), after being trained in basic qualitative interviewing techniques. These interviews were recorded and later translated verbatim with the aid of a professional translator. All interview transcripts were translated into English, and specific cultural details were confirmed by community members.
Participant observation (Spradley 1980), or what Clifford Geertz (1998, 69) once referred to as 'deep hanging out', along with daily fieldnote writing and in-depth qualitative interviews formed the basis of this ethnographic study and were closely intertwined. The fieldnotes generated from participant observations contributed both to the development of the in-depth interview guides as well as to the analysis of the interviews subsequently. In total, 41 jogappas were recruited for in-depth interviews through purposive and snowball sampling. Most interviews were conducted in Kannada (except for three that were conducted in Hindi) and took place at the residences of participants where they felt most comfortable, with a few conducted at the office of Sweekar.
Ethical approval to conduct the study was obtained from the St John's Medical College Institutional Ethical Review Board based in Bangalore. Only travel reimbursements were provided to research participants so as not to unduly influence the participation of members of an impoverished community.

Analysis
All transcripts were reviewed by the authors and analysed manually. Employing thematic interpretive analysis and inductive reasoning, the first analytic stage involved the team reviewing a sample of transcripts to develop a set of descriptive codes (Creswell 2007), which were then grouped into themes using social scientific notions of structural violence as the theoretical lens to organise them (i.e. inhibited access to social and economic resources, institutional discrimination, mistreatment by family and society, etc.). Discrepancies between the thematic groupings generated by the team were resolved through discussion and used to finalise a coding scheme to analyse the remainder of the data. As themes and interpretations were developed, they were cross-checked with members of the jogappa community who were most actively involved in supporting the fieldwork.

Findings
The findings are grouped into two sections. First, three ethnographic portraits, drawn from fieldnotes and interview transcripts, illuminate the overlapping effects of structural violence on the life worlds of jogappas. Second, we draw out an analysis of the key themes related to structural violence, highlighting their contribution to the burden of jogappas' social suffering. But first we begin with a demographic overview of the participants.

Participant demographics
The 41 participants' ages ranged from 20 to 60 years, with only 7 (17%) over 50 years. Most were born in low-income Hindu families belonging to historically marginalised groups, with only a few Muslim participants, reflecting the religious diversity in the region where the large majority are Hindus.
All participants self-identified as jogappas, and more than half (59%) were able to read and write in Kannada and Marathi and were conversant in Hindi. Many, however, had received no formal education and were illiterate (41%). Based on their daily earnings (less than US$1), most participants qualified within the parameters of the below poverty line (BPL) category as defined by the Indian government. A few managed small businesses. Those who qualified in the category of BPL mostly depended on jogwa (receiving small sums of money and food as alms) and other religious performances for their income. The participants who were in their early 20s or 30s sometimes joined the hijras, to practise sex work, which paid far more than jogwa.

Lived realities and social suffering
We provide depictions of three jogappas that are illustrative of the spectrum of gender nonconformity in the community and the milieux in which discrimination emerges, suffering is experienced and transgender subjectivities and life possibilities are realised in the realm of religiosity.

Mallika
Mallika was born in a small town in Bagalkot. In her childhood, she enjoyed playing the role of a woman in carrying out household chores and preferred the company of neighbourhood girls, fascinated with their clothing and jewellery. Although her mother and brothers were not bothered by her femininity, her father, a bus driver, disapproved. Over the years, Mallika's father, who was an alcoholic and kept a devadasi mistress, became abusive towards her and her mother. Mallika claimed that her father loathed her and saw her as a disgrace to his family. Whenever he visited, drunk and angry, he would beat up Mallika until his anger subsided. Occasionally, her brothers would intervene, but her mother continued to remain a silent spectator.
She recalled how boys at school frequently harassed her for her gender nonconformity. One day Mallika was assaulted in the school toilet. The boys held her inside and taunted her, asking her if she urinated sitting down. Mallika was angry and scared. She tried to loosen the grip of the boy who held her wrist tightly. To escape the situation, she pushed the boy. This action enraged him, and he encouraged others to strip Mallika and check to see if she had a penis. Mallika pleaded with her abusers to stop; however, they continued. She attempted to cry out but one of the boys held her mouth while the others continued to strip her. They looked at her and touched her inappropriately while calling her names until other students showed up. The boys finally left Mallika alone, feeling humiliated. This event led her to stop attending school, the only school in her village.
Mallika emotionally shut down, refusing her mother's relentless questioning over her long absence from school. When her father came to know about her absences, he lashed out at his wife, blaming her for the situation. He then dragged Mallika, who was sitting outside, pulling her by the hair and started kicking her. Mallika could hear her mother screaming and calling out to her brothers who were not around. Mallika recounts that when her father started to strangle her, she suddenly retaliated:

