A Pilot Study to Assess Emotional Distress and Quality of Life among Transgenders in South India

Background and aims: Transgenders face several social disadvantages in the Indian cultural context, and often live on the fringe of the society. Presence of adverse life circumstances predisposes them to have psychological morbidity. In the absence of previous systematic evidence, this pilot study aimed to assess emotional distress and quality of life among transgenders attending a clinic in south India. Methods: This hospital based cross-sectional study assessed transgenders attending a specialized multi-speciality clinic. Participants were assessed for relevant demographic and clinical information. Anxiety and depression were assessed using Hospital Anxiety and Depression Scale (HADS), while General Health Questionnaire (GHQ) was used to assess for general emotional distress. WHOQOL Bref was used to assess quality of life. Results: The pilot study included 15 transgenders with a median age of 30 years. All the participants had experienced sexual abuse in childhood, and 11/15 (73.3%) had a lifetime suicide attempt. The median HADS anxiety, HADS depression and GHQ scores were 9, 14 and 8 respectively. About 66.7% of the sample had significant anxiety symptoms while 100% had significant depressive symptoms as per HADS cut-off. The quality of life scores were particularly low for the ‘social’ domain. Conclusion: Transgenders experience considerable emotional distress and have poor social quality of life. Medical professionals need to be sensitive to the health-care needs of transgenders to improve their psychological wellbeing.