Quantitative research in adult transgender: A conceptually-informed review

Background: The health of transgender individuals and communities has long been overlooked in public health policy, despite emerging research evidence documenting high prevalence rates of negative health indicators. To guide an evidence-informed public health response for the transgender population, we aimed to review and synthesize the published empirical literature on adult transgender health.

Methods: We searched PubMed to identify quantitative articles published through 2012 related to adult transgender health. Articles were excluded if transgender-specific information was not disaggregated from the sample population, if the study only addressed intersex populations, and if the sample focused on youth. Eligible articles were reviewed and categorized thematically to identify trends in research on transgender health.

Results: We identified 9 public health themes characterizing the published empirical research on adult transgender populations: HIV and STIs; mental health; gender affirmation procedures; substance use; social and familial networks; health services; socioeconomic status; stigma and discrimination; global health. The following gaps were identified: Studies focused largely on MTF communities with little research on FTM or non-binary gender identities; small convenience studies were common and were often limited to clinical or community-based samples; non-standardized measures and health indicators were frequently employed; limited recognition of social determinants of health, especially the role of gender affirmation and “syndemics” affecting this population; limited use of theory.

Discussion: Substantial efforts are needed to eliminate the current invisibility of transgender people in public health research, programs, and policies. Reducing transgender public health disparities requires investment in basic research, intervention, and public health services.