Unseen pain behind a smile; oral health and psychological distress among Indonesian transgenders (warias): a survey study on oral discomfort, sense of defeat, and oral hygiene behaviors

Background: . Methods: , with a mean age of 36 years (standard deviation = 10.5) in Jakarta, recruited via cluster sampling from five districts. Data were collected using a digital, semistructured questionnaire, including an OHB index and the Indonesian version of the Oral Discomfort Scale, which measures both psychological and physical discomfort. Sense of defeat was also assessed. The study was classified as a one-time, non-invasive procedure and was exempt from medical research regulations. Results: = -0.11, ns). Conclusions: . Healthcare and social service providers consider this connection and both emotional wellbeing and oral self-care in interventions.