Transgender persons face several hardships and struggle to earn a sustainable livelihood since they are discriminated and ostracized by the society. Once they reveal their gender identity they are disowned by family members due to the stigma surrounding them. In a survey conducted prior to the formulation of Transgender policy in 2015, it has been identified that almost 51% of Transgender population in the State were estranged by their own families. 
The transgender persons resort to Sex Re-assignment Surgery (SRS) and hormone treatments which help them in their transition to self-identified gender. These surgical transitions may include several procedures and is very much complicated. 
Also due to lack of social support they often face atrocities and are subjected to crisis which may require immediate medical assistance, treatment, food, shelter, clothing and legal aid. Social Justice Department has introduced a noble initiative known as ‘Karuthal’. The main objective of the scheme is to cater assistance to such needy trasngenders who require immediate support during crisis or facing emergency situations. 

Guidelines for scheme implementation
An advisory committee has to be constituted in each district empanelling the following members.

Eligibility criteria

1.    Scheme beneficiaries must possess Transgender Certificate/ Transgender ID card.
2.    BPL category limit/Ration card need not be considered.
3.    The fund can be utilized for catering the needs such as emergency surgeries, first aid, ambulance service, food and clothing, legal aid, etc.
4.    This fund can be utilized for emergency assistance/treatment of any complications after SRS. 
5.    The fund can be utilized for medical examination, rehabilitation and shifting of destitute transgender persons to care home/shelter homes.
6.    Providing emergency medical assistance and food for transgender persons who are victims of natural calamities.
7.    The fund can also be utilized for providing emergency medical aid for transgender persons who are victims of acid attacks and life-threatening burns.
8.    In case of a danger to life or property of a transgender individual, the fund can used to take suitable remedial measures for ensuring care and protection.
9.    District Social Justice Officer will have the financial power to utilize funds not exceeding Rs. 25,000/-. Prior approval of monitoring committee has to be taken to utilize funds exceeding Rs. 25,000/-.
10.     The fund can also be used for administering support of a caregiver.