Gender-affirming healthcare for incarcerated transgender and gender diverse people: An international scoping review.

Abstract

<h4>Background</h4>Transgender and gender diverse (TGD) people face unique challenges and have distinct needs while incarcerated. Gender-affirming healthcare improves mental health outcomes and supports gender transition. While in recent years, correctional institutions have begun to recognize and address the gender-affirming healthcare needs of TGD people, there is a lack of understanding and awareness of TGD people's experiences when accessing gender-affirming healthcare while incarcerated.<h4>Aims/method</h4>We conducted a scoping review on international empirical research published from 2018 to 2024 on TGD people's experiences with gender-affirming healthcare while incarcerated using the Joanna Briggs Institute methodology. A search of the databases Web of Science, PsycInfo, and PubMed was completed on May 6, 2024. The data was analyzed using thematic analysis with an abolition feminist framework and transformative approach.<h4>Results</h4>Our search yielded 15 studies published between 2018 and 2024, across eight countries. The studies included qualitative and quantitative method designs. The main outcomes of interest were hormone replacement therapy (HRT), staff competency and training, institutional policies, gender-affirming surgeries, and mental health.<h4>Conclusions</h4>Findings from this review highlight the need for consistent, adequate, trans-informed gender-affirming healthcare for all TGD people experiencing incarceration. TGD people frequently face institutional and interpersonal barriers when trying to access gender-affirming healthcare. There is a need for culturally-informed training for correctional staff and clear policies in correctional settings to ensure the delivery of adequate and gender-affirming healthcare.