Abstract
IntroductionThe prevalence of depression and suicidality is high among men who have sex with men (MSM) and transgender women (TGW) worldwide. Stigma and discrimination are likely contributing factors. More research is needed in low-income, non-English speaking countries to assess the effects of social and structural factors on depression and suicidality among MSM and TGW.MethodsNepalese MSM and TGW (n = 340) were recruited using a respondent-driven sampling design and filled out a survey questionnaire. The outcomes were depression and suicidality. Data was analyzed using bivariate and multivariable logistic regression.ResultsMore than half of the participants (59%) suffered from depression. Severe depression was more common among TGW compared to MSM (41 and 20%, respectively). When it comes to suicidality, TGW had higher lifetime prevalence of suicidal thoughts compared to MSM (32 and 5%, respectively). Depression was positively associated with sex work both for MSM (AOR: 7.9; 95% CI 3.4–18.2) and TGW (AOR: 6.5; 95% CI: 2.3–18.2). MSM who were evicted by family had high odds of suicidal thoughts (AOR: 6.2; 95% CI: 1.3–28.8). For TGW, suicidality was associated with being cheated and threatened (AOR: 3.9; 95% CI: 1.2–12.5) and having forced to marry a female (AOR: 2.2; 95% CI 1.1–5.1).ConclusionsNepalese MSM and TGW suffer from a high degree of mental and psychosocial health issues. Future studies should focus on intervention research and on collecting data from a larger variety of gender and sexual minorities.
Highlights
The prevalence of depression and suicidality is high among men who have sex with men (MSM) and transgender women (TGW) worldwide
The majority of TGW identified as third gender (63%) whereas most of the MSM reported a male identity (87%)
Another study from India on psychiatric morbidities among TG showed that 31.2% suffered from current depression and 18.7% of dysthymia [48]. When it comes to suicidality, nearly 1/3 of TGW and 5% of MSM had ever had suicidal thoughts
Summary
The prevalence of depression and suicidality is high among men who have sex with men (MSM) and transgender women (TGW) worldwide. More research is needed in low-income, non-English speaking countries to assess the effects of social and structural factors on depression and suicidality among MSM and TGW. TG describes individuals who were assigned female or male sex at birth but whose gender identity does not match the assigned gender [2]. Stigma towards these groups common and a major cause of negative health outcomes [3, 4]. Much of the research on gender and sexual minorities to this day has been conducted in high-income, English speaking countries and focused on physical health [5]. We have focused on mental health aspects among MSM and TG women (TGW) in Nepal
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