A systematic review of recommendations for behavioral health services for transgender and gender diverse adults: The three-legged stool of evidence-based practice is unbalanced.

Abstract

There is a growing literature of clinical recommendations for transgender and gender diverse (TGD) affirming behavioral health care, yet it is unknown to what extent these recommendations are rooted in evidence-based practice (EBP). This systematic review included 65 articles published between 2009 and 2018 with recommendations for behavioral health services with TGD adults, emphasizing general clinical care. Coded variables included type of article, participant demographics, aspects of EBP, and whether care was informed by objective assessment. Most articles did not equally draw from all components of EBP. Recommendations for specific clinical problems are increasingly available and address diversity within TGD communities. More research, including clinical trials adapting established interventions, is needed to inform state-of-the-art TGD-affirmative behavioral health care. Public Health Significance StatementThis study highlights the need for improved guidance for affirming behavioral healthcare with transgender and gender diverse adults that integrates all aspects of evidence-based care: clinical judgment, research evidence, and patient characteristics.

Research on evidence-based practice with transgender adults: A commentary on “A systematic review of recommendations for behavioral health services for transgender and gender diverse adults”.

“…Also, there is still a great need for stronger research and science related to evidence-based practice with TGD populations. The article by Holt et al (2021) provides an excellent overview of the current state of the literature on evidence-based practices with TGD clients and areas that need to be strengthened. Holt et al (2021) reviewed 65 articles published between 2009 and 2018 and evaluated how well these articles integrated evidence-based practice (EBP) approaches.…”

“…The article by Holt et al (2021) provides an excellent overview of the current state of the literature on evidence-based practices with TGD clients and areas that need to be strengthened. Holt et al (2021) reviewed 65 articles published between 2009 and 2018 and evaluated how well these articles integrated evidence-based practice (EBP) approaches. EBP was evaluated through the integration of the best research evidence, use of clinical judgment, and considerations of client characteristics, values, and contexts, as well as the integration of objective assessments.…”

“…Also, there is still a great need for stronger research and science related to evidence-based practice with TGD populations. The article by Holt et al (2021) provides an excellent overview of the current state of the literature on evidence-based practices with TGD clients and areas that need to be strengthened.…”

“…Holt et al (2021) reviewed 65 articles published between 2009 and 2018 and evaluated how well these articles integrated evidence-based practice (EBP) approaches. EBP was evaluated through the integration of the best research evidence, use of clinical judgment, and considerations of client characteristics, values, and contexts, as well as the integration of objective assessments.…”

Transgender and gender-diverse health: A work in progress.

“…Moreover, as with any minority population it is essential that the care is delivered in an affirming, competent manner. Holt and Colleagues (2021) highlight this vital point and conduct a comprehensive review of the literature to evaluate the evidence-base of interventions; their review is not only timely but essential. The findings from Holt et al’s review note key points and gaps that warrant further discussion and guide future directions.…”