Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Mar 11;19(3):e0299373.
doi: 10.1371/journal.pone.0299373. eCollection 2024.

Health status of transgender people globally: A systematic review of research on disease burden and correlates

Ayden I Scheim  1   2 , Ashleigh J Rich  3 , Dougie Zubizarreta  4 , Mannat Malik  5 , Kellan E Baker  6 , Arjee J Restar  7 , Leigh Ann van der Merwe  8 , June Wang  9 , Bianca Beebe  10 , Kathleen Ridgeway  10 , Stefan D Baral  11 , Tonia Poteat  3 , Sari L Reisner  12
Affiliations

Health status of transgender people globally: A systematic review of research on disease burden and correlates

Ayden I Scheim et al. PLoS One. .

Abstract

Background and objectives: Transgender and gender diverse (trans) health research has grown rapidly, highlighting the need to characterize the scientific evidence base. We conducted a systematic review of peer-reviewed research on disease burden and correlates in trans adolescents and adults over a 20-month period to identify knowledge gaps and assess methodological characteristics including measurement of gender identity, community engagement, and study quality.

Data sources, eligibility criteria, and synthesis methods: We searched seven databases using terms related to (a) transgender populations and (b) health or disease. Eligible studies were in English, French, or Spanish and reported original quantitative data on mental health or substance use conditions, infectious diseases, or non-communicable conditions in at least 25 trans individuals aged 15+. Quality assessment was performed in duplicate on a 10% sample of articles and findings were summarized using narrative synthesis.

Results: The 328 included studies were conducted in 45 countries, with most from North America (54%) and limited research from South Asia (3%), Sub-Saharan Africa (3%), and the Middle East and North Africa (2%). Most studies used cross-sectional designs (73%) and convenience sampling (65%). Only 30% of studies reported any form of community engagement. Mental health and substance use disorders were the most studied area (77% of studies) and non-communicable conditions the least (16%). Available data indicated that trans populations experience high disease burden with considerable heterogeneity within and across settings. Of 39 articles assessed for quality, 80% were rated as fair, 18% as poor, and 3% as good quality.

Conclusions and implications: Geographic, gender-specific, and topical gaps remain in trans health, but we found more research from African countries, with transmasculine people, and on non-communicable conditions than previous syntheses. Areas for growth in trans health research include community engagement, non-binary health, chronic and age-related conditions, and health determinants.

Registration: PROSPERO CRD42021234043.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Study selection.
Fig 2
Fig 2. Geographic distribution of studies (n = 328).
©Mapbox, © OpenStreetMap. Map based on Longitude (generated) and Latitude (generated). Color shows details about Heat map group as an attribute. Details are shown for Country. The data is filtered on Heat map group, which excludes Null.
Fig 3
Fig 3. Gender distribution of datapoints (n = 1476).
Abbreviations: SAAB = sex assigned at birth, AMAB = assigned male at birth, AFAB = assigned female at birth, NR = not reported. Note: Transmasculine includes transmasculine people and trans men; transfeminine includes transfeminine people and trans women.
Fig 4
Fig 4. Number of studies and datapoints for mental health and substance use disorders, infectious disease outcomes, and non-communicable conditions.
Note: Percentages will add to 100% for datapoints, but will not add to 100% for studies since studies could report on multiple outcomes.
See this image and copyright information in PMC

References

    1. Pew Research Center. About 5% of young adults in the U.S. say their gender is different from their sex assigned at birth. https://www.pewresearch.org/fact-tank/2022/06/07/about-5-of-young-adults... (accessed September 1 2022).
    1. Meerwijk EL, Sevelius J. Transgender population size in the United States: A meta-regression of population-based probability samples. Am J Public Health 2017;107(2):e1–e8. doi: 10.2105/AJPH.2016.303578 - DOI - PMC - PubMed
    1. Zhang Q, Goodman M, Adams N, Corneil T, Hashemi L, Kreukels B, et al.. Epidemiological considerations in transgender health: A systematic review with focus on higher quality data. Int J Transgender Health 2020;21(2):1–13. doi: 10.1080/26895269.2020.1753136 - DOI - PMC - PubMed
    1. Goodman M, Adams N, Corneil T, Kreukels B, Motmans J, Coleman E. Size and distribution of transgender and gender nonconforming populations: a narrative review. Endocrinol Metab Clin 2019;48(2):303–321. doi: 10.1016/j.ecl.2019.01.001 - DOI - PubMed
    1. Spizzirri G, Eufrásio R, Lima MCP, Nunes HRdC, Kreukels BPC, Steensma TD, et al.. Proportion of people identified as transgender and non-binary gender in Brazil. Sci Rep 2021;11:2240. doi: 10.1038/s41598-021-81411-4 - DOI - PMC - PubMed

Publication types