Mental health interventions for transgender persons are long overdue and must be implemented at the earliest to reduce depression, anxiety, and psychological distress within the community.
In a major step towards addressing the mental health needs of transgender communities in the National Capital Region (NCR) of Delhi, a new study by The George Institute for Global Health India has shown that a peer-led intervention model can improve mental health outcomes among transgender individuals in resource-constrained settings.
The findings of the Manthan study, which is the first of its kind intervention study in India aimed at enhancing the mental health and well-being of the transgender community in Delhi NCR. The study has shown a major reduction of depression and anxiety and improvement in the psychological well-being of the transgender community that continues to face stigma, discrimination, exclusion, and disproportionately high mental health challenges.
The paper was authored by Dr. Sandhya Kanaka Yatirajula, Prof. Pallab Maulik, Ms. Manmeet Kaur Bhatia, Mr. Naushad Alam Khan, Mr. Aman Rastogi from The George Institute for Global Health India and Mr. Vaideek Shukla, a member of the trans advisory group of Manthan has been published in the Journal of Global Health Neurology and Psychiatry.
Transgender individuals bear the brunt of severe mental health concerns as a result of stigmatization, discrimination, social exclusion, and deprivation of health services. Existing studies in India have focused on HIV related interventions with limited data on mental health interventions for the transgender community.
The Manthan study addressed this critical gap through a 12-month peer support intervention involving structured group sessions facilitated by trained transgender peers. The sessions focused on mental health awareness, stress management, resilience building, behavioral activation, mindfulness, self-care, anger management, suicide safety planning, and coping strategies.
This study screened a total of 300 transgender individuals, and identified 82 high-risk persons who presented with anxiety, depression, and self-harm or suicidal tendencies. Of these, 62 participants completed the baseline assessment, and 58 completed the intervention.
The intervention involved peer-led group sessions conducted by trained transgender facilitators, focusing on mental health awareness, stress and anger management, mindfulness, self-care, resilience building, and coping strategies. The sessions created safe spaces for participants to share experiences, build emotional support networks, and address stigma, social isolation, anxiety, and depression. Researchers noted that the peer-led approach helped improve trust, participation, and overall psychological wellbeing among participants.
Preliminary findings show that depression scores dropped from 13.1 to 7.0, and anxiety scores dropped from 11.2 to 6.0. For the mental health intervention activities implemented under this project, improvements were observed across all domains of mental health well-being and quality of life among all participants. Over 60% of participants achieved clinically significant improvements in their depression scores, while nearly 59% of participants experienced clinically meaningful reductions in anxiety symptoms.
The median attendance rate across the full course of intervention exceeded 91%. Participants also showed reduced mental health treatment-seeking stigma, as well as improvements in their mental health-related knowledge, attitudes, and behaviors.
"Manthan created a safe and inclusive environment where transgender individuals could openly discuss their lived experiences, emotional struggles, and mental health challenges without fear of judgement. Participants not only developed a better understanding of their mental health but also learned practical coping strategies that helped them manage anxiety, depression, stress, and social isolation.
By:Dr Sandhya Kanaka Yatirajula
Program Lead - Mental Health, The George Institute for Global Health India
"The study demonstrates that community-led, peer-driven mental health interventions can play a transformative role in improving mental wellbeing among transgender individuals. Importantly, the intervention was delivered by trained peers rather than specialist mental health professionals, highlighting the feasibility and scalability of such models in low-resource settings.
By:Prof. Pallab Maulik
Director of Research at The George Institute for Global Health India
The study also highlighted several factors that contributed to the program's success, including relatable peer-led discussions, creation of safe spaces, flexible delivery formats, and practical mental health tools. Participants reported that the sessions helped them better recognise symptoms of stress, anxiety, depression, and burnout, while also improving their confidence and social connectedness.
At the same time, the study identified barriers such as long travel times, severe psychological distress requiring individual counselling, and discomfort among some participants in sharing personal experiences within group settings.
The study was funded by the Indian Council of Medical Research (ICMR). Collaborating organisations included Tweet Foundation, Basic Foundation, Satrangi Samaj Foundation, and Balvikas Dhara.
The researchers emphasized that larger multi-site randomized controlled trials are needed to strengthen evidence and support policy integration of transgender-focused mental health services in India.
