Exploring Interactions Between Transgender, Gender-Diverse, and Nonbinary Individuals and Allied Health Professionals in Clinical Practice: A Scoping Review.

Abstract

Transgender, gender diverse, and nonbinary (TGDNB) individuals access allied health care services for various reasons; however, barriers such as fear of discrimination and stigmatization exist. Little is known about the positive or negative features of health care encounters between allied health professionals and TGDNB individuals. This scoping review sought to (1) summarize current evidence describing health care encounters between allied health professionals and TGDNB individuals; (2) identify the extent of clinical practice guidance specific for allied health professionals; and (3) identify recommendations for improving allied health care for TGDNB individuals. A comprehensive search of four electronic databases and two grey literature sources was conducted from January 1, 2000 to September 26, 2021. Relevant data were extracted and summarized narratively, and recommendations were summarized via table. Thirty-five articles were included in this review. Barriers faced by TGDNB individuals in accessing allied health services included previous negative experiences, lack of clinician competence, financial barriers, travel times, lack of understanding of allied health scope and fear of stigmatization, and discrimination. No clinical guidelines were identified specific to allied health; however, eight key recommendations emerged from the synthesis: a need for TGDNB-specific referrals, resources and advocacy, clinician education, awareness and use of patient pronouns, gender neutral environments, inclusive and welcoming environments, gender-inclusive intake forms, confidentiality and privacy, and reduction of stigma and discrimination. Findings suggest that improvements to optimize allied health care experiences of TGDNB individuals are indicated and feasible. Significant scope remains for patient-centered research to improve health care experiences for TGDNB individuals.