Abstract
BACKGROUND: Nearly half a million transgender Bangladeshi are unable to access basic education, healthcare, and employment due to their gender identification. Social exclusion and marginalization make this community more susceptible to undiagnosed mental health issues. This study aimed to assess the range of undiagnosed psychiatric disorders and psychosocial factors among transgender adults attending outreach centers in Dhaka City. METHODS: A cross-sectional study was conducted over a 12-month period from January to December 2022 among transgender adults aged 18 to 65 years in Dhaka City, Bangladesh. Participants were initially screened using the Bengali version of the Self-Reporting Questionnaire-20 (SRQ-20). Those who screened positive underwent further assessment using the Mini-International Neuropsychiatric Interview (M.I.N.I.). English version 7.0.0, based on the Diagnostics and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria. Data were analyzed using SPSS version 27.0. RESULTS: Of 157 participants, 73.25% were aged 18–30 years; 86.62% were assigned male at birth, though 54.14% identified as transwomen, 38.85% as genderqueer, and 7.01% as transmen. Most participants were from urban (44.59%) or semi-urban (32.48%) areas. Among the psychosocial stressors, 36.94% reported blackmail, and 29.30% had attempted suicide. Overall, 61.8% were diagnosed with psychiatric disorders, of which Generalized Anxiety Disorder (GAD) (17.20%) was the most common, followed by Minor Depressive Disorder (12.10%), Bipolar I Disorder (6.40%), and Major Depressive Disorder (6.40%). Suicide attempts (p = 0.018) and life dissatisfaction (p = 0.031) were positively associated with psychiatric illness. When comparing GAD with the rest of the psychiatric illnesses, emotional bullying (p = 0.007), physical abuse (p = 0.018), and sexual abuse (p = 0.032) were positively associated with the development of GAD. CONCLUSION: The study reported a high rate of psychiatric disease in transgender individuals in Dhaka, highlighting the vital need for equitable mental health treatment through tailored approaches and specialist clinics. CLINICAL TRIAL NUMBER: Not applicable.