Abstract
Trans and gender non-conforming (TGNC) people experience poor health care and health outcomes. We conducted a qualitative scoping review of studies addressing TGNC people's experiences receiving physical health care to inform research and practice solutions. A systematic search resulted in 35 qualitative studies for analysis. Studies included 1,607 TGNC participants, ages 16–64 years. Analytic methods included mostly interviews and focus groups; the most common analysis strategy was theme analysis. Key themes in findings were patient challenges, needs, and strengths. Challenges dominated findings and could be summarized by lack of provider knowledge and sensitivity and financial and insurance barriers, which hurt TGNC people's health. Future qualitative research should explore the experiences of diverse and specific groups of TGNC people (youth, non-binary, racial/ethnic minority), include community-based methods, and theory development. Practice-wise, training for providers and skills and support for TGNC people to advocate to improve their health, are required.
Highlights
Specialty section: This article was submitted to Public Health Education and Promotion, a section of the journal Frontiers in Public Health
We focused our review on physical health experiences because a recent review of mental health care experiences exists (4); and mental health often requires different approaches, interactions, and treatments than physical health experiences to be combined meaningfully in an analysis of physical health interactions
Authors defined trans in different ways by most commonly including participants who identified as “trans” [e.g., (24, 30, 34, 46)], “trans or gender non-conforming” [e.g., (35, 43, 44)] or as having a different gender identity compared to the birth identity [e.g., (41, 51)]
Summary
Specialty section: This article was submitted to Public Health Education and Promotion, a section of the journal Frontiers in Public Health. Trans and gender non-conforming (TGNC) people experience poor health care and health outcomes. Future qualitative research should explore the experiences of diverse and specific groups of TGNC people (youth, non-binary, racial/ethnic minority), include community-based methods, and theory development. Discrimination and minority stress contribute to higher rates of poor mental health outcomes among TGNC people (4). These outcomes include, but are not limited to, depression (5–7), anxiety (5, 6), and suicide attempts (5, 7, 8). As understanding of the TGNC population and their health needs has increased, the community, itself, has changed to include more diverse identities and experience of gender (13). As a result of this, TGNC individuals may experience negative experiences in healthcare, as a result of societal stigma, and due to competency issues among providers
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