BACKGROUND:
Oral health is a core non-communicable disease (NCD) priority and is strongly shaped by social exclusion and constrained living conditions. Transgender people living in urban informal settlements may experience distinctive barriers to maintaining oral hygiene and addressing oral health problems.

METHODS:
We conducted a qualitative phenomenological study using 24 in-depth interviews with transgender people residing in urban informal slums in Odisha, India. Interviews were conducted face-to-face in Odia (average duration 25 minutes), audio-recorded, transcribed, translated into English, and analyzed using thematic analysis, with transcript cross-checking and independent validation.

RESULTS:
Oral hygiene practices were discussed prominently, particularly among trans women engaged in sex work. Participants described routine toothbrushing practices (commonly twice daily) alongside self-reported oral health concerns, including mouth and lip ulcers, burning sensations, white patch-like problems on the lips, and observations of pimple-like growth near the lip area. Some participants linked oral symptoms to night-time work routines and low water intake, while others highlighted that peers often concealed “oral disease” due to fear of comments, stigma, and insecurities. Narratives also suggested that economic pressures could shape sexual practices in ways that participants perceived as compounding oral health risk and delaying help-seeking.

CONCLUSIONS:
Findings indicate that oral health inequities among transgender people in informal settlements reflect intersecting drivers—poverty, stigma, and limited supportive services—consistent with the Congress theme of equity and inclusion. NCD strategies should integrate transgender-affirming oral health promotion, stigma-sensitive counselling, and accessible pathways for oral screening and care through community-based platforms serving transgender communities.