Background This study explored oral hygiene behavior (OHB), physical and psychological oral discomfort (OD), and their relationship with sense of defeat (SoD) among Indonesian transgender individuals ( warias ), for whom oral health plays a vital role in social and sexual interactions. Given the orofacial area's impact on attractiveness and intimacy, poor oral health may significantly affect the wellbeing and perceived desirability of warias . Methods A cross-sectional study was conducted in March–April 2019 among 92 warias , with a mean age of 36 years (standard deviation = 10.5) in Jakarta, recruited via cluster sampling from five districts. Data were collected using a digital, semistructured questionnaire, including an OHB index and the Indonesian version of the Oral Discomfort Scale, which measures both psychological and physical discomfort. Sense of defeat was also assessed. The study was classified as a one-time, non-invasive procedure and was exempt from medical research regulations. Results Correlation analyses showed that smoking was significantly positively associated with SoD ( r = 0.25, p = 0.019), but not with OD or OHB. Perceived oral health was significantly positively associated with experienced emotional aspect ( r = 0.31, p = 0.003) and with consumption of sugar-containing snacks and/or soft drinks ( r = 0.24, p = 0.02), but it was significantly negatively associated with SoD ( r = −0.24, p = 0.02), OD ( r = −0.26, p = 0.01), and ODPhy ( r = −0.27, p = 0.01). Linear regression analysis identified both SoD ( β = 0.23, p = 0.023) and experienced emotional aspect ( β = −0.30, p = 0.004) as significant independent predictors of OD, explaining 18% of the variance R 2 = 0.18, F (3,91) = 7.58, p = 0.001. The variable expectations of optimal OHB did not have a significant effect ( β = −0.11, ns). Conclusions Psychological distress—particularly feelings of defeat—plays a significant role in the oral health of Indonesian warias . Healthcare and social service providers consider this connection and both emotional wellbeing and oral self-care in interventions.
Buunk‐Werkhoven et al. (Wed,) studied this question.