This book chapter examines sexual health knowledge, attitudes, and behaviors among South Asian international students studying in the United States, with a particular focus on how these experiences differ from those of domestic U.S. students. This study explores how cultural norms, values, and socialization in countries such as India, Pakistan, China, Nepal, Bangladesh, and Sri Lanka shape students’ understanding of sexual health as they navigate a new educational and cultural environment.

The chapter is based on a survey specifically designed to capture the experiences of international students enrolled at a Central–South university campus. By focusing on this population, the study highlights how prior exposure to limited or abstinence‑based sexual health education, cultural taboos surrounding discussions of sexuality, and differing expectations around relationships and gender roles influence sexual health knowledge and decision‑making among South Asian international students. These cultural factors often contrast sharply with the more comprehensive, open, and institutionally supported sexual health education commonly experienced by domestic students in the United States.

Preliminary findings reveal significant disparities in sexual health knowledge, comfort seeking information, and access to culturally responsive resources when compared to domestic student populations. International students often report uncertainty navigating U.S. sexual health systems, reluctance to engage with campus resources due to stigma or cultural expectations, and challenges reconciling home‑country values with U.S. campus norms.

By highlighting these differences, the chapter underscores the importance of moving beyond one‑size‑fits‑all approaches to sexual health education in higher education. The findings offer important implications for policymakers, university administrators, faculty, and international students by emphasizing the need for culturally responsive sexual health programming, inclusive institutional policies, and targeted support services. Ultimately, this work contributes to broader conversations on health equity and inclusive health promotion, advocating for approaches that recognize cultural context as central to supporting the well‑being of international student communities.

This book chapter presents a comprehensive review of the academic literature on Hijras of India, a historically marginalized and culturally distinct gender‑diverse community. Drawing from sociological, public health, and interdisciplinary scholarship, the chapter examines social identity, health disparities, stigma, and systemic exclusion experienced by Hijras. By synthesizing existing research, it highlights critical gaps in knowledge related to health, social inclusion, and policy, while emphasizing the importance of culturally informed and equity‑centered approaches. The chapter contributes to broader conversations on gender diversity, social justice, and health equity within global and cross‑cultural contexts.

Within the Indian sociocultural context, Hijras are recognized as a distinct gender community with a long historical presence that predates contemporary Western understandings of gender identity. Unlike the term transgender commonly used in the United States—which broadly refers to individuals whose gender identity differs from their sex assigned at birth—the Hijra identity is shaped by specific cultural, religious, social, and communal traditions unique to South Asia. Hijras are often socially recognized as neither male nor female and have historically held ceremonial and cultural roles, while simultaneously facing significant stigma, marginalization, and exclusion from mainstream social, economic, and health systems.

In contrast, U.S. transgender frameworks are typically grounded in individual identity, medical transition narratives, and civil rights discourse. These differing cultural constructions underscore the importance of contextualizing gender diversity within local histories and social structures, rather than applying Western identity frameworks universally. This chapter reinforces the need for culturally grounded and context‑specific approaches when examining gender‑diverse communities, particularly within global public health, sociology, and equity‑focused research.