ISSN 2407-2230 | E-ISSN 1907-3062 | Universa Medicina content is searchable on DOAJ, Google Scholar, and OAI

High perceived discrimination and no family support increase risk of poor quality of life in gender dysphoria

Surilena Hasan, Yovita Alviany, Cerellia Clarissa, Sonia Sudana
Submission date: Friday, 02 June 2017
Published date: Monday, 13 November 2017


Family support and low discrimination perceptions are a factor in protecting against mental disorders and poor quality of life in male to female (MtF) gender dysphoric individuals. The aim of this study was to determine the role of family factors, peer support, self-esteem, perceived discrimination, depression, anxiety, and stress on the quality of life among MtF gender dysphoric individuals.

A cross-sectional study was conducted involving 106 MtF gender dysphoric individuals of Sanggar Swara Jakarta. Respondents filled out questionnaires on demographics, WHOQL-BREF, perceived discrimination, Rosenberg self-esteem, family support, social support (SSQ6), family relations (FACES III), and depression anxiety stress scale (DASS). Simple and multivariate logistic regression tests were used to analyze the data.

Among the 106 MtF gender dysphoric individuals of Sanggar Swara Jakarta with an age range of 18-45 years, 78.3% had no family support, 64.1% no peer support, 62.3% high perception discrimination, 64.1% low self-esteem, 36% extreme family relations, 44.3% depression, 59.4% anxiety, 35.8% stress and 62.3% poor quality of life. Employment, perception of discrimination, self-esteem, family support, and anxiety were significantly associated with quality of life (p<0.05). Multiple logistic regression analysis showed that perceived discrimination (Odds Ratio=13.89; 95% CI: 5.89-11.99), and family support (Odds Ratio=29.11; 95% CI: 2.45-8.21) were significantly associated with quality of life.

High perceived discrimination and no family support increase the risk of poor quality of life in MtF gender dysphoric individuals. These findings suggest the need for prevention and intervention of stigmatization and discrimination that should have a special focus on families with MtF gender dysphoric individuals.


Quality of life; family support; perceived discrimination; gender dysphoria

Full Text:



Bradford J, Reisner SL, Honnold JA, et al. Experiences of transgender-related discrimination and implications for health: results from the Virginia Transgender Health Initiative Study. Am J Public Health 2013;103:1820–9.

Abigail, S. Regional feature: the GWL-INA: the formation of a national network of gay men, transgender and MSM in Indonesia. HIV Australia 2012;10:43.

Bockting WO, Miner MH, Swinburne RE, et al. Stigma, mental health, and resilience in an online sample of the US transgender population. Am J Public Health 2013;103:943-51.

Prabawanti C, Bollen L, Palupy R, et al. HIV, sexually transmitted infections, and sexual risk behavior among transgenders in Indonesia. AIDS Behav 2011;15:663–73.

Zelle A, Arms T. Psychosocial effects of health disparities of lesbian, gay,bisexual, and transgender older adults. J Psychosoc Nurs Ment Health Serv 2015;53:25–30.

Kaiser CR, Major B. A social psychological perspective on perceiving and reporting discrimination. Law Soc Inq 2006;31:801-30.

Belkin A. Caring for our transgender troops-the negligible cost of transition-related care. N Engl J Med 2015;373:1089-92.

Pascoe EA, Smart RL. Perceived discrimination and health: a meta-analytic review. Psychol Bull 2009;135:531-54.

Sopiyudin MD. Besar sampel dan cara pengambilan sampel dalam penelitian kedokteran dan kesehatan. Edisi 2. Jakarta: Salemba Medika; 2009.

Robins RW, Hendin HM, Trzesniewski KH. Measuring global self-esteem:construct validation of a single-item measure and the Rosenberg self-esteem. PSPB 2001:27:151-61.

Bradford J, Reisner SL, Honnold JA, et al. Experiences of transgender-related discrimination and implications for health: results from the Virginia Transgender Health Initiative Study. Am J Public Health 2013;103:1820-9.