Social relationships and subsistence
Mallika had a small circle of friends, including a kind-hearted hijra who took her in when family troubles erupted. Mallika soon dedicated her life to Yellamma, and began to publicly project a feminine persona. Mallika started going out for jogwa with other jogappas and also participated in jagrans. Mallika shared that jogwa and jagrans were not enough for jogappas to survive on, even when supplemented by meagre income earned as daily wage labourer on farms or construction sites. Mallika, who was young, desired to earn more. The hijra who supported her after she fled home frequently travelled to bigger cities like Mumbai and Bangalore and through her Mallika became involved in sex work: Sex work has been happening since long. Jogappas who want more money and at the same time wish to fulfil their desire, go for sex work. We get less money during jagran and even lesser money and rice during jogwa. That's why a jogappa gets into sex work.
Mallika soon found a panthi (lover) and thought she found the ultimate happiness in life. Even though her jogappa Guru and peers sensed that Mallika engaged in sex work in Mumbai, none of them interfered.
You see, it [sex] is not allowed in our community but everybody does it. Since we are jogappas, we are supposed to abstain from having sex and alcohol. You just avoid doing it openly and get caught, nobody seems to care. Our reputation is of primary importance to us so we jogappas do not indulge in sex work in our own village or town. Unlike many other jogappas, Mallika never took a Guru in the hijra community. She always wanted to remain a jogappa and regularly stayed in her home town where Yellamma devotees congregated. During one such visit, she got to know about her father's death. She wanted to meet her mother, but refrained from visiting her family, instead sending home gifts and money. However, Mallika finally visited home to attend her brother's wedding and while there was some initial awkwardness with her transformation as a jogappa, eventually that dissipated allowing her to visit more regularly.

Illness encounters
A few years into sex work, Mallika began to fall sick repeatedly, which affected her primary income source, sex work. Mallika, who was unaware of the health risks from unprotected sex, went for diagnostic tests, as recommended by one of her peers in Mumbai. Recounting her experience of these events, Mallika looked at me for a few seconds to gauge my reaction and said: Yes. I am an HIV-positive person. I was very disturbed when I got to know my status. I just wanted to die as I felt there is nothing left for me to live. I was extremely sad and didn't interact with anybody for a few days. I wanted to kill myself and tried, a few times, but failed. Slowly I realised I have a mother to support and a lover to take care of me, which made me decide to live. Once while in [Belguam], I was invited to participate in a jagran. After dancing, I felt very tired and started coughing. I began to spit out blood. After I went back to Mumbai, my panthi [partner] told me that these are the symptoms of tuberculosis. So he took me to the government hospital and made me complete the drug course. Once I was cured, he left me without saying goodbye. I was heartbroken and decided to leave Mumbai for ever.
Mallika visited a HIV community-based organisation (CBO) in her home town that was supposed to be friendly for jogappas and hijras; however, she was disappointed upon seeing mostly kothis in charge. Mallika also accessed the government health services and reiterated the discrimination faced by her community. 'We look different, men wearing sarees, so other patients and paramedics would stare at us and make snide remarks. We are used to it now'.
Mallika's family continued to be unaware of her HIV status, and she started working as a peer educator in the same CBO that once helped her. Apart from serving Yellamma and her devotees, she took tremendous pride in educating other young kothis, hijras and jogappas about safer sex practices, determined that they would not suffer the way she had.

