Mental Health of Transgender and Gender-Diverse Persons in India: A Scoping Review of Literature Since Legal Recognition of Self-Affirmed Gender Identity, 2014–2024

PURPOSE: India's 2014 Supreme Court ruling in National Legal Services Authority v. Union of India affirmed transgender and gender-diverse (TGD) persons as equal citizens with a right to self-identified gender. This scoping review (2014-2024) sought to map TGD mental health research in India, characterize study details and themes, and identify gaps to guide future research and interventions. METHODS: Following Joanna Briggs Institute methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we conducted a systematic search of peer-reviewed literature (PubMed, PsycINFO, Web of Science, Google Scholar, specific journal search, hand search) and grey literature (Google Scholar, websites of LGBTQ organizations, and digital thesis repositories Shodh Ganga and Shodh Gangotri). All publications between April 2014 and December 2024 that focused on the mental health of the Indian transgender population were included. RESULTS: From 246 initial sources, 124 were included in the review. The reviewed studies described prevalence rates of common mental disorders, transgender-specific psychosocial stressors, positive psychology variables, role of mental health professionals, mental health interventions and guidelines, forced gender "correction" practices, mental health impact of gender-affirming surgeries, links between sexual health and mental health, and experiences during the COVID-19 pandemic. CONCLUSIONS: This review demonstrates substantial mental health needs among TGD communities in India but a narrow, uneven evidence base. Several articles revealed researcher misconceptions indicating ethical and epistemic harm. Priority next steps are adequately powered, intersectional longitudinal studies and rigorously evaluated, community-partnered interventions (including family support and mental health professional training) to advance gender-affirming, evidence-based care.