Born in 1947 as Joan Rousmaniere Ewing, Lama Tsultrim was raised by her parents, James Ewing, a small-town New England newspaper publisher, and Ruth D. Ewing, a labor mediator. Her maternal grandparents both received PhD. degrees in philosophy at Harvard University. Her grandmother was the fifth women in history to receive a PhD. from Harvard. This same grandmother, Frances R. Dewing, gave Lama Tsultrim her first book on Buddhism when she was only fifteen years old, planting a seed that would come to fruition in a life devoted to Buddhist teachings. Her paternal grandfather was Oscar Ewing, a lawyer and politician who, as a cabinet member under President Truman, sought universal health care, but due to the political climate had to settle for what became Medicare.

Lama Tsultrim grew up in Maine and New Hampshire with her older sister, Carolyn, and younger brother, Thomas. At nineteen, in 1967, having read every book available at the time about Tibet, she traveled to Nepal and India with her college friend, now filmmaker, Victress Hitchcock, who created the film Blessings and When the Iron Bird Flies.

At the age of 22, on the full moon of January 1970 in Bodhgaya, India, she was ordained as Karma Tsultrim Chödron by the 16th Karmapa, Rigpai Dorje, along with the four main reincarnate tulkus: H.E. Tai Situ, H.E. Jamgon Kongtul, H.E. Gyaltsap Rinpoche, and H.E. Sharmar Rinpoche as her witnesses. She was the first American ordained by H.H. Karmapa and he became her root Lama.

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