Sowmya
Gender nonconformity and becoming a jogappa Sowmya was born in a small village in Belgaum as the youngest of four siblings. When she turned 11, her desire as a girl began to grow, and she became uncomfortable with her masculine clothing and longed to wear sarees with beautiful jewellery, like her mother.
Sowmya's parents owned a house and some acres of farmland. She was sent to the nearby village school for her primary education. At age 11, Sowmya went through a series of illnesses that halted her education. Her illness was considered mysterious because she didn't recover, despite various medical interventions. Her family believed that Sowmya was possessed by a malevolent spirit. When rituals conducted by the local shaman failed to work, Sowmya's family agreed to conduct the initiation ceremony at the Yellamma temple. All of her ailments suddenly vanished, and her eyes lit up seeing a saree, and jewellery of her own, as part of the initiation ceremony.

Family resentment
Sowmya's dedication to a feminine appearance was not agreeable to her family, who subjected her to constant verbal abuse, particularly her brothers who struggled to deal with village ridicule. Eventually Sowmya left home at age 14 to preserve her selfesteem. As the years passed, Sowmya continued to be estranged from her family. She said, 'You know, we cannot be happy. Problem is, whatever we become, we do not have anybody for us. We cannot be a part of a family … I was not invited for my own brother's marriage'.
There were also financial implications as she was kept from inheriting family property, which went to her brothers. At the same time, the rejection by her family cemented her relationship with other jogappas who shared similar stories. As expressed by Sowmya, 'I love to be in the company of other jogappas and kothis … They are the only one who responds to our ups and downs in life … who stand by us when we have any health ailments'. She shared how she had once eloped with a panthi who claimed to love her despite her being transgender. They got married in a temple in Mumbai and lived as a couple secretly for about two years until both families found out; their interference led to the break-up of the relationship. Her panthi eventually got married and then ignored her.

Castration and religious violation
Sowmya decided to become a nirvan (undergo genital excision), compelled by her intense desire to feel and look like a woman. However, this was considered blasphemous in the jogappa community. After she became a nirvan, in an attempt to regain her place in the jogappa community and to appease them, she had to pay a fine of rupees 50,000, although she never regained the same respect.

Daily routine and livelihood
Residing in a small, two-room accommodation with a kitchen, but no toilet, Sowmya's daily routine involved waking up early each morning, taking a shower and offering puja (blessing) to Yellamma. The devotees attending the rituals as worshippers donated small amounts of food or money to the jogappas.
Sowmya joined her fellow jogappas, travelling to nearby villages and towns for jogwa, and accepting alms without any bargaining. By end of the day, they would divide up their earnings and return home. 'It is difficult to survive on our traditional livelihood system. These days, jogappas rear animals, do farming, work in the beedi factory [that makes cigarettes filled with unrefined tobacco] and farmlands'. On most days, if she did not go out for jogwa, Sowmya would be busy in livestock breeding.

