Mental health of cisgender and transgender during COVID-19 pandemic

Normally every individual wants to lead a free life movement but sometimes could not possible due to external environmental effects. During and after the home quarantine, people are still scared by consistent death and infected news of 2019-nCoV pandemic. Which is why, most of the persons have been feeling insecure and nervous that significantly growing up long term stress. The current study depicts the ongoing mental health condition of Bangladeshi cisgender and transgender individuals caused by SARS-CoV-2 outbreak.


Introduction
At present, our healthy world has been badly suffering from a bio-attack, Coronavirus pandemic Therefore, most of the persons would be more sensitive especially for communicating with others than before. In the literature, some researchers found that cisgender and transgender living in a developing country is mainly stressed due to financial obstacles during the COVID-19 crisis [7,8].

Materials and Methods
Study method and sampling: The present study  Exclusion criteria: Participants having surgery records within the last six months or less and suffering from other major diseases like blood cancer were excluded from this study.

Statistical tools:
The survey data arranged on MS Excel, which was inserted on the STATA (15.0) platform to conduct the study analysis. Table 1 indicate the overall stress level of cisgender and transgender living in Bangladesh. In the country, mental stress has significantly increased (M=32.61) due to the 2019-nCoV pandemic, which is higher than China (M=23.65)

Results in
[1].     -2.93, p=0.000, 95% CI -1.81 to -3.09). Specifically, transgender people were in a dire situation because of less access to daily income, which has been statistically evidenced in Table 5.

Discussion
In the current COVID-19 pandemic, the research on  One of the studies ' relevant facts is that age and education levels haven't any significant impact on mental stress during an external or uncontrollable environmental pandemic but the other major differences in stress levels are denoted and significant by infected status, financial constraints, and exercise. However, the social changes such as long term restrictions on moving out and limited access to outside dramatically have reduced the income or day-to-day working opportunity mostly for transgender people than cisgender individuals in the country.
Therefore, the home quarantine procedure was like a prison life for all. This rising issue had vastly developed mental illness among cisgender as well as transgender people and reasonably they experienced high levels of stress. According to the results distributed in Table 2, similar to previous research, the current study found that mental illness might not be developed surprisingly because of any change in age or education level [1,6]. In contrast, doing daily exercise less or more significantly reduces mental stress (Table 4), which is found relevant to other recent mental health studies [1,5,6].
The study results also showed that individuals who stopped working during the lockdown were more stressed than individuals working from home (online desk) or having other working sources for income.

Limitations
Similar to other research studies, this study faced some limitations. Firstly, the present study was derived from evidence on selected divisions by a cross-sectional survey. Therefore, the study findings are predictable only. Secondly, in the present study sample, several participants were found as infected by SARS-CoV-2 but the number of those participants wasn't really large. Thirdly, the study results show a comprehensive overview of severe levels (focus on stress) of mental illness caused by the COVID-19 pandemic but some of the participants already had similar stress problems due to their previous chronic disease or economic constraints.

Conclusion
To sum up, the current study findings disclose that the mental illness caused by the COVID-19 outbreak is significantly higher among Bangladeshi transgender than cisgender but experiencing depression or stress might disrupt the regular activities of both groups. Furthermore, both cisgender and transgender individuals are mainly being stressed because of financial constraints rather than COVID-19 fear. Therefore, high levels of stress would negatively influence the health and work efficiency as well as the regular life activities of many individuals during or after the COVID-19 pandemic. So, this study recommends adopting daily exercise and positive thinking techniques to reduce mental stress and start a healthy life again. Lastly, the current research also suggests that transgender individuals may need more financial support than cisgender people to reduce their long term mental distress, which would truly increase their life satisfaction.
What does the study add to the existing knowledge In the literature, this study would help to increase knowledge on the mental stress condition of cisgender and transgender due to virus fear and financial constraints in the developing country during the COVID-19 pandemic.
14. I felt scared without any good reason   [Crossref] 11. Fortunato VJ, Harsh J. Stress and sleep quality-The moderating role of negative affectivity. Personality and Individual Differences.