Experiences and Perceptions of Trans and Gender Non-Binary People Regarding Their Psychosocial Support Needs: A Systematic Review of the Qualitative Research Evidence

McCann, Edward; Donohue, Gráinne; Brown, Michael

doi:10.3390/ijerph18073403

Cited by 17 publications

(8 citation statements)

References 60 publications

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“…Indeed, the available literature indicates that nonbinary, gender nonconforming, and transgender youth are at heightened risk for a range of psychiatric disorders including mood and anxiety disorders, and for suicide (Reisner et al., 2016; Wolford‐Clevenger, Frantell, Smith, Flores, & Stuart, 2018). Transgender and gender nonconforming people worldwide face minority stress and discrimination (McCann, Donohue, & Brown, 2021), and difficulties accessing health care (Koch, McLachlan, Victor, Westcott, & Yager, 2019). In recent years, as the human rights of transgender and gender nonconforming people has become more of a political spotlight, discrimination, personal attacks, and restrictions on healthcare access may further exacerbate mental health disparities with cisgender people.…”

Section: Part V: Conclusion: Levels Of Intervention and Pathways Forwardmentioning

confidence: 99%

Annual Research Review: Sex, gender, and internalizing conditions among adolescents in the 21st century – trends, causes, consequences

Keyes

Platt

2023

Child Psychology Psychiatry

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Internalizing conditions of psychopathology include depressive and anxiety disorders; they most often onset in adolescence, are relatively common, and contribute to significant population morbidity and mortality. In this research review, we present the evidence that internalizing conditions, including depression and anxiety, as well as psychological distress, suicidal thoughts and self‐harm, and fatal suicide, are considerably increasing in adolescent populations across many countries. Evidence indicates that increases are currently greatest in female adolescents. We present an epidemiological framework for evaluating the causes of these increases, and synthesize research on whether several established risk factors (e.g., age of pubertal transition and stressful life events) and novel risk factors (e.g., digital technology and social media) meet conditions necessary to be plausible causes of increases in adolescent internalizing conditions. We conclude that there are a multitude of potential causes of increases in adolescent internalizing conditions, outline evidence gaps including the lack of research on nonbinary and gender nonconforming populations, and recommend necessary prevention and intervention foci from a clinical and public health perspective.

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Section: Part V: Conclusion: Levels Of Intervention and Pathways Forwardmentioning

confidence: 99%

Annual Research Review: Sex, gender, and internalizing conditions among adolescents in the 21st century – trends, causes, consequences

Keyes

Platt

2023

Child Psychology Psychiatry

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“…Most of the literature in this review comes from a medical standpoint, which tends towards a deficit model of characterisation as the focus is on identifying and treating illness. Some qualitative studies have addressed more positive accounts and the importance of taking a non-pathologising stance [85], but this research tends to focus on adults' experiences. None in the present sample focused on characterising resilience factors, and this will be an important direction for future research.…”

Section: Plos Global Public Healthmentioning

confidence: 99%

A PRISMA systematic review of adolescent gender dysphoria literature: 2) mental health