Transgender identity
When asked how she preferred to identify herselfas a jogappa or a hijra -Sowmya replied, 'I want to be identified as a woman'. When informed about the change in government policies that permits transgender people to choose their preferred gender in legal documents such as the voter identity card or passport, she smiled, pulled out her identity documents with a sense of pride and said: 'Yes, and I am identified as a female'. Unlike most of her jogappa peers, Sowmya faced few bureaucratic hurdles in applying for these documents as a woman.
Sowmya only identified as a hijra when she visited Bangalore, the capital city of Karnataka, where she practised sex work. 'We hijras and jogappas are different, based on the work we do. Hijras also give programmes, basti bedodu [asking for alms in exchange of blessings]. But they clap their hands and scare people when they collect money from them. Their way is different'. Sowmya took pride in being a jogappa who are the key bearers of religious customs that give them an elevated social status. According to her, the elderly and people from educated and well-to-do families treated jogappas with respect.
Sexual violence Sowmya reflected how, over time, jogappas get accustomed to the rude remarks, filled with sexual innuendoes, of young boys and men in villages or towns. However, she recounted one event that was particularly upsetting.
It was amavasya [new moon night] with not much street light at the spot where I waited for the bus. As I was travelling on short notice, my friends couldn't accompany me. Suddenly an autorickshaw stopped near me and four men got down, held my mouth tightly and forcibly pulled me inside the autorickshaw and drove away. They stopped somewhere and dragged me out of the autorickshaw to a secluded place. They kept intimidating me with a knife, threatening to slash my face and throat. They demanded I hand over all my cash and jewellery. I feared for my life. I handed them rupees 1500 and begged them not to kill me. They took the cash and all of them sexually assaulted me and left me there. No, I didn't go to the police as they only abuse us. My community helped me deal with it and took care of me as I was injured.
Although this event deeply troubled Sowmya, she felt she had also become stronger in standing up for herself: Once I was performing in a programme hosted in our locality. I was dancing when policemen suddenly stopped me and asked me to get down from the stage. When I didn't oblige, they dragged me off the stage. I was very angry, and I told them that I am not a girl but a jogappa and this is what I do for a living and will continue doing so. I told them to question the organisers of this function and not me or other jogappas who were performing to earn money. How did they give permission to the organisers to hold the programme and then question us? They didn't speak a word after that and left from there.

Venu
When introduced, 43-year-old Venu, with a tall and masculine physique and thick moustache, appeared to 'pass' as a man in daily life. (The pronouns 's/he', 'they' and 'them' are used to convey Venu's gender ambiguity).

Disturbance and becoming a jogappa
Born into a farming family, Venu was the youngest of five siblings. Venu's older brother dropped out of school to work the fields, while the three sisters were married off early. Venu studied until high school when s/he was married off by his parents, with the prospect of a dowry.
Soon after marriage, Venu began experiencing physical and mental disturbances, with blood oozing from his penis and going into a trance-like mental state. These were taken as signs of Yellamma's possession. Initially, Venu's parents resisted the entrance of their son to jogappahood but gave in with his progressing illness. A senior jogappa in the Yellamma temple was asked to carry out the initiation, following which Venu's health improved. Venu never went back to school again.

Family disapproval
Venu began to display a feminine gender, revering Yellamma for saving their life. I was about to die but the goddess saved me. After that, while worshipping the goddess, whatever I predicted, would come out to be true. The villagers made me a jug for Yellamma rituals … I stayed in a hut along with the jug near the temple for three years. I predict what the goddess says to people … I had a tiny jug and I made a temple and now my temple has gotten bigger due to the blessings of the goddess.
As Venu's life unfolded, s/he began to explore their sexuality. Venu's parents wanted their 'son' to take up more 'mainstream' work, objecting to his mingling with jogappas. Venu's older brother once brutally assaulted them for entertaining the sexual advances of young village men. Although initially angry, with time, Venu actually grew thankful to their brother for saving them from 'a lifestyle that causes disease and death'.
Venu continued with his marriage and fathered two sons. 'People used to ridicule my son and passed derogatory remarks about me'. Venu and his wife soon separated but never divorced. Venu hoped his sons would complete their education and live a respectful life.

Religiosity and subsistence
Venu's day usually begins at six in the morning with a ritual shower followed by prayers at the Yellamma temple. Throughout the day, devotees visit the temple with offerings of fruits, cash and garments. Venu, as temple owner, is among the few in the jogappa community whose livelihood as an ascetic is relatively secure. Venu was fortunate to save enough money from giving predictions to build a modest accommodation and temple.

Older jogappas
Venu was upset seeing how many senior jogappas end up on the streets without a place to live due to abject poverty. S/he regularly visited four impoverished older jogappas, struggling to survive in a thatched hut, sleeping on mats, with only a small oven, a few pots, and an almost empty granary. The placement of a small idol of Yellamma in their hut, however, brought the occasional village women with offerings of fruits and vegetables.

