Mental Health and Substance Use Amongst Trans Women in India

Trans women in India, especially those engaged in sex work, face significant mental health challenges. As a part of a larger study on trans health needs, we aimed to assess the prevalence of alcohol abuse among trans women attending the Mitr Clinic in Hyderabad, India, and determine if there is an association between sex work and poor mental health. A cross-sectional study surveyed 300 trans women at the Mitr Clinic. Mental health was assessed using the GHQ-12, and substance use was evaluated using the ASSIST. Data on demographics, occupation, education, and HIV status were collected. Relevant ethical approvals were obtained. Among participants, 21% were identified as sex workers. GHQ-12 scores were significantly higher among sex workers compared to non-sex workers, indicating poorer mental health (<i>p</i> = 0.004). High-risk alcohol use was reported by 4% of participants, with a marginal association between sex work and alcohol use (<i>p</i> = 0.05). Trans women engaged in sex work in India have significantly poorer mental health compared to their non-sex working peers. We advocate for culturally sensitive and targeted interventions to support the unique needs of this vulnerable population.