Date of Award

January 2013

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)


School of Public Health

First Advisor

Trace Kershaw

Second Advisor

Rosana Gonzalez-Colaso


Men who have Sex with Men (MSM) and Transgender (TG) women are known to experience high levels of mental stress secondary to stigma associated with their gender identity or sexual orientation. We conducted a cross sectional study to assess how gender identity, sexual orientation, sexual stigma, violent sexual stigma, and important covariates (life satisfaction, social support, and alcohol dependency) influence major mental health outcomes (depression, anxiety and PTSD) among 101 MSM and 53 TG women recruited from 7 sex cruising zones in Chennai, India. Results showed that the gender identity and sexual orientation scale may provide a new method to subjectively measure MSM and TG women's inner feelings, and that alternative binomial measures may inadequately represent their true gender identity and sexual orientation. Sexual stigma rates were alarmingly high. Furthermore, we found high rates of depression, anxiety, and PTSD symptoms in MSM and TG women. Linear regressions showed that gender identity, sexual orientation and sexual stigma were only significantly related to PTSD symptoms, while social support, life satisfaction, alcohol dependency, and self reported fair or poor health were significantly related to depression or anxiety. These results suggest the need to create interventions that provide access to mental healthcare and education for learning coping mechanisms to deal with sexual stigma and symptoms of PTSD. They also suggest that in the face of high sexual stigma and isolation from society, interventions need to help MSM and TG women learn how to increase social support and maintain good health in order to increase overall wellbeing.


This is an Open Access Thesis.

Open Access

This Article is Open Access