Psychological Distress and Attitudes Toward Seeking Professional Psychological Help among Transwomen in Indonesia

Evelyn Tandias, Theresia Indira Shanti
(Submitted 31 May 2022)
(Published 30 April 2024)


Transwomen are one of the minority groups in Indonesia vulnerable to a high level of psychological distress. The level of psychological distress can indicate the need to seek psychological help. The most basic component of seeking help is attitude. Without a positive attitude, individuals are less likely to have the intention of seeking help and do seeking help. This study aimed to investigate the level of psychological distress, attitudes toward seeking professional psychological help, and the relationship between symptoms of psychological distress with attitudes toward seeking professional psychological help in 117 samples of transwomen in Indonesia. Results indicated that 72% of participants were classified as having a high level of psychological distress. A negative association between anxiety symptoms and psychological openness indicated that the more symptoms of anxiety that participants were experiencing, the less likely they were to open up about their psychological problems.


Attitudes toward seeking professional psychological help; transwomen; psychological distress

Full Text: PDF

DOI: 10.22146/jpsi.75026


Arora, P. G., Metz, K., & Carlson, C. I. (2016). Attitudes toward professional psychological help seeking in South Asian students: Role of stigma and gender. Journal of Multicultural Counseling and Development, 44(4).

Bariola, E., Lyons, A., Leonard, W., Pitts, M., Badcock, P., & Couch, M. (2015). Demographic and psychosocial factors associated with psychological distress and resilience among transgender individuals. American Journal of Public Health, 105(10).

Bartlett, J. E., Kotrlik, J. W. K. J. W., & Higgins, C. (2001). Organizational research: Determining appropriate sample size in survey research appropriate sample size in survey research. Information Technology, Learning, and Performance Journal, 19(1), 43.

Boas, A. A. V., & Morin, E. M. (2014). Psychological well-being and psychological distress for professors in Brazil and Canada. Revista de Administracao Mackenzie, 15(6).

Budge, S. L., Adelson, J. L., & Howard, K. A. S. (2013). Anxiety and depression in transgender individuals: The roles of transition status, loss, social support, and coping. Journal of Consulting and Clinical Psychology, 81(3).

Cardemil, E. V., Nelson, T., & Keefe, K. (2015). Racial and ethnic disparities in depression treatment. In Current Opinion in Psychology (Vol. 4).

Chen, P., Liu, X. J., Wang, X. Q., Yang, B. X., Ruan, J., & Liu, Z. (2020). Attitude toward seeking professional psychological help among community-dwelling population in China. Frontiers in Psychiatry, 11.

Clement, S., Schauman, O., Graham, T., Maggioni, F., Evans-Lacko, S., Bezborodovs, N., Morgan, C., Rüsch, N., Brown, J. S. L., & Thornicroft, G. (2015). What is the impact of mental health-related stigma on help-seeking? A systematic review of quantitative and qualitative studies. In Psychological Medicine (Vol. 45, Issue 1).

Corder, G. W., & Foreman, D. I. (2009). Nonparametric statistics for non-statisticians: A step-by-step approach. John Wiley & Sons, Inc.

Derogatis, L. R., Lipman, R. S., Rickels, K., Uhlenhuth, E. H., & Covi, L. (1974). The Hopkins Symptom Checklist (HSCL): A self‐report symptom inventory. Behavioral Science, 19(1).

Fauk, N. K., Merry, M. S., Putra, S., Sigilipoe, M. A., Crutzen, R., & Mwanri, L. (2019). Perceptions among transgender women of factors associated with the access to HIV/ AIDS-related health services in Yogyakarta, Indonesia. PLoS ONE, 14(8).

Franzen, J., Jermann, F., Ghisletta, P., Rudaz, S., Bondolfi, G., & Tran, N. T. (2021). Psychological distress and well-being among students of health disciplines: The importance of academic satisfaction. International Journal of Environmental Research and Public Health, 18(4).

Goldbach, C., Knutson, D., & Milton, D. C. (2021). LGBTQ+ people and COVID-19: The importance of resilience during a pandemic. Psychology of Sexual Orientation and Gender Diversity, 8(2).

Griffiths, K. M., Crisp, D. A., Barney, L., & Reid, R. (2011). Seeking help for depression from family and friends: A qualitative analysis of perceived advantages and disadvantages. BMC Psychiatry, 11.

Hoffman, B. (2014). An overview of depression among transgender women. In Depression Research and Treatment (Vol. 2014).

Lytle, M. C., Silenzio, V. M. B., Homan, C. M., Schneider, P., & Caine, E. D. (2018). Suicidal and help-seeking behaviors among youth in an online lesbian, gay, bisexual, transgender, queer, and questioning social network. Journal of Homosexuality, 65(13).

Mackenzie, C. S., Knox, V. J., Gekoski, W. L., & Macaulay, H. L. (2004). An adaptation and extension of the attitudes toward seeking professional psychological help scale. Journal of Applied Social Psychology, 34(11), 2410–2433.

