A few small neuroanatomical studies show distinctions in transgender people, but results are limited in their scope due to small sample sizes and confounding variables such as adult hormone exposure.

The gap

Consensus across the literature

Supporting evidence — 4 representative gaps

• Manthan - Promoting the mental health and wellbeing of transgender persons in the national capital region of Delhi using a peer support approach: A pre-post mixed method study (2026) · doi

  The majority of interventions undertaken to address the mental health concerns of transgender individuals have been short-term in nature, ranging from a few weeks to a few months, which raises questions about their long- term effects. Manthan, by contrast, with its 12-month intervention period, provides more robust data on the long-term effects on clinically relevant mood and anxiety symptoms, with clear indications of beneficial changes in quality of life. While the multicomponent nature of the intervention limits the attribution of effects to individual components, it reflects real-world delivery conditions and aligns with community preferences for holistic, peer- led support. However, the mean depression and anxiety scores of participants at endline remained at mild levels, suggesting that additional mental health support may be required for those who continued to show residual symptoms. Manthan had a relatively small sample size and employed a quasi-experimental design, which limits the generalizability of the findings. Given the modest sample size, two-time-point pre-post structure, and limited number of covariates, paired t-tests were considered the most appropriate analytical approach. Furthermore, Manthan was conducted in a single city, which further constrains the generalizability of the findings. Additionally, while effectiveness outcome data were collected by data collectors external to the intervention, the qualitative data informing the acceptability assessment were collected by the Manthan team itself, which may have introduced socially desirable responding. Future studies employing larger, multisite samples, a controlled or randomised design, additional follow-up time points, and mixed-effects models would enable more robust analyses capable of accounting for participant-level heterogeneity and potential confounders.

  Keywords: effects manthan term intervention mental health nature long robust anxiety symptoms limits support additional sample
• Transgender and anxiety: A comparative study between transgender people and the general population (2016) · doi

  The data available on anxiety disorders in the transgender population is limited by the small numbers, the lack of a matched controlled population and the selection of a nonhomogenous group of transgender people.

  Keywords: transgender population available anxiety disorders limited small numbers lack matched controlled selection nonhomogenous group people
• Health-related quality of life in transgender adolescents: Associations with body image and emotional and behavioral problems (2018) · doi

  Although adolescence is a time of considerable psychosocial and physical change, generally associated with a decline in health-related quality of life (HRQoL), research on HRQoL in transgender youth and possible predictors is sparse.

  Keywords: hrqol adolescence time considerable psychosocial physical change generally associated decline health related quality life transgender
• Update on the Biology of Transgender Identity (2013) · doi

  A few small neuroanatomical studies show distinctions in transgender people, but results are limited in their scope due to small sample sizes and confounding variables such as adult hormone exposure.

  Keywords: small neuroanatomical show distinctions transgender people limited scope sample sizes confounding variables adult hormone exposure