Transgender and Gender Diverse Patient Experiences, Care and Health Outcomes in Medical Imaging: A Scoping Review.

Background: Changes in legislation and social attitudes towards transgender and gender diverse (TGD) people have prompted clinical and ethical questions about the experiences, care, and health outcomes of TGD patients in medical imaging.

Aim: The aim of this scoping review is to identify the main themes surrounding TGD patient care in medical imaging. The research question 'What are the current themes surrounding transgender and gender diverse patient experiences, care, and health outcomes in medical imaging?' was developed to guide this exploration.

Methods: A scoping search of the PubMed database for publications dated 2014-2024 was completed. Publications were included if they were considered relevant to the research question after full-text screening. Qualitative thematic analysis was guided by Braun and Clarke's (2006) approach to thematic analysis, and themes were subsequently identified.

Results: The search resulted in 118 publications of which 28 were included after the screening process. Training and education (n = 14), the MID environment (n = 15), diagnostic implications (n = 12), and a lack of specific guidelines in literature (n = 11) were identified as common themes surrounding TGD people's experiences, care, and health outcomes in medical imaging.

Conclusion: The scoping review concludes that TGD patient experiences, care, and health outcomes in medical imaging are impacted by the diagnostic implications of accurately identifying sex and gender, training and education, the MID environment, and a lack of specific guidelines in literature. Is it essential that radiographers, radiologists, and medical imaging staff recognise the impact that accurate identification of sex assigned at birth can have on diagnoses in medical imaging? MIDs must invest in creating accurate and safe methods to identify sex and gender identity and creating environmentally inclusive facilities that are gender-affirming. Disciplines in medical imaging must develop and teach TGD curriculum and champion research aimed at formulating modality-specific guidelines from TGD patient data.