Poverty, Psychological Distress, and Suicidality Among Gay Men and Transgender Women Sex Workers During the Covid-19 Pandemic in Phuket, Thailand

INTRODUCTION: Thai gay men and transgender women (GM&TGW) sex workers are more likely to suffer from economic harm since the sex tourism industry in Thailand has been hit hard by the Covid-19 pandemic. They also are more likely to experience poverty and mental health issues subsequent to the pandemic as minority groups in conservative Thai society. While their highly problematic social and economic situation would predict a wide range of psychological issues, little is known about their mental health. Hence, this study examined the prevalence and symptom severity of psychological distress among the group as well as the associations between suicidal ideation, poverty, and psychological distress.

METHODS: Two hundred seventy questionnaire responses were collected online via Google forms in Phuket in 2021. Data analysis was conducted using SPSS and Smart-PLS.

RESULTS: Based on the results, most respondents had experienced mild to extremely severe symptoms of psychological distress. However, transgender women sex workers scored higher on depression and anxiety compared to gay men sex workers. This study confirmed the prominent associations between the study variables and the mediation effect of psychological distress.

CONCLUSIONS: Poverty resulting from the pandemic imposes a substantial human cost for this vulnerable minority beyond the virus itself as it amplifies mental health problems.

POLICY IMPLICATIONS: The findings further extend our awareness of the discriminatory treatment of Thai GM&TGW sex workers and address a gap in Thai law and policy for prohibiting discrimination against them. It is of urgent necessity for Thai public health and tourism policymakers to establish sound support interventions.