Artistic and Playful Resources as Mental Health Support in the Life Trajectories of Trans and Gender-Diverse People: A Qualitative Study from a Public Health Perspective

Trans and gender-diverse (TGD) people experience significant mental health inequalities. These disparities are associated with structural stigma, social exclusion, and persistent barriers to accessing health services, representing a critical public health issue. Although existing research has largely emphasized biomedical and clinical responses, less is known about non-biomedical resources that support mental health across life trajectories. This qualitative study explored, based on participants' narratives, how artistic and playful resources contribute to mental health across life trajectories, considering contexts of social inequities and social determinants of health. Four trans and gender-diverse participants aged 18-27 years were recruited through snowball sampling and took part in two in-depth semi-structured interviews conducted remotely. Data were analyzed using Reflexive Thematic Analysis combining deductive and inductive coding. Findings indicate that artistic and playful practices were described as non-biomedical resources for emotional regulation, coping with minority stress, identity affirmation, and social connection across different life stages. These practices were narrated as helping participants manage psychological distress associated with stigma, discrimination, and limited access to affirmative mental health care. From a public health perspective, the results underscore the importance of recognizing culturally situated, everyday expressive practices as complementary forms of mental health support. Integrating such resources into broader mental health strategies may contribute to more comprehensive, equitable, and non-pathologizing public mental health approaches for trans and gender-diverse populations.