Place M, Hulsmeier J, Brownrigg A, et al. The family adaptability and cohesion evaluation scale (FACES): an instrument worthy of rehabilitation. Psychiatrist 2005;29:215-8.

Pastrana A. Being out to others: the relative importance of family support, identity and religion for LGBT latinas/os. Lat Stud 2015;13:88-112.

Alexander A, Mustafa A, Emil SAV, et al. Social support during delivery in rural central Ghana: a mixed methods study of women’s preferences for and against inclusion of a lay companion in the delivery room. J Biosoc Sci 2014;46:669-85.

Tran TD, Fisher J. Validation of the depression anxiety stress scales (DASS) 21 as a screening instrument for depression and anxiety in a rural community-based cohort of northern Vietnamese women. BMC Psychiatry 2013;13:24. doi:10.1186/1471-244X-13-24.

Yang X, Zhao L, Wang L, et al. Quality of life of transgender women from China and associated factors: a cross-sectional study. J Sex Med 2016;6:977-87. doi: 10.1016/j.jsxm.2016.03.369.

Prabawanti C, Dijkstra A, Riono P, et al. A survey on HIV-related health-seeking behaviors among transgender individuals in Jakarta, based on the theory of planned behavior. BMC Public Health 2015;15:1138. doi:10.1186/s12889-015-2480-0.

Nuttbrock L, Bockting W, Rosenblum A, et al. Gender abuse, depressive symptoms, and substance use among transgender women: a 3-year prospective study. Am J Public health 2014; 104:2199–206.

Bazargan M, Galvan F. Perceived discrimination and depression among low-income Latina male-to-female transgender women. BMC Public Health 2012;2:663. doi:10.1186/1471-2458-12-663.

Poguri M, Sarkar S, Hawa SN. A pilot study to assess emotional distress and quality of life among transgender in South India. J Neuropsychiatry 2016;2:1-13.

Bariola E, Lyons A, Leonard W, et al. Demographic and psychosocial factors associated with psychological distress and resilience among transgender individuals. Am J Public Health 2015;105:2108–16.

George A, Janardhana N, Muralidhar D. Quality of life of transgender older adult. Int J Soc Sci Humanit Invent 2015;4:7-11.

Wilson EC, Chen YH, Arayasirikul S, et al. The impact of discrimination on the mental health of trans female youth and the protective effect of parental support. AIDS Behav 2016;20:2203–11. doi:10.1007/s10461-016-1409-7.

Bar MA, Jarus T, Wada M, et al. Male-to-female transitions: Implications for occupational performance, health, and life satisfaction. Les transitions homme-femme/ : conséquences en matière de rendement occupationnel, de sante et de satisfaction face à la vie. Can J Occup Ther 2016;83:72–82.

Burgess D, Lee R, Tran A, et al. Effects of perceived discrimination on mental health and mental health services utilization among gay, lesbian, bisexual and transgender persons. J LGBT Health Res 2008;3:1–14.

Simon L, Schararger SM, Clacrk LF, et al. Parental support and mental health among transgender adolescents. J Adolesc Health 2013;53:791-3. doi: 10.1016/j.jadohealth.2013.07.019.

Nemoto T, Bödeker B, Iwamoto M. Social support, exposure to violence and transphobia, and correlates of depression among male-to-female transgender women with a history of sex work. Am J Public Health 2011;101:1980–8.

Weissman A, Ngak S, Srean C, et al. HIV prevalence and risks associated with HIV infection among transgender individuals in Cambodia. PLoS ONE 2016;11:e0152906. doi:10.1371/journal.pone.

Basar K, Gokhan O, Jale K. Perceived discrimination, social support, and quality of life in gender dysphoria. J Sex Med 2016;7:1133-41. doi: 10.1016/j.jsxm.2016.04.071.

Wilson EC, Garofalo R, Harris RD, et al. Transgender female youth and sex work: HIV risk and a comparison of life factors related to engagement in sex work. AIDS Behav 2009;13: 902–13.


  • There are currently no refbacks.

Copyright (c) 2017 Universa Medicina

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

Creative Commons License
Universa Medicina by Faculty of Medicine, Trisakti University is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Based on a work at