Some families demonstrated acceptance by actively supporting their transmasculine relative’s gender expression (e.g., clothes, hairstyle) or by not interfering with their choices. These family members accepted the participants just as they are, often since childhood. In some cases, family members showed quiet acceptance by not questioning changes in the participant’s gender expression.  

“They never told me to wear girls’ clothes or play girls’ games and never stopped me. They let me keep my hairstyle as per my wish.” (23, Delhi, Hindu, OBC) 

“Moreover, our father also understood that I did not like to live in a girl’s way anymore. I had long hair before. I got my hair cut on my birthday. Nobody asked why I cut my hair.” (25, Kanpur, Hindu) 

Family members also showed acceptance by trying to use correct names, pronouns, and titles. In some cases, family members were initially hesitant but started using correct names, pronouns, and titles over time. 

“They try to speak with me as a boy. Trying it slowly.” (30, Mumbai, Hindu, OBC) 

“My brother accepted me so much. He started calling me brother from then on.” (23, Mumbai, Christian) 

Assistance with the transition process was an important form of family support.  Some families provided financial help, while others who were not in a position to give money showed their support by providing care and being physically present for medical procedures. Participants expressed a particular appreciation for this type of support. 

“I just told her that I am going to do this, then my mother said, “It is your life, you know how you want to live. It all depends on you.” So she told me that I should call her when I have an operation, and she will come.” (24, Delhi, Hindu) 

“When I started my hormone therapy, I became very sick and lost my appetite. My parents took good care of me and supported me a lot. They said they couldn’t support me financially, but they will be by my side. And I can do whatever I want to.” (22, Jamshedpur, Hindu) 

Some parents expressed pride in their transmasculine children and were happy to see them thrive after beginning to transition.  

“Mother tells me that whatever I am happy with, they are also happy with. Papa also used to say, ‘I have a girl’, but now he sees me as a boy, and tells me that I am his son.” (30, Nagpur, Hindu, OBC) 

“My mother has told all of our relatives what I have done. My mom is proud of me. My mother says, “my child did not run away like other children. Didn’t do any wrong.”” (20, Mumbai, Hindu, ST) 

Family members often pressured or forced participants to follow social expectations for people labeled female at birth, including dressing in a feminine manner, staying home, and marrying a cisgender (non-trans) man. This pressure began in childhood but continued into adulthood for some participants. Participants struggled with not being able to live their lives in the way they desired and with feeling constantly pressured by family members.  

“Those moments were very tough for me, because there was family pressure on me to get married and I had just gone through a breakup.” (50, Gauhati) 

“They think of me as a girl and girls are not supposed to go out. Girls should put on makeup and they should not wear clothes as I do. I cannot live my life the way I want to so I am a bit disturbed and try to control my feelings so that they do not one day cause an outburst.” (29, Lucknow, Hindu) 

Some participants had to leave their family homes in order to start their transition process due to family members denying their gender identities or refusing to accept their transition. In other cases, participant’s families did not entirely oppose their transition but refused to provide financial support, even if they were financially able to do so. 

“Don’t stay here and do whatever you want to do [they said]. You have to leave the village…You go out, do your best, use your money, but don’t stay here and do it. If you want to go bald, go out of town and do it.” (25, Washim, Hindu, OBC) 

“When I started treatment, my family could have provided support, but I took care of everything. They are with me but they have a condition that ‘whatever you spend is on your own’.” (25, Mumbai, Hindu, OBC) 

A few participants felt that becoming financially independent might change their family’s response. They shared that becoming independent would enable them to bear all the costs of transition and potentially lead to greater family support. 

 “I told them about the surgery, but they are not ready for that as every parent fears for their child. Right now, they are not supporting it, and maybe in the future, if I become independent, they will support me.” (23, Delhi, Hindu, OBC) 

Some participants were taken by their families for “conversion therapy” in which doctors or religious/spiritual healers attempted to change their gender identity or convince them to identify with their gender assigned at birth.  In some cases, family members forcefully tried to make the participants take hormones or other medications. One participant highlighted being kicked out of the house when nothing changed after the family took him for conversion therapy . 

“My family forcibly tried to make me live like a girl and forced me to take medicine for about 4 to 5 months.” (22, Jamshedpur, Hindu) 

“They took me to a psychiatrist around 2 to 3 km away from my house for my treatment. After listening to my case, the doctor’s reaction was very weird and negative. He told them that I was mentally sick and should be given female hormones to cure my problem.” (22, Jamshedpur) 

“When I told them, they thought I was possessed by a ghost, and took me to Baba (magician). Nothing happened there. We went to Brahmin (priest) later, nothing happened there. I was beaten a little after that. Bored, they finally kicked me out of the house.” (20, Mumbai, Hindu, ST) 

Fear of rejection and stigmatization from other family members, relatives, and society led some family members to reject the transmasculine person in public, even if they were accepting in private. These family members were concerned about how they would be treated if they openly accepted the participant’s gender identity or transition. One participant described avoiding family events because of the pain caused by being misgendered. 