Thompson

Sarovic

Wilson

et al. 2022

PLOS Glob Public Health

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It is unclear whether the literature on adolescent gender dysphoria (GD) provides sufficient evidence to inform clinical decision making adequately. In the second of a series of three papers, we sought to review published evidence systematically regarding the extent and nature of mental health problems recorded in adolescents presenting for clinical intervention for GD. Having searched PROSPERO and the Cochrane library for existing systematic reviews (and finding none), we searched Ovid Medline 1946 –October week 4 2020, Embase 1947–present (updated daily), CINAHL 1983–2020, and PsycInfo 1914–2020. The final search was carried out on the 2nd November 2020 using a core strategy including search terms for ‘adolescence’ and ‘gender dysphoria’ which was adapted according to the structure of each database. Papers were excluded if they did not clearly report on clinically-likely gender dysphoria, if they were focused on adult populations, if they did not include original data (epidemiological, clinical, or survey) on adolescents (aged at least 12 and under 18 years), or if they were not peer-reviewed journal publications. From 6202 potentially relevant articles (post deduplication), 32 papers from 11 countries representing between 3000 and 4000 participants were included in our final sample. Most studies were observational cohort studies, usually using retrospective record review (21). A few compared cohorts to normative or population datasets; most (27) were published in the past 5 years. There was significant overlap of study samples (accounted for in our quantitative synthesis). All papers were rated by two reviewers using the Crowe Critical Appraisal Tool v1·4 (CCAT). The CCAT quality ratings ranged from 45% to 96%, with a mean of 81%. More than a third of the included studies emerged from two treatment centres: there was considerable sample overlap and it is unclear how representative these are of the adolescent GD community more broadly. Adolescents presenting for GD intervention experience a high rate of mental health problems, but study findings were diverse. Researchers and clinicians need to work together to improve the quality of assessment and research, not least in making studies more inclusive and ensuring long-term follow-up regardless of treatment uptake. Whole population studies using administrative datasets reporting on GD / gender non-conformity may be necessary, along with inter-disciplinary research evaluating the lived experience of adolescents with GD.

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“…One of the challenges of the future in trans-specific care will be enabling access to it without pathologizing transsexual persons as mentally ill. Some transsexual persons nowadays even feel relieved when “receiving” the necessary diagnosis [ 35 ]. In our opinion, the diagnosis of a mental illness should neither be the precondition for an acknowledgment of transsexualism nor be necessary for opening the gates to trans-specific care.…”

Section: Discussionmentioning

confidence: 99%

Restriction of Access to Healthcare and Discrimination of Individuals of Sexual and Gender Minority: An Analysis of Judgments of the European Court of Human Rights from an Ethical Perspective

Skuban

Orzechowski

Steger

2022

IJERPH

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Individuals of sexual and gender minority (SGM) form a vulnerable group with specific healthcare needs that might be prone to experience discrimination and restrictions regarding their access to healthcare. As the judgments of the European Court of Human Rights (ECtHR) offer a normative perspective on these issues, we analyzed them systematically (1) to identify whether and in what manner ECtHR’s judgments concern restriction of access to healthcare for SGM individuals and (2) to identify and categorize the ways of discrimination to which SGM individuals are exposed. We conducted a systematic search of the database of the ECtHR’s judgments with the use of specified search terms. Descriptive statistics were performed on the identified judgments. Subsequently, we analyzed the judgments with the use of a qualitative method of thematic analysis. We identified n = 73 cases relevant for our study. In n = 7 (9.59%) of judgments, we found limitations of access to healthcare for SGM individuals, e.g., in cases of restrictions for transsexual individuals to receive hormone or surgical therapy. We regard this as a specific form of discrimination. Furthermore, we identified five other categories of discrimination: restriction of parental rights, failure to respect one’s gender identity/sexual orientation, discrimination by jurisdiction, prohibition of promotion, and verbal/physical attacks. The ECtHR proves to have a balanced view on the sensitive topic of sexual self-determination condemning any form of discrimination or restriction of access to healthcare. However, there is a need for further research on discriminatory acts by other individuals, e.g., healthcare providers, rather than by public authorities.

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Experiences and Perceptions of Trans and Gender Non-Binary People Regarding Their Psychosocial Support Needs: A Systematic Review of the Qualitative Research Evidence

Cited by 17 publications

References 60 publications

Annual Research Review: Sex, gender, and internalizing conditions among adolescents in the 21st century – trends, causes, consequences

Annual Research Review: Sex, gender, and internalizing conditions among adolescents in the 21st century – trends, causes, consequences

A PRISMA systematic review of adolescent gender dysphoria literature: 2) mental health

Restriction of Access to Healthcare and Discrimination of Individuals of Sexual and Gender Minority: An Analysis of Judgments of the European Court of Human Rights from an Ethical Perspective

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