(WITHDRAWN) Unearthing Tgnc Latinx Experiences: A Scoping Review through a Biopsychosocial Lens

Background & Purpose: US-based literature has documented multiple challenges among predominately White transgender and gender nonconforming (TGNC) individuals (e.g., discrimination, violence and limited trans-affirmative health care, etc.). US Latinx communities are also rapidly growing and more diverse (e.g., TGNC, immigrant). Yet, few studies examine individuals living at the intersection of Latinx and TGNC identities in the US. To support the development and implementation of culturally and gender-centered clinical interventions, we conducted a scoping review of