 “My parents tried to convince me to stop being like this and said that we are very poor people and explained this to my elder sisters and brother-in-law. No one will understand [they said].” (22, Jamshedpur, Hindu) 

“When someone new visits, my family members will call me a girl and tell them I am their daughter. I feel very bad when they look at me and I am mentally disturbed, so I walk away. I don’t like it. If there is an event in our family, I avoid it. They have accepted me, but they do not accept me in front of other people.” (26, Mumbai, Hindu) 

Some participants faced verbal abuse or physical violence at the hands of family members when they disclosed their gender identity or attempted to express their gender on their own terms.  

“Once I tried to speak to my father, but he also responded in the same way. He told me that, are you out of your mind? And he behaved a bit violently. My father started saying, “Get out from here. I have always provided you with everything as per your requirement. I don’t know what else you want from us.” He said all these things by shouting.” (23, Bijnor, Hindu, OBC) 

“When I used to wear shirts and pants, they would hit and scold me. I have had a lot of beatings, and I got so strong and adamant that I would not care if anyone hit me anymore.” (40, Nagpur) 

Family acceptance had a positive impact on transmasculine persons’ mental health and well-being, made the transition process easier, and led to greater acceptance from their relatives and the wider society. Conversely, family rejection led to stigmatization and rejection from others and had a negative impact on overall health and well-being.  

Participants expressed that support from one’s own family is key to broader acceptance from relatives and society: 

“When I found out about myself, everyone gave me a lot of support. After the transition, my family and villagers wouldn’t let me feel that what I have done is different. Everyone speaks with the same respect as before. Giving me more respect than before. So, I didn’t get a negative response. Initially, there was a bit of an argument when the surgery was done but I didn’t have any problems as my parents were supporting me.” (23, Mumbai, Hindu, OBC) 

“If your parents don’t accept you, then what are you going to do about society? They will say that your parents do not support you. Why do you expect support from us when the people who gave birth to you do not support you? This leads to mental stress. Sometimes I remember not getting a good night’s sleep.” (29, Nagpur, Hindu, SC) 

As the participant above notes, family rejection can be extremely stressful. On the other hand, family acceptance led to better mental health and well-being. Participants shared that family support gave them the strength to deal with the stigma they faced from the wider society and helped them to navigate the transition process.  

“The most important thing for me is that my parents have accepted me, it does not matter to me what society says. My depression has reduced a lot due to my parents’ acceptance. I am still taking medicine, but I no longer have severe depression.” (23, Delhi, Student, Muslim) 

“My mother and my sister supported me in this. I was very sad and lonely, then my sisters came to me and sat along with me. They tried to distract me from this and ask me to play, to exercise, and to dance. Gradually I felt an improvement in myself. Then I started meditation and it helped me a lot.” (23, Churu) 

“My number two brother was very supportive. He helped me a lot when I started the transition. He said, do it, I am with you.” (36, Pune, Hindu, ST) 

Participants shared some of the strategies they personally used that helped them to gain acceptance from their family members. Some educated their families about transgender people and the transition process by showing them online videos. This helped family members to better understand transgender identities and transition processes. 

“When I completed the 10th standard, I told them back home and showed them videos about transgender people. They watched videos and said all right.” (25, Mumbai, Hindu, OBC) 

“When I told my family that I wanted to change and do surgery, their response was neither negative nor positive. They feel shocked and ask if this happens? So I told them this could happen, and I showed them a YouTube video of surgery and the people who did this. I made myself comfortable with family members and made them positive about my decision.” (26, Thane, Hindu, OBC) 

In addition to online videos, some participants received help from trans peers who explained the transition process to their family members. Communicating directly with trans peers helped them to understand transition procedures and address their safety concerns. 

“I have one old friend who had a small surgery. I asked him to come home and meet my parents. Afterward mother said ok. She spoke with our family doctor and they also said ok. There is not any problem with health. Afterward, the family gave permission.” (26, Thane, Hindu, OBC) 

Another participant shared that professional counseling for his parents led them to accept him and assist in affirming his gender:  

“The doctor talked to my parents for half an hour to one hour and explained about this, after that when they came out, they first took me to the salon, and got my hair cut.” (26, Kashmir, Muslim) 

Participants highlighted the importance of open communication among family members to facilitate support and acceptance over the long term. Participants highlighted that it is not always easy for parents to understand and accept them, so communication is key for both transmasculine people and their parents. 

“I think it is a big responsibility of parents to understand their children. When parents need to explain something to their children they should explain and when they want to ask something, they should also ask.” (27, Delhi, Hindu)