New York: Over 40 percent unemployed or low-income young transgender women struggle with one or more mental health issues and nearly one in five from two or more psychiatric disorders, according to a new study. Transgender youth includes adolescent and young adult, born as male at birth but identify as girls, women, transgender women, transfemale, male-to-female or another diverse gender identity on the transfeminine spectrum. The study showed that transgender women are a vulnerable population at risk for negative mental health disorders such as depression, anxiety, post-traumatic stress and were addicted to alcohol and other psychoactive substance usage. The team used a diagnostic interview method of 298 sexually active US transgender women (aged 16 - 29) to assess the prevalence of mental health, substance dependence and coexisting psychiatric disorders. Nearly three-quarters of the study group was unemployed and nearly half had an annual income of less than $10,000. "Culturally tailored interventions that work to decrease mental health distress and substance use among young transgender women are needed," said study author Sari L. Resiner, assistant professor at Harvard Medical School in the US. The findings, published online by JAMA Pediatrics, showed that the rate of depressive incidents currently in these women was as high as 14.7 percent and such risks in their lifetime was 35.4 percent. The risk rate of suicide in a month was at 20.2 percent. Anxiety disorder in the past six months stood at 7.9 percent and posttraumatic stress disorders at 9.8 percent. The dependence on alcohol in the past 12 months was 11.2 percent and usage of non-alcohol psychoactive substance was at 15.2 percent. "The entire framework of transgender health care would benefit from a restructuring to meet the needs of patients and clients, as well as acknowledging pragmatic limitations of available professionals," writes Johanna Olson-Kennedy from Children's Hospital Los Angeles, in a related editorial. However, the researchers stressed that the study enrolled relatively poor participants with sexually risky behaviour and, as such, the results cannot be generalised to all transgender women population.