Anxiety, Social and Hospital Phobia among Transgender at a Community Centre in Chennai, Southern India: A Mixed Method Study

Abstract

ntroduction: Stigma and discrimination within the healthcare sector in general may impact transgender people’s desire and ability to access appropriate medical treatment. The transgender community have specific healthcare needs which may go untreated leading to increased disease burden in the community. In India there is a gap in understanding the factors affecting utilisation of health services by transgender community. Aim: To determine the factors affecting presence of social, hospital phobia and anxiety among transgender individuals at a Transgender community centre in south India, and to understand the perspective of the community members on using healthcare services. Materials and Methods: The present quantitative component embedded within a qualitative study was conducted in the Department of Physiology, Dhanalakshmi Srinivasan Medical College and Hospital (DSMCH) (Community Centre), Siruvachur, Perambalur, Tamil Nadu, India for two days, during the month of August 2022 among 24 transgender adults. Semi-structured in-depth interviews were conducted with the group for the qualitative part of the study during two consecutive days in August 2022, and quantitative part was analysed within the same group using three questionnaires for social phobia, hospital phobia and hospital anxiety. Age-wise and genderwise distribution of scores in social phobia, hospital phobia and hospital anxiety were analysed using Mann-Whitney U tests as the data was not normally distributed. Results: Out of the 24 participants, 20 (83.33%) were in the age-group of 18-35 years and 18 (75%) identified themselves as transfemales. Qualitative analysis of semi-structured interview found prevalence of gender based discrimination and mistreatment at hospitals faced by transgender individuals leading to fear of hospitals. Out of 24, nine participants had hospital related anxiety score more than four out of nine. Social phobia score out of 36 was given and the highest score was 27, with a mean score of 11.416±8.445. Hospital phobia score out of 32 was given and mean score was 13±6.041. Conclusion: Transgender individuals feel hesitant to approach hospitals due to the discrimination they have faced and continue to face at hospitals. There is a need to make our hospitals a more inclusive space for them.