Transgender and gender various (TGD) people expertise violence to a higher extent in comparison with their cisgender counterparts, together with hate crimes, bodily violence, and sexual and psychological abuse (Stotzer, 2009; Flores et al, 2022). For instance, transgender people are over twice as more likely to expertise bodily and sexual intimate companion violence in comparison with cisgender folks (Peitzmeier et al, 2020).
There are various potential penalties of violence, each within the brief and lengthy phrases. These embody bodily results, corresponding to accidents and transmission of sexually transmitted infections or ailments, and psychological results, corresponding to anxiousness, despair, and suicidality (Rivara et al, 2019). The well being sector is due to this fact important within the therapy of bodily accidents or signs in addition to therapy and prevention of psychological well being deterioration. Nevertheless, TGD people face a number of challenges when making an attempt to entry high quality well being providers, corresponding to care refusals and additional victimisation by well being professionals (Cicero et al, 2019; Strauss et al, 2020 – blogged right here by Dr. Talen Wright).
It’s on this context that Kaptchuk and colleagues (2025) carried out a overview summarising the findings from earlier analysis on elements and practices of well being providers which might be most popular and valued by TGD people and well being suppliers serving them.
The well being sector response to violence in opposition to transgender and gender various people performs a key position in lowering post-violence mortality.
Strategies
Kaptchuk and colleagues (2025) carried out a complete search to be able to determine publications wanting on the traits that TGD adults and well being suppliers supporting TGD people want to discover in well being providers when accessing them after experiencing interpersonal violence. The search included six on-line databases, secondary references, and gray literature, corresponding to convention abstracts and publications on web sites of related organisations. Eligible research included solely TGD adults (18 or older) and/or well being suppliers serving TGD adults, or a extra common inhabitants however the place information on TGD adults solely had been reported. Any methodology was included, so long as it offered major information assortment, in addition to any language and geographical area.
Three reviewers accomplished the screening course of, extracted, and analysed the info utilizing inductive thematic evaluation, which is a analysis strategy in keeping with which the researcher identifies recurring patterns within the information with none pre-established categorisation. Rigor of the recognized themes was assessed utilizing the Grading of Suggestions Evaluation, Growth and Analysis (GRADE), whereas general confidence within the outcomes was assessed utilizing the Confidence within the Proof from Evaluations of Qualitative Analysis (CERQual) strategy.
Outcomes
The overview included 16 research carried out in ten completely different international locations, permitting for the illustration of assorted populations and well being providers. The themes emerged from the evaluation had been:
- Well being supplier training
Individuals mentioned the significance of offering training in well being providers in relation to the completely different types of violence which might be particular to TGD people, in addition to the assorted elements that make TGD people extra susceptible to violence, corresponding to social norms and the intersection of gender id and race. Such training would permit well being professionals and volunteers to offer help that meets the wants of TGD people.
- High quality of care
TGD-individuals-specific high quality of care embody protected, empowering, supportive, and respectful providers and interactions between sufferers and well being suppliers. This contains utilizing the affected person’s most popular pronouns, finishing up bodily examinations in a gender-affirming manner, and utilizing a trauma-informed, victim-centred strategy.
- Inclusive promoting
TGD people typically really feel they don’t seem to be welcome in post-violence well being providers, and they don’t seem to be conscious of what providers can be found to them. Because of this, post-violence well being providers’ promoting ought to be extra inclusive, for instance by focusing on TGD populations, utilizing inclusive language, and by explicitly stating whether or not TGD individuals are served there.
- TGD-inclusive insurance policies and repair environments
Each TGD people and well being suppliers expressed that insurance policies ought to be developed to create a protected and inclusive service surroundings to be able to take away limitations to accessing post-violence help. Options included displaying TGD-affirming stickers, offering gender-inclusive amenities, and growing an express plan on the right way to help TGD people who skilled violence or discrimination.
- Illustration and position of TGD people inside employees, programme improvement, and advocacy roles
Individuals reported that TGD people had a extra optimistic expertise accessing providers when there have been TGD illustration or somebody with violence lived expertise among the many service employees members. Nevertheless, one research within the overview reported that some TGD individuals feared that TGD employees members would disclose the consumer’s personal info to different members of the trans neighborhood.
- Devoted providers for TGD people
Some individuals highlighted the worth of specialized providers to be able to present the suitable help to TGD people who had been victims of violence, assembly their distinctive wants.
- Present well being navigation, coordination, and linkage to providers
So as to entry sufficient and well timed care and help, affected person navigation fashions ought to be developed. Moreover, individuals felt that referrals to gender-affirming providers ought to be facilitated by way of enhanced communication between providers’ employees members.
- Incorporate psychological well being help
Individuals steered that psychological well being help ought to be built-in in post-violence providers, the place well being professionals are educated and conscious of TGD-specific violence and broader socio-structural experiences.
- Accessibility of post-violence healthcare areas
One research within the overview recognized limitations in relation to the situation of gender-based violence providers, that are at lengthy distances from individuals.
