Mental Health and Psychosocial Processes in Transgender and Gender Diverse Adults with Chronic Physical Illnesses: A Scoping Review.

Abstract

Transgender and gender diverse (TGD) adults experience high rates of chronic physical illnesses (CPIs) and mental health difficulties, yet little is known about the psychosocial processes underlying this relationship. This scoping review aimed to map and synthesize the literature examining psychosocial factors associated with mental health among TGD adults living with CPIs. Following PRISMA-ScR and Joanna Briggs Institute guidelines, systematic searches were conducted in PubMed, PsycINFO, Scopus, and Google Scholar. Eligible qualitative and quantitative studies that investigated psychosocial processes and mental health outcomes among TGD adults with CPIs were included. Twenty-five studies met the eligibility criteria. Most were cross-sectional and focused on transgender women living with HIV. Minority stress-related experiences, including stigma, discrimination, trauma, and violence, were consistently associated with depression, anxiety, psychological distress, poorer quality of life, and reduced healthcare engagement. In contrast, social support, community connectedness, resilience, coping, mindfulness, and spirituality emerged as important protective factors. Few studies examined CPIs beyond HIV or biophysiological processes. Overall, the evidence highlights the central role of minority stress in shaping mental health among TGD adults with CPIs while revealing substantial gaps regarding diverse TGD populations, non-HIV chronic illnesses, and transdiagnostic and biopsychosocial mechanisms that should be prioritized in future research.