Values and preferences regarding the health sector response to interpersonal violence against transgender and gender-diverse individuals: a systematic review

Abstract

Transgender and gender-diverse (TGD) people are disproportionately affected by interpersonal violence and face barriers to accessing post-violence health services globally. Post-violence care guidelines are broadly applicable, but specific considerations for TGD individuals have not been synthesised. In this systematic review, we synthesise the values and preferences of TGD adults and health providers related to post-violence health services. We searched PubMed, Embase, CINAHL, Cochrane Central, LILACS, and PsycINFO for qualitative and quantitative studies reporting on values and preferences related to health services received or sought by TGD adults following interpersonal violence published between Jan 1, 2013, and March 31, 2024. We qualitatively summarised findings by study design, location, and population, and we provided confidence ratings using GRADE CERQual. We included 16 studies reporting data from ten countries. Themes included health provider education, quality of care, inclusive advertising, TGD-inclusive policies and service environments, representation of TGD individuals within service roles, dedicated services, cross-sectoral health navigation and coordination, mental health care, and accessibility of post-violence health-care locations. Health provider training, gender-affirming policies and practices, and inclusive environments can increase access and enhance effectiveness of post-violence health services for TGD individuals. Tailored guidelines for post-violence care provision to TGD people are needed to ensure equitable access globally.