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References to a "third gender" exist in ancient Indian texts like the Mahabharata and the Ramayana . Historically, Hijras held significant roles in royal courts and were believed to possess the power to grant blessings or curses.

: While some seek medical treatments like hormone therapy or surgery to align their physical bodies with their identity, a transgender identity is not dependent on medical procedures. Global Perspectives and Cultural History india shemale

NGOs like the and Sahodari Foundation run targeted interventions, including drop-in centers, free STD checks, and peer-led outreach, but coverage remains patchy. References to a "third gender" exist in ancient