Introduction

In this binary world, the third category of human beings is excluded because of their living lifestyles, called transgender people or Hijra. Individuals related to this group face many problems in their daily lives, i.e., rejection, criticism, and discrimination, influencing their well-being [1,2].

Transgender

Transgender is a category that belongs to individuals who are unfit in the world of men and women. Individuals' sex characteristics or appearance in case they may differ from their usual biological birth sex (boy/girl) is characterized as transgender. There is no generally approved description for a Khwaja sira, and this term has a different use in Pakistan. Pakistani transgender sometimes uses the term Hijra to refer to themselves, but this term sounds very rude and offensive. "Khwaja sira" is a polite and correct term compared to Hijra, so they preferred to call them Khwaja sira [3,4]. Transgender consists of people who are deliberated as being neither male nor female as they are intersex. They are lowered and face difficulty matching up with the culture. They live in particular societies without education, salary-oriented jobs, and no legal policies. They met insufficient financial resources and received a rejection from people due to severe stigmatization and discrimination.

Psychological problem of transgenders

Psychological problems faced by trans-people can express the challenges linked to living in an unjust society and victimization related to gender [5]. Social and cultural biases for individuals within the society proceeded as an obstruction for transgender people to "open up" them and "come out" of their gendered personality. The effect of a culture's gender-related acceptance structure or belief system initiates as swiftly as a child is born. That is why transgender individuals, whose particular gender personality differs from the sex they were assigned at birth, continue to face social and legal preconception, discrimination, and physical violence across the world. Numerous inclusive evaluations have established that sexual and gender minority groups are more likely to be victims of physical threats, harassment, and sexual violence. This marginalized group is also at advanced risk of poor mental well-being or health than the general population. This discrimination and harassment lead to increased stress levels, including anticipatory pressure [6].

Ostracism

Ostracism is defined as the action of snubbed and excluded and frequently happens without extreme description or explicit harmful devotion. It is usually operationalized and categorized as a clarifying arrangement of reactions tolerated while being ignored and excluded [7].

"The act of ignoring and exclusion" hurts just as loneliness kills, which explains why we guard against it with great sensitivity. Rejection, ignoring, and excluding a targeted person, just arose as one of the different standard and destructive procedures of social argument. Bullies psychological needs (affection, self-esteem, control and meaningful existence); and it explores a variety of physiological, affective, cognitive and behavioral responses.

Ostracism contains three stages: The first action of being unnoticed or excluded, managing, and notification. On experiencing ostracism, which is the first stage, they move on to the second stage of coping. Some people might try harder to be re- included in the group. They might obey, follow, mimic, copy, comply, conform, cooperate, and assist. However, if they sense little expectation for re-inclusion or slight regulation over their lives, they may employ challenging actions and even aggression. They stopped trying to be liked and appreciated but resort to being noticed. The third stage is resignation, when the victim cannot hold on, simply giving up trying [8].

Ostracism affects the four basic needs of a person. The need for belongingness, i.e., the need for social acceptance as well as linkage and connection to others, the need for control, i.e., the necessity for the logic of mastery over oneself, atmosphere, and surroundings, the need for self- esteem, i.e., the need to have positive feelings of self-worth, and the need for a meaningful existence, i.e., the need to have a sense of purpose and acknowledgment from others [9,10].

Well-being

"Well-being or welfare is a general term for the state of an individual or gathering, for instance (social, financial, psychological, spiritual, and medical state). The high prosperity implies that, in some sense, the individual or gathering's knowledge is certain while low well-being is related with negative happenings". Well-being is used as an alternative to healthfulness. Health is a positive state of mental and physical. It does not refer to the absence of any illness. Well-being also refers to great personal satisfaction. Well-being is harmony between negative affect and positive affect and evaluating one working. There are two types of well-being given below [11-15].

Cognitive well-being

It is recognized by assessing one's collaboration with the extreme condition and other individuals. This dimension of well-being also comprised bliss, fulfillment, and prosperity of an individual. It relies on the psychological idea like; needs of the individual, satisfaction, and frustrations. When an individual interprets his wishes and needs to be happy with the earth, that individual builds up personal prosperity. In various economic classes, an individual assesses himself and contrasts his style and needs, and others improve his psychological reasoning and keep an eye on higher well-being [16].

