Worldwide prevalence of anxiety in transgender persons: Systematic review with meta-analysis

Objective: This systematic review and meta-analysis estimate the global pooled prevalence of anxiety among transgender individuals. Methods: A comprehensive search was conducted in Scopus, Web of Science, Embase, EBSCOhost, VHL, PsycINFO, and PubMed. Observational studies reporting anxiety prevalence in transgender people were included. Meta-analytical methods were applied using a random-effects model to compute pooled prevalence estimates. Heterogeneity, publication bias, and subgroup analyses were assessed. Results: A total of 71 studies, comprising 73,565 transgender individuals from 23 countries, were included. The global pooled prevalence of anxiety was 43% (95% CI: 38–48%), with higher rates among non-binary individuals (59%) compared to transmasculine (44%) and transfeminine (37%) identities. Significant variability was observed across geographic regions, age groups, ethnicity/race of the samples, and assessment methods. Non-probabilistic sampling and self-reported measures were associated with higher prevalence estimates. Conclusion: Transgender individuals experience a disproportionately high prevalence of anxiety, with notable disparities by gender identity and region. Findings emphasize the need for targeted mental health interventions and inclusive healthcare policies. Standardized methodologies and broader geographical and ethnical representation in future research are essential to enhance global understanding and inform policy development.