{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T02:32:19Z","timestamp":1782873139634,"version":"3.54.5"},"reference-count":82,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2025,6,20]],"date-time":"2025-06-20T00:00:00Z","timestamp":1750377600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Travestis and transgender women in Brazil face a disproportionate burden of mental health conditions, exacerbated by structural discrimination, violence, and social exclusion. This narrative review synthesizes evidence on the prevalence of depression, anxiety, suicidality, and substance use among travestis and transgender women in Brazil, and examines intersecting social and health disparities. We searched PubMed, Embase, and PsycINFO in April 2025, identifying peer-reviewed studies in English or Portuguese reporting mental health outcomes or associated social determinants of health in this population. Thirty-one studies across twelve different cities (n = 7683) were included and grouped into two thematic domains. Reported prevalence ranged from 16\u201370.1% for depression, 24.8\u201326.5% for anxiety, and 25\u201347.3% for suicidality. Substance use was also highly prevalent, with studies reporting high rates of alcohol (21.5\u201372.7%), tobacco (56.6\u201361.6%), cannabis (19\u201368.9%), and cocaine\/crack (6\u201359.8%) use. Discrimination, violence, economic hardship, and HIV were consistently associated with psychological distress and barriers to care. These findings underscore the urgent need to integrate mental health, gender-affirming care, and HIV services into Brazil\u2019s Unified Health System (Sistema \u00danico de Sa\u00fade\u2013SUS), strengthen anti-discrimination and violence-prevention policies, and adopt inclusive public health strategies that prioritize the leadership and lived experiences of transgender, nonbinary, and gender diverse people, particularly amid rising political threats to gender-affirming care.<\/jats:p>","DOI":"10.3390\/ijerph22070977","type":"journal-article","created":{"date-parts":[[2025,6,20]],"date-time":"2025-06-20T09:04:49Z","timestamp":1750410289000},"page":"977","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Mental Health Outcomes Among Travestis and Transgender Women in Brazil: A Literature Review and a Call to Action for Public Health Policies"],"prefix":"10.3390","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4217-2399","authenticated-orcid":false,"given":"David R. A.","family":"Coelho","sequence":"first","affiliation":[{"name":"Division of Public and Community Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA"},{"name":"Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Luiza N.","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Instituto Fernandes Figueira, Funda\u00e7\u00e3o Oswaldo Cruz, Rio de Janeiro 22250-020, RJ, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3022-7997","authenticated-orcid":false,"given":"Willians Fernando","family":"Vieira","sequence":"additional","affiliation":[{"name":"Instituto e Centro de Pesquisas S\u00e3o Leopoldo Mandic, Faculdade S\u00e3o Leopoldo Mandic, Campinas 13045-755, SP, Brazil"},{"name":"Departamento de Anatomia, Instituto de Ci\u00eancias Biom\u00e9dicas, Universidade de S\u00e3o Paulo, S\u00e3o Paulo 05367-000, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex S.","family":"Keuroghlian","sequence":"additional","affiliation":[{"name":"Division of Public and Community Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA"},{"name":"The Fenway Institute, Fenway Health, Boston, MA 02215, USA"},{"name":"Department of Psychiatry, Harvard Medical School, Boston, MA 02215, USA"},{"name":"Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sari L.","family":"Reisner","sequence":"additional","affiliation":[{"name":"The Fenway Institute, Fenway Health, Boston, MA 02215, USA"},{"name":"Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02215, USA"},{"name":"Department of Epidemiology, University of Michigan, Ann Arbor, MI 48109, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,6,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1089\/lgbt.2018.0136","article-title":"Psychiatric Epidemiology of Transgender and Nonbinary Adult Patients at an Urban Health Center","volume":"6","author":"Beckwith","year":"2019","journal-title":"LGBT Health"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1037\/cou0000143","article-title":"Discriminatory Experiences Associated with Posttraumatic Stress Disorder Symptoms among Transgender Adults","volume":"63","author":"Reisner","year":"2016","journal-title":"J. Couns. 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