McDermott, E., Hughes, E., & Rawlings, V. (2018). Norms and normalisation: understanding lesbian, gay, bisexual, transgender and queer youth, suicidality and help-seeking. Culture, Health and Sexuality, 20(2), 156–172.

McNair, R. P., & Bush, R. (2016). Mental health help seeking patterns and associations among Australian same sex attracted women, trans and gender diverse people: A survey-based study. BMC Psychiatry, 16(1), 1–16.

Mesidor, J. K., & Sly, K. F. (2014). Mental health help-seeking intentions among international and African American college students: An application of the theory of planned behavior. Journal of International Students, 4(2), 137–149.

Mirowsky, J., & Ross, C. E. (2003). Social causes of psychological distress (2nd ed.). Walter de Gruyter.

Mitchell, E., Lazuardi, E., Rowe, E., Anintya, I., Wirawan, D. N., Wisaksana, R., Subronto, Y. W., Prameswari, H. D., Kaldor, J., & Bell, S. (2019). Barriers and enablers to HIV care among waria (transgender women) in Indonesia: A qualitative study. AIDS Education and Prevention, 31(6).

Mojtabai, R., Evans-Lacko, S., Schomerus, G., & Thornicroft, G. (2016). Attitudes toward mental health help seeking as predictors of future help-seeking behavior and use of mental health treatments. Psychiatric Services, 67(6).

Nelson, T., Ernst, S. C., Tirado, C., Fisse, J. L., & Moreno, O. (2021). Psychological distress and attitudes toward seeking professional psychological services among black women: The role of past mental health treatment. Journal of Racial and Ethnic Health Disparities.

Nuttbrock, L., Bockting, W., Rosenblum, A., Hwahng, S., Mason, M., Macri, M., & Becker, J. (2014). Gender abuse, depressive symptoms, and substance use among transgender women: A 3-year prospective study. American Journal of Public Health, 104(11).

Perrin, P. B., Sutter, M. E., Trujillo, M. A., Henry, R. S., & Pugh, M. (2020). The minority strengths model: Development and initial path analytic validation in racially/ethnically diverse LGBTQ individuals. Journal of Clinical Psychology, 76(1).

Rickwood, D., & Thomas, K. (2012). Conceptual measurement framework for help-seeking for mental health problems. Psychology Research and Behavior Management, 5, 173–183.

Rickwood, D., Thomas, K., & Bradford, S. (2012). Help-seeking measures in mental health: A rapid review. Sax Institute, August, 1–35.

Sandanger, I., Moum, T., Ingebrigtsen, G., Sørensen, T., Dalgard, O. S., & Bruusgaard, D. (1999). The meaning and significance of caseness: The Hopkins Symptom Checklist-25 and the Composite International Diagnostic Interview II. Social Psychiatry and Psychiatric Epidemiology, 34(1).

She, R., Mo, P. K. H., Cai, Y., Ma, T., Liu, Y., & Lau, J. T. F. (2021). Mental health service utilisation among transgender women sex workers who are at risk of mental health problems in Shenyang, China: An application of minority stress theory. Health and Social Care in the Community.

Shetty, V., & Jain, T. (2016). Attitudes and stigma towards seeking professional psychological help among college going students. Indian Journal of Mental Health(IJMH), 3(2).

Tan, K. K. H., Ellis, S. J., Schmidt, J. M., Byrne, J. L., & Veale, J. F. (2020). Mental health inequities among transgender people in Aotearoa New Zealand: Findings from the counting ourselves survey. International Journal of Environmental Research and Public Health, 17(8).

Turnip, S. S., & Hauff, E. (2007). Household roles, poverty and psychological distress in internally displaced persons affected by violent conflicts in Indonesia. Social Psychiatry and Psychiatric Epidemiology, 42(12), 997–1004.

Wild, D., Grove, A., Martin, M., Eremenco, S., McElroy, S., Verjee-Lorenz, A., & Erikson, P. (2005). Principles of good practice for the translation and cultural adaptation process for patient-reported outcomes (PRO) measures: Report of the ISPOR Task Force for Translation and Cultural Adaptation. Value in Health, 8(2).

Yamauchi, T., Suka, M., & Yanagisawa, H. (2020). Help-seeking behavior and psychological distress by age in a nationally representative sample of Japanese employees. Journal of Epidemiology, 30(6).

Zay Hta, M. K., Tam, C. L., Au, S. Y., Yeoh, G., Tan, M. M., Lee, Z. Y., & Yong, V. V. (2021). Barriers and facilitators to professional mental health help-seeking behavior: Perspective of Malaysian LGBT individuals. Journal of LGBT Issues in Counseling, 15(1), 38–58.


  • There are currently no refbacks.

Copyright (c) 2024 Jurnal Psikologi

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