The Utilization of Syndemic Theory in Transgender Literature: A Structured Literature Review.

Purpose: Trans and gender diverse (TGD) people are one of the world's most marginalized populations. Current evidence indicates that ostracism faced by these communities leads to multiple adverse conditions. The synergistic impact of these conditions -a syndemic-has been well established among other marginalized populations. Despite disproportionate rates of syndemic conditions, there is a dearth of literature exploring their effect among TGD people. This review sought to summarize the current literature regarding syndemic conditions among this population.

Methods: A comprehensive search of databases (Medline, Embase, Global Health, PsycInfo, and CINAHL) was conducted; search terms included syndemics, syndemic theory, transgender, sexual minority, and gender minority. References within selected articles were also reviewed. Inclusion criteria for this review included studies that (1) explored the impact of syndemic factors and/or theory among TGD people, (2) were written in English, and (3) published up to December 2020.

Results: The search generated 192 articles; 10 met the inclusion criteria. Substance use, mental health, and victimization were the most prominent syndemic conditions assessed. Current evidence is limited to sexual risk behaviors and provides preliminary support for an association between syndemic conditions and sexual risk behaviors.

Conclusion: Understanding syndemics is vital to developing contextually suitable interventions or TGD people. Future researchers should work toward longitudinal or high-level modeling approaches of syndemic theory to effectively design interventions to improve health outcomes among TGD people. Furthermore, scholars should study the relationship between syndemic conditions and other outcomes to better understand the impact of syndemics on broader health consequences.