Background Trauma and distress are common characteristics of mental disorder among the Transgender (TG) community. However, little is known about the context and forms of mental distress, and the coping mechanisms TGs employ. This study seeks to understand the various mental health issues among TGs in Delhi, and prevalent government service usage patterns. Further, it intends to advocate for the inclusion of mental health services within the existing Government health policies.

Methods Qualitative in-depth interviews were conducted with twenty TGs from Delhi. Purposive sampling was done to maximise variation in relevant socio-demographic characteristics. Respondents were recruited from a targeted intervention programme run by Delhi State AIDS Control Society. An open ended interview guide consisting of a range of mental health themes were used. Interviews were conducted in the local language, Hindi, and transcripts were translated to English. A thematic content analysis was conducted by coding data manually.

Results The study revealed poor mental health among TGs. They face increased societal stigma, discrimination, poverty, familial rejection coupled with extreme physical and social violence, leading to anxiety and depression, with instances of suicidal attempts. Further, to cope with the multitude of problems, alcohol and self-harm are used as temporary escape. Importantly, it is found that the TG community does not avail most government services due to aforementioned causes, which negatively affects their self-esteem and overall mental health.

Conclusion Results of this study reflect heightened mental distress and minimal usage of existing health services among TGs in Delhi. The need of the hour is to improve their mental health through provision of adequate services that are accessible and stigma free. The study proposes that this can be achieved by integrating mental health services within the larger HIV prevention programmes of the Government of India.

Disclosure No significant relationships.