Institutional discrimination
Venu's repeated attempts to open a bank account failed, and s/he expressed hesitancy in interacting with the 'mainstream society', particularly government officials. Venu said, 'Even though our body is of male, we feel like women … When we visit government offices for any work, we are being driven away; being dev manush [a godly person] we have to live our life this way'.
Additionally, Venu shared experiences of blatant discrimination from doctors and paramedics in the government hospitals. Doctors commonly would refuse to touch them or check their vitals, instead prescribing medications without any inquiry or investigation. Health professionals also humiliated them by inquiring about their sexual lives. Venu finds private medical facilities to be more tolerant; however, they are beyond the reach of most jogappas.

Sexually transmitted infections, asceticism and social stigma
Venu claimed that sexually transmitted infections (STIs) are prevalent among jogappas and those affected by it endure the shame. Venu insisted that a jogappa should remain pious and avoid all sexual thoughts and activities, so as not to affect the reputation of Yellamma. Venu felt the stigma associated with STIs is high among the jogappa community, so much so that some jogappas have refused to attend funerals of peers who died of AIDS.
My friend Pranathi lived in a village in Belgaum and she used to have sex continuously with panthis. I reprimanded her many times; but she would just not listen … Eventually she died. Only three people attended her funeral … I have seen many people who died of AIDS and who are being taken to their pyre with the help of sticks and bamboos so nobody touches them.

Sexual harassment and assault
Venu placed much blame for jogappas' suffering on men who pursue jogappas to fulfil their sexual needs, causing them death and disease. Venu said that men especially looked out for the newly initiated jogappas for sex. Venu recalled instances where jogappas were harassed and sexually abused by drunken men during jagran ceremonies. The men would verbally abuse the jogappas as they performed; they would come in groups and drag jogappas to nearby deserted areas and sexually assault them.
Public places offered little safety to jogappas. Men pursue them while riding trains or buses, forcefully occupying the seat next to jogappas, touching them inappropriately, and making lewd comments and gestures. As Venu explained, 'While travelling in buses, men touch us from behind or push us and rub our bodies. The men take great interest the moment they see the jogappas'.

Enduring structural deprivation
While elementary education is recognised by the Right to Education Act of 2010 (Mehrotra 2012), in reality, poverty in India deprives many children of basic education, who engage in various forms of child labour (Brown 2012). Many of the participants reported a lack of access to schooling and education during their childhood, mainly because of poverty. However, as Mallika and Sowmya's life histories demonstrate, for many participants, relentless taunting, harassment and ridicule, directed at their gender nonconformity, interrupts their education.
The ritual of dedicating a child for lifelong servitude to the Goddess Yellamma is embedded in the notion of sacrifice; the act of dedication becomes the pathway to recuperate from disease, disability and hardship. Becoming a jogappa led participants to a way of earning a livelihood through religiosity, which generated small amounts of cash for jogappas.
For most, a religious livelihood was insufficient for survival, so they turned to farming, rearing of animals and working in construction sites and factories to supplement their income. With prevailing social stigma, however, participants generally found it difficult to work in the formal labour sector. After initiation, their gender nonconformity often becomes apparent, making it challenging to secure employment. Sex work becomes one of the only ways that participants are able to supplement meagre earnings from religious work. Like Mallika and Sowmya, younger participants often preferred sex work with hijra groups, and intentionally travelled to other cities to safeguard their reputation.
As Venu's story underscores, old age among jogappas comes with growing financial challenges. According to participants, old age diminished the ability to earn a livelihood through jogwa and jagran. Irregular and limited revenue exacerbated their living conditions, leading to homelessness, malnourishment, and rapid health deterioration, with a lack of access to medical assistance. Given the intense suffering they endured over the life course, older participants recommended the termination of the jogappa tradition.
Recent legislation in most Indian States permits transgender individuals to alter the gender assigned to them at birth to match their current gender self-expression, like Sowmya did. However, the majority of participants in this study had not changed their identification documents. Most had a masculine birth name and gender displayed on their birth certificate. After initiation, their gender expression, attire and name reflected a feminine gender. Confusion over gender identity on the part of government officials coupled with jogappas' unfamiliarity with the legal policies that protect jogappas made it challenging for them to procure corrected identity documents. Their claims were either outrightly dismissed or postponed to a later date. They reported an inability to procure an Aadhaar card, a 12-digit unique identifier linked to biometrics and demographic information. Lack of these cards in India limits jogappas' access to social welfare benefits.
Jogappas describe their inequitable access to various institutions, facing discrimination at every level. Within the health care system, participants faced discrimination at the hands of health care providers. Some were denied entry into the health care premises or were asked to wait for excessive periods of time. Consistently, participants reported that doctors refused to touch them or examine them properly, and they were often refused consultation and treatment, and treated in a humiliating fashion.
Not unlike Sowmya' police encounter during her religious work, participants recounted frequent police harassment. Many participants described how police officers ignored their claims for protection. Participants were not only physically harassed, dismissed and ridiculed when they sought justice, but were also falsely accused, leading to arrests coloured by verbal harassment and physical abuse. Although these incidents of police harassment represent forms of direct, personal violence, they also enact indirect violence by effectively discouraging the wider jogappa community from accessing protection under the criminal justice system.
The stories of Mallika, Sowmya and Venu illuminate family as a profoundly influential institutional force in India. After being faced with familial disapproval, most participants were forced to leave their home, disowned and disinherited, much like Sowmya. Many participants were rejected by their families after being initiated, or they fled their homes to escape abuse. Once rendered an outcast from family, social suffering unfurled as they publicly encountered verbal, physical and sexual abuse in their daily lives. Except for the few like Venu, who tended to pass as a gender-normative man, most participants narrated how they were repeatedly disrespected in public. Participants faced regular harassment in public facilities, on buses and trains and in public toilets, particularly at the hands of younger as compared to older men, who, they claimed, were generally more respectful of their religious status. Indeed, countless atrocities recurred along the road to becoming a jogappa and the realisation of a transgender identity.

