Mental health challenges in medical transition and social adaptation among transgender individuals in Sri Lanka

Abstract

This study investigates the mental health challenges faced by transgender individuals in Sri Lanka, focusing on their experiences during medical transition and social adaptation. Despite growing international recognition of gender identity as a human right, transgender people in Sri Lanka continue to experience social stigma, legal invisibility, and limited access to genderaffirming healthcare. The study aims to examine policy interventions to promote transgender well-being, analyse mental health issues during social adaptation, and identify psychological challenges during medical transition. The research questions guiding this study are: What are the prevalent mental health conditions experienced during medical transition? What psychological challenges influence social adaptation among transgender individuals? What regulations are required to address these issues? The Minority Stress Model provides the theoretical framework, highlighting how internalised stigma and discrimination contribute to psychological distress. A mixed-methods convergent design was employed. Primary data were collected through semi-structured questionnaires and unstructured interviews, while secondary data were obtained from reports, academic articles, and media sources. The study recruited 110 participants, including transgender people, mental health professionals, religious leaders, activists, and members of the general public, using purposive and snowball sampling techniques. Quantitative data were analysed using SPSS, and qualitative data were subjected to thematic analysis. Findings indicate that a substantial proportion of transgender individuals experience mental health difficulties during medical transition, primarily due to social pressure, institutional barriers, and delays in care. Emotional distress is intensified by financial obstacles and negative encounters with medical professionals. Family rejection, especially among transgender men, emerges as a significant psychological stressor, compounded by societal stigma and rigid traditional gender norms, leading to anxiety, depression, and emotional dissatisfaction. The study concludes that systemic changes in social services, healthcare, and education are necessary to safeguard and promote transgender mental health. Recommendations include legal recognition of gender equality, free mental health care, awareness-raising initiatives, and inclusive policy-making to reduce stigma and advance social justice.