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. 2020 Nov;5(11):e003471.
doi: 10.1136/bmjgh-2020-003471.

Health of transgender men in low-income and middle-income countries: a scoping review

Ayden Scheim  1   2 , Vibhuti Kacholia  3 , Carmen Logie  3   4 , Venkatesan Chakrapani  5   6 , Ketki Ranade  7 , Shaman Gupta  8
Affiliations

Health of transgender men in low-income and middle-income countries: a scoping review

Ayden Scheim et al. BMJ Glob Health. 2020 Nov.

Abstract

Introduction: Despite the rapid growth of research on transgender (trans) health globally, the extent of research on trans men and other transmasculine persons assigned the female sex at birth remains unclear. We, therefore, conducted a scoping review on trans men's health in low-income and middle-income countries (LMICs).

Methods: The review included peer-reviewed articles and conference abstracts, and grey literature published from 1 January 1999 to 5 July 2019 in English, French, Hindi or Spanish and reporting original quantitative and/or qualitative data on the health of trans men or transmasculine persons living in LMIC. Studies were excluded if they did not disaggregate data for trans men or if they only described surgical techniques or laboratory values.

Results: We included 53 studies (42 peer-reviewed and 11 grey literature) from 19 LMIC. Most were conducted in higher-middle-income countries (n=12) and in Latin America (n=16, 30.2%), the Middle East (n=14, 26.4%) or Sub-Saharan Africa (n=12, 22.6%) and published in 2014 or later (n=44, 83.0%). Approximately half of studies used quantitative methods (52.8%, n=28), of which 64.3% (n=18) had fewer than 50 participants and 14.2% (n=4) had over 150. Across study designs, social determinants of health and gender-affirming care were the most commonly represented domains (49.1% and 47.1% of studies respectively), with common themes including gender-based violence, coercion and discrimination as well as unprescribed hormone use. Other domains represented included mental health (32.1%), sexual and reproductive health (24.5%), general healthcare access (18.9%), physical health (9.4%) and substance use (9.4%).

Conclusion: Greater inclusion and disaggregation of trans men and transmasculine persons in global health research is needed to support sex- and gender-based analyses of trans health. Community-based research approaches and theoretically driven research may help to increase the relevance and rigour of such research. Funders should invest in research on trans men's health in LMIC.

Keywords: mental health & psychiatry; public health; review; systematic review.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
PRISMA flow diagram. LMIC, low-income and middle-income country; PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses.
Figure 2
Figure 2
Countries represented in peer-reviewed studies on the health of trans men in low-income and middle-income countries.
See this image and copyright information in PMC

References

    1. Winter S, Diamond M, Green J, et al. . Transgender people: health at the margins of Society. Lancet 2016;388:390–400. 10.1016/S0140-6736(16)00683-8 - DOI - PubMed
    1. Marshall E, Claes L, Bouman WP, et al. . Non-suicidal self-injury and suicidality in trans people: a systematic review of the literature. Int Rev Psychiatry 2016;28:58–69. 10.3109/09540261.2015.1073143 - DOI - PubMed
    1. Khobzi Rotondi N. Depression in trans people: a review of the risk factors. Int J Transgend 2012;13:104–16. 10.1080/15532739.2011.663243 - DOI
    1. Baral SD, Poteat T, Strömdahl S, et al. . Worldwide burden of HIV in transgender women: a systematic review and meta-analysis. Lancet Infect Dis 2013;13:214–22. 10.1016/S1473-3099(12)70315-8 - DOI - PubMed
    1. Poteat T, Scheim A, Xavier J, et al. . Global epidemiology of HIV infection and related syndemics affecting transgender people. J Acquir Immune Defic Syndr 2016;72 Suppl 3:S210–9. 10.1097/QAI.0000000000001087 - DOI - PMC - PubMed

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