Workers coaching provision, transgender and gender various (TGD) illustration, and TGD-inclusive insurance policies are all elements of post-violence providers valued by TGD adults and well being suppliers serving them.
Conclusions
This research by Kaptchuk and colleagues (2025) highlights that there are a number of areas the place enchancment is required to be able to present protected and affirming providers to TGD communities following a violence expertise. As well being suppliers’ training alone will not be sufficient, a multilevel response is due to this fact known as for, involving adjustments at each the societal and structural ranges.
A multilevel response is important for transgender and gender various people to entry high quality post-violence providers.
Strengths and limitations
The findings of this research present helpful insights on the right way to enhance post-violence providers to be able to higher help TGD populations, who face an amazing burden of violence. The research was conceptualised and designed alongside a person with associated lived expertise, making certain that the main target of the analysis remained related to TGD people. The search technique was sound and complete, resulting in each peer-reviewed articles and gray literature being included within the analyses. Moreover, the reviewers assessed rigor and general confidence within the synthesised themes, that are noteworthy within the interpretation of the outcomes.
Nevertheless, some limitations have to be thought of:
- Only some research included within the overview instantly investigated the preferences and values for post-violence providers, whereas others targeted on violence experiences and care-access limitations for TGD populations.
- Most individuals had been transgender ladies, highlighting the necessity for additional examination on transgender males and gender various people’ views.
- Though there’s proof suggesting that transgender and gender various youth face an amazing degree of violence (Goldenberg et al, 2018; Norris et al, 2020) in addition to limitations to affirming-care entry (Inward-Breland et al., 2021), solely grownup individuals had been included within the overview. The inclusion of TGD people youthful than 18 in future research may present further views on values and preferences concerning post-violence providers.
This research has successfully synthesised the present information on the values and preferences of TGD communities in relation to well being providers responding to interpersonal violence.
Implications for observe
The findings of this research’s worth primarily lies with the implications for observe. The views of TGD populations and well being suppliers serving TGD people reported within the overview can inform post-violence well being providers and suppliers in addition to scientific tips. In gentle of the present findings, well being providers could introduce new insurance policies and practices particular to the response to interpersonal violence in opposition to TGD people.
For instance, care suppliers ought to obtain coaching on the distinctive expertise of violence in opposition to the trans neighborhood, understanding the interlocking system of oppression on the base of such violence. Care suppliers also needs to be required to offer respectful and gender-affirming care. Providers’ commercials and public well being programmes also needs to transfer in direction of utilizing extra inclusive language, permitting TGD people to know that prime high quality help is accessible to them.
TGD populations will solely be capable to entry protected, empowering, and affirming post-violence help by multilevel adjustments knowledgeable by TGD’s personal voices and views.
Transgender and gender various voices have to be heard to have the ability to present them with the form of help that meets their distinctive wants.
Assertion of pursuits
None.
Hyperlinks
Major paper
Kaptchuk P R, Kennedy Okay S, Wong B W. et al (2025) Values and preferences concerning the well being sector response to interpersonal violence in opposition to transgender and gender-diverse people: A scientific overview. Lancet Psychiatry. 2025, 12(7)524-534.
Different references
Breland-Inwards D J, Karrington B, & Sequeira G. (2021) Entry to look after transgender and nonbinary youth: Ponder this, innumerable limitations exist. Jama Pediatrics 2021 175(11) 1112-1114.
Cicero E, Reisner S R, Silva S G. et al (2019) Healthcare experiences of transgender adults: An built-in combined analysis literature overview. Advances in Nursing Science 2019 42(2) 123-138.
Flores A R, Stotzer R L, Meyer I H. et al (2022) Hate crimes in opposition to LGBT folks: Nationwide crime victimization survey, 2017-2019. PLoS ONE 2022 17(12).
Goldenberg T, Jadwin-Cakmak L J, & Harper G W. (2018) Intimate companion violence amongst transgender youth: Associations with intrapersonal and structural elements. Violence and Gender 2018 5(1).
Norris A L, & Orchowski L M. (2020) Peer victimization of sexual minority and transgender youth: A cross-sectional research of highschool college students. Psychology of Violence 10(2) 201-211.
Peitzmeier S M, Malik M, Kattari S Okay. et al (2020) Intimate companion violence in transgender populations: Systematic overview and meta-analysis of prevalence and correlates. American Journal of Public Well being 2020 110(9), e1-e14.
Rivara F, Adhia A, Lyons V. et al (2019) The consequences of violence on well being. Well being Affairs. 2019 38(10) 1622-1629.
Stotzer R L. (2009) Violence in opposition to transgender folks: A overview of United States information. Aggression and Violent Behaviour 2009 14(3) 170-179.
Strauss P, Lin A, Winter S. et al (2020) Choices and realities for trans and gender various younger folks receiving care in Australia’s psychological well being system: findings from Trans Pathways. Australian & New Zealand Journal of Psychiatry 2020 55(4).