Conclusion
Reading the life histories of Mallika, Sowmya and Venu through the lens of structural violence reveals how power operates through social institutions to create deprivation and discrimination in everyday lives. Concurrently, however, their life stories also display a resourcefulness in coping with myriad forms of stigma, especially through their entrance into a religious community that venerates the goddess Yellamma. Through their religious bonding with each other, jogappas actively cope with, navigate, and even resist various forms of structural violence. They not only survive but live meaningful lives amid adversity. At the same time, becoming a jogappa marks them publicly as abject beings, affording them little social, economic and physical protection. Importantly, the intensity of social suffering registers not only as something that happens to oneself; it is a shared experience of violation stemming from 'policies and programs of the state that have marginalized these communities and endangered their sense of identity' (Das et al. 2001, 8).
The forms of torment endured by jogappas find echoes in larger health policy discussions and studies taking place globally, particularly in Euro-American contexts (see, for example, Divan et al. 2016). For instance, Porter et al. (2016), in their analysis of American Psychological Association guidelines pertaining to transgender people, discuss how transgender people experience discrimination over the life course, tracing the historical context that has shaped older transgender people's experience of discrimination in the USA. The importance of identity documents features prominently in transgender rights discussions in the USA (Johnson 2015); while, in Canada, not having documents that matches one's lived gender has been associated with suicidality (Bauer et al. 2015). Exclusions and other forms of discrimination in medical settings are well documented in the USA (Jaffee, Shires and Stroumsa 2016). And with respect to the family, statistical associations have been drawn between family disownment of transgender youth and depression (Yadegarfard, Meinhold-Bergmann and Ho 2014).
At the same time, however, our study cautions against too monolithic a view of transgender psychologies and mental health problems. Attention to the structural and social conditions in which transgender subjectivities emerge move us to think beyond notions of 'the third gender' and anatomical sex to consider the mutual constitution of social suffering and engagement with locally specific forms of religiosity (cf. Reddy 2005, 99-120;Hossain 2012, 497-499). As a result, policy makers in South Asia and in the wider global health community, in order to better respond to the structural barriers that inhibit transgender well-being over the life course, should seek to attend to the diverse and distinctive cultural realities of different transgender communities throughout the region. Note 1. The Hindu Goddess Yellamma, in cosmological terms, is considered both fierce and protective, the cause and cure of various illnesses, and is associated with 'heat' and sexuality.