Affective well-being

This type of Well-being is influenced by various levels, for example, high and low beneficial outcomes and high and low negative impact; the low positive impact is featured by a sort of un- charming and quiet excitement of direct like listless and dull mien. The high positive impact is spoken by satisfying excitement and a crisp mindset. The low negative influence will, in general, be smoothness and unwinding in conduct, and high adverse effects have indications of nervousness and antagonistic vibe. This type of well-being makes the laborers more persevering progressively driven, and the specialist figures out how to adapt to function pressure [17].

Review of Literature

Research recommends that transgender people experience large amounts of cultural segregation, adding to their conflicting danger for weakness. In any case, the sexual orientation dissension, as a noticeable indication of one's criticized status in a transgender individual, strengthens the idea that trans individuals' encounters with judgment and, thus, their well-being is also affected. A piece of gathered information from the most extensive study by the National transgender discrimination survey (N=4,115) grown-up transgender in the United States was selected. The relationship between sexual orientation dissension, transphobic separation, and well-being hurting practices (i.e., attempted suicide, tranquilize/liquor misuse, and smoking) was explored. The outcomes recommend that sex nonconforming trans individuals face more separation and, this way, are more plausible to include in undesirable activities than trans individuals who are sex acclimating. Our decisions bring up the job of sexual orientation rebelliousness in the social associations and prosperity of transgender individuals [18].

Another study aimed to distinguish the challenges identified with the helplessness and psycho-social hazard elements of individuals as transgender. A pertinent electronic database from 2007 to 2017 was selected. This investigation included transgender individuals’ helplessness and hazard factors. Following thorough inclusion and exclusion criteria, 21 papers were selected based on their suitability. These papers had sexual dangers, substance use, mental weakness, hazard elements, and defensive variables and practices against transgender [19].

The research has shown that ostracism is destructive to the health and the ostracized individual's well-being. This study mainly focused on the LGBT issues caused due to ostracism. It is observed that every act of ostracism produces risk for mental and physical harm to people who are LGBT. They suffered from the issues like depression, suicide, and signs of adverse effects on their physical health.

Transgender and Gender Diverse (TGD) individuals are also bullied. A study on the sample of 274 youth population of United Kingdom. The age range of this sample was from 16 to 25 years. Most of these participants are bullied by various means during their school years. Due to bullying, they suffered from various psychological problems such as anxiety, depression and, poor self-esteem [20].

Stigmatization, social exclusion, and consequential exclusion from society make trans gender's life even more challenging; separating, aggressive, and imposing them into unsuitable manners/habits like trading sex. The research was conducted on the transgender community of Rawalpindi and Islamabad (Pakistan).

Based on cross-sectional study design, the sample of 189 transgender was selected, and a snowball sampling technique was used. A validated close- ended questionnaire was used to assess the high- risk behaviors among them. Multivariate logistic regression investigated exciting assumptions related to suicidal risk, selling sex, and substance abuse.

Findings of the study exposed that transgender people are mostly detested and discriminated that makes them more prone to vulnerability of suicide, depression, begging, drug abuse, and being a commercial sex worker [21].

Transgender people are being humiliated and also face many psycho-social problems. An ostracized person is likely to be more aggressive and disappointed, facing many psychological problems.

It is also evident by the previous literature that rejected people express the failure of self- regulation, and hence it allows an inclination for anti-social and aggressive behaviors. Previous research on transgender people typically focused on various psychological factors (like anxiety and depression).

In Pakistan, research related to the transgender population is scarcely reported, and most of this research focused on variables such as transgender's life experiences, perception, and attitudes.

The current study variables are understudied, so this study would be an effort to see the predictive role of ostracism in the subjective well-being of transgender people [22,23].

Following are the hypotheses of the study;

H1. There would be a significant relationship between ostracism and subjective well-being components (satisfaction with life, positive and negative affect) in transgender.

H2. Ostracism would significantly predict subjective well-being components (satisfaction with life, positive and negative affect) in transgender.

H3. There would be a significant difference in subjective well-being components (satisfaction with life, positive affect, and negative affect) regarding education level among transgender people.

Methods

Research design

A cross-sectional research design was used in the current research.

Participants

The sample size was 109 transgender people with an age range of 20-55 years. The sample was targeted from different Daras and Non- Government Organizations of Faisalabad and Lahore cities. The sample size was determined according to the formula "N>50+8K (where K=Number of Predictors)" [24].

Measures

The following measures were used to check the effect of ostracism on well-being.

Demographic information sheet

The current study used the demographic sheet to collect data on various demographic variables (like age, education, profession, and living area).

General Ostracism Scale (GOS); Adapted version of workplace ostracism scale

The General Ostracism Scale is a 13 item scale. It contains a 5-point Likert type scale raged from never=1 to Always=5. It is a reliable measure to check the levels of ostracism with Chronbac Alpha of .80 on the original scale.

The scale does not contain any reverse-coded items. According to the current study population's requirement, the English version of this scale was adapted and translated into the Urdu language as General Ostracism Scale with alpha reliability of .84, respectively [25].

Satisfaction with Life Scale (SWLS)

The translated version of the Satisfaction with Life Scale (SWLS) was used in the present research to assess the cognitive component of subjective well- being.

This scale includes five items that consider the individual's satisfaction with life with no reverse coded items. Respondents answered on a 7-point Likert type scale ranging from 1 strongly disagree to 7 strongly agree. The internal consistency of the scale is on the current study was 0.87 [26].

Negative and Positive Affect Scale (NPAS)

It is a 12 item scale but later is converted into a short version of 10 items. The first five items represent negative affect, while the other five represent positive affect. This scale also has no reverse-coded items. These items measure the mood of a person over the previous 30 days. The Urdu translated version of the negative and positive affect scale was used. The Alpha values for the negative and positive affect for this scale in the current study were 0.75 and 86 [27].

Procedure

Firstly, an authority letter was taken from the department for data collection. Permissions were also taken from original authors, and Urdu- translated versions used their study measures. Data was collected by using purposive and snowball sampling techniques.

Transgender people were approached individually from different areas of Faisalabad city [28]. The President of the Hijra community was also approached in Painsra for formal data collection permission from transgender.

After following standard procedures for data collection, approval was also sought from Fountain House (Lahore) authorities.

Data were collected using the following instruments general ostracism scale, satisfaction with life, positive and negative affect scale. By approaching individually, some transgender people refused to cooperate, so some came by Guru and other resources such as Khwaja sira society, Akhuwat foundation for transgender and system foundation school for transgender Faisalabad.

Ethical considerations were followed, such as permission from participants before collecting study data. The main aim and the procedure of the study were explained to them. Furthermore, they were assured that gathered information would not be disclosed, and anonymity of the research would be maintained. If study participants want to withdraw they will be permitted.

Results

The results of table 1 show that the reliability coefficient of all the study measures ranges between 0.75 to 0.87 for the current study sample, which is considered acceptable to good. The results of correlation analysis display that ostracism has a significant positive correlation with negative affect. In contrast, with other components of subjective well-being like satisfaction with life and positive affect, a non- significant correlation was found among transgender people [31,32]. Table 2 shows that ostracism is a significant positive predictor of negative affect and explains 11% of the variance in the model (R2=0.12, F=14.85, **p<0.001). The results of Multivariate Analysis of Variance (MANOVA) shows significant difference on life satisfaction [F (30,394) =1.947, **p<0.001; Wilks` λ=0.57, partial η<sup>2</sup>=0.105], and positive affect [F (30,394) =1.947, **:p<0.001; Wilks` λ=0.57, partial η²=0.105] in terms of edication among transgender (Table 3). The results of post hoc analysis show significant differences across education levelson life satisfaction and positive affect scale among transgender people (Table 4).

Discussion

The current study examined the association between ostracism and subjective well-being components among transgender people. It was hypothesized that there would be a significant relationship between ostracism and subjective well-being components like life satisfaction, positive and negative affect among transgender. The results showed that ostracism was positively related to negative affect among transgender people. In contrast, with the upbeat nature components such as positive affect and life satisfaction, the relationship was non-significant. Our study results align with previous research as Gilman et al. found that ostracism has been linked with adverse psychological and disturbed cognitive processing. Buelow et al. also discussed that experiencing ostracism leads to loneliness, stress, depression, and many other psychological problems. These adverse outcomes create risks to overall levels of well-being. Ostracism also impairs individuals' self-regulation, negatively impacting emotional outcomes.

Furthermore, ostracism has been linked to low self-esteem, helplessness, isolation, feelings of unimportance, hostility, and thoughts about suicide. By keeping in view our cultural context, the positive relationship between ostracism and negative affect is quite logical as in our society, and transgender people are considered a marginalized community. Therefore, they are frequently ostracized by the general public, which is linked with negative affect, a form of negative emotion to show their dissatisfaction with the current state of affairs ostracism. The current study results further indicate that ostracism is also a significant positive predictor of negative affect, a component of subjective well- being. The results are in line with a study on disadvantaged youth, and findings reveal the positive predictive effect of ostracism on depression among the study population in China. As mentioned above, ostracism or social exclusion and rejection by peer groups, family, friends, and society cause harmful consequences and decrease life satisfaction by inducing worthlessness and disappointment in transgender people. Negative affect is a sub-category of the negative and positive affect scale, which focuses on measuring the effect of negative and positive experiences, incidents faced by transgender people, that affect their mood and emotions. i.e., when they face social rejection, ignorance, or exclusion, these negative experiences will lead to various negative feelings such as worthlessness and disappointment.

In Pakistani society, transgender people are invited to homes on different happy occasions, i.e., wedding ceremonies, the birth of a baby, etc. They are invited to parties at one event while considered ugly and filthy on the other hand. This contradictory treatment also influences the transgender community’s psychological state. So they try to capture the attention of others by wearing feminine dresses, doing make-up as a coping mechanism for rejection and ostracism, and to some extent, they get rid of their overwhelming feelings of loneliness, anxiety, and depression for a while. It was further supported by the current study findings that the levels of education significantly influence life satisfaction and positive affect of transgender people. The more educated participants, the better understanding of the situation participant, have and quickly find a solution to cope with that situation to improve their psychological well-being state. Once they comprehend the problem, it will increase satisfaction with life and experience positive affect mood that will enhance their psychological well- being.

Conclusion

It is concluded that transgender individuals are ostracized due to their Trans status. Due to being excluded, their levels of subjective well-being are also found to be affected. Ostracism was further found to be a significant positive predictor of negative affect. In contrast, substantial differences across education levels were observed on life satisfaction and positive affect (the components of subjective well-being). Therefore education can be considered one of the salient demographic variables that contribute to the subjective well- being of transgender people.

Limitations and Suggestions

Few limitations and future recommendations are that the current study mainly focused only on adult transgender people to assess the effects of ostracism on their subjective well-being, so teenage and old-age transgender people should be targeted in the future. The second limitation is that only Muslim transgender people were taken Non- Muslim transgender should also be part of future research. The data was collected from two cities only, limiting the generalizability of the research findings, so transgender people from different cities of Punjab and other provinces of Pakistan should be taken to get a broader view on the issues faced by the Pakistani transgender population.

Implications

The current study findings can be utilized in multiple mental health settings by clinical psychologists, psychiatrists, and Non- Government Organizations (NGOs) to teach transgender people coping strategies. Furthermore, mental health professionals can arrange assertiveness training workshops and teach the marginalized community perspective-taking exercises to cope with the issue of ostracism. The affected levels of subjective well-being of transgender people due to being ostracized can be improved through psychological interventions. The social workers can help them get social support from their families, friends, and the transgender community.

References

1. Baumeister RF, DeWall CN. Ciarocco NL, Twenge JM. Social exclusion impairs self-regulation. J Pers Soc Psychol 2006; 88: 589-604.

   [Crossref] [Google Scholar]

2. Buelow MT, Okdie BM, Brunell AB, Trost Z. Stuck in a moment and you cannot get out of it: The lingering effects of ostracism on cognition and satisfaction of basic needs. Pers Individ Differ 2015; 76.

   [Crossref] [Google Scholar]

3. Coleman E, Bockting W, Botzer M, Cohen-Kettenis P, DeCuypere G, Feldman J, et al. Standards of care for the health of transsexual, transgender, and gender- nonconforming people, version 7. International Journal of Transgenderism. 2011; 13: 165-232.

   [Crossref] [Google Scholar]

4. Daniels K, Kevin M. Measures of five aspects of well-being at work. Journal of Human Relations. 2000; 53: 279-294.

   [Crossref] [Google Scholar]

5. Eisenberger I, Lieberman D, Williams KD. Does rejection hurt? An fMRI study of social exclusion. Science. 2003; 302: 290-2.

   [Crossref] [Google Scholar]

6. Ellis SJ, Bailey L, McNeil, J. Tran’s people’s experiences of mental health and gender identity services: A UK study. Journal of Gay and Lesbian Mental Health. 2015; 19: 4-20.

   [Crossref] [Google Scholar]

7. Ferris DL, Brown DJ, Berry JW, Lian H. The development and validation of theworkplace ostracism scale. Journal of Applied Psychology. 2008; 93: 1348.

   [Crossref] [Google Scholar]

8. Gilman R, Carter-Sowell A, Dewall CN, Adams RE, Carboni I. Validation of the ostracism experience scale for Psychological Assessment. 2012; 25: 319-30.

   [Crossref]

9. Wise SL, Hyde JS. Victimization experiences of lesbian, gay, and bisexual individuals: a meta-analysis. The Journal of Sex Research. 2012; 49: 142-167.

   [Crossref] [Google Scholar]

10. McCann E, Brown M. Vulnerability and psycho-social risk factors regarding people who Identify as transgender. A systematic review of the research Issues in Mental Health Nursing. 2018; 39: 3-15.

    [Crossref] [Google Scholar]

11. Miller LR, Grollman EA. The social costs of gender nonconformity for transgender adults: Implications for discrimination and Sociological Forum. 2015; 30: 809-831.

    [Crossref] [Google Scholar]

12. Mroczek DK, Kolarz CM. The negative and positive affect scale (NAPAS).Measurement instrument database for thesocial science.

    [Crossref] [Google Scholar]

13. Nadal K, Skolnik A, Wong Y. Interpersonal and systemic micro aggressions toward transgender people: Implications for counselling. Journal of LGBT Issues in Counselling. 2012; 11: 55-82.

    [Crossref] [Google Scholar]

14. Onoda K, Okamoto Y, Nakashima K, Nittono H, Yoshimura S, Yamawaki S, et al. Does low self-esteem enhance social pain? The relationship between trait self- esteem and anterior cingulate cortex activation induced by ostracism. Social Cognitive and Affective Neuroscience. 2010; 5: 385-391.

    [Crossref] [Google Scholar]

15. Rahilly EP. The gender binary meets the gender-variant child: Parents’ negotiations with childhood gender variance. Gender and Society. 2014; 29: 338-361.

    [Crossref] [Google Scholar]

16. Reisner SL, Hughto JM, Dunham E. Legal protections in public accommodations settings: A critical public health issue for transgender and gender-nonconforming The Milbank Quarterly. 2015; 93: 484-515.

    [Crossref] [Google Scholar]

17. Riva P, Wesselmann ED, Wirth JH, Carter-Sowell AR, Williams KD. When pain does not heal: The common antecedents and consequences of chronic social and physical pain. Basic and Applied Social Psychology. 2014; 36: 329-346.

    [Crossref] [Google Scholar]

18. Saylor CF, Williams KD, Nida SA, McKenna ME, Twomey KE, Macias MM, et al. Ostracism in paediatric populations. Journal of Developmental and Behavioural Paediatrics. 2013; 34: 279- 287.

    [Crossref] [Google Scholar]

19. Schlosser B. The assessment of subjective well-being and its relationship to the stress Journal of Personality Assessment. 1990; 54: 128-140.

    [Crossref] [Google Scholar]

20. Shah HBU, Farah Rashid IA, Hydrie MZ, Fawad MWB, Muzaffar HZ, Rehman A et al. Challenges faced by marginalized communities such as transgender in The Pan African Medical Journal. 2018; 30.

    [Crossref] [Google Scholar]

21. Veale JF, Watson RJ, Peter T, Saewyc EM. Mental health disparities among Canadian transgender youth. Journal of Adolescent Health. 2017; 60: 44-9.

    [Crossref] [Google Scholar]

22. Wesselmann E, Williams KD. Ostracism and stages of coping. The Oxford handbook of social exclusion. Oxford University Press. 2013; pp: 20-30.

    [Crossref] [Google Scholar]

23. Williams KD, Nida A. Ostracism: Consequences and Coping. Current Directions in Psychological Science, 2011; 20: 71-75.

    [Crossref] [Google Scholar]

24. Williams KD. Provides a comprehensive review of ostracism and related phenomena. Annual Review of Psychology. 2007; 58: 425-452.

    [Crossref] [Google Scholar]

25. Witcomb GL, Claes L, Bouman WP, Nixon E, Motmans J, Arcelus J, et al. Experiences and psychological well-being outcomes associated with bullying in treatment-seeking transgender and gender-diverse youth. LGBT Health, 2019; 6: 216-227.

    [Crossref] [Google Scholar]

26. Wylie K, Knudson G, Khan SI, Bonierbale M, Watanyusakul S, Baral S, et al. Serving transgender people: Clinical care considerations and service delivery models in transgender health. 2016; 388: 401-411.

    [Crossref] [Google Scholar]

27. Yu X, Zhang L, Lin Z, Zhou Z, Hazer- Rau D, Li P, et al. Ostracism, psychological capital, perceived socialsupport and depression amongeconomically disadvantaged youths: Amoderated mediation model. International Journal of Environmental Research. 2021; 18: 11282.

    [Crossref] [Google Scholar]

28. Zautra AJ, Reich JW. Life events and perceptions of life quality: Development in a two? Factor approach. Journal of Community Psychology. 1983; 11: 121-

    [Crossref] [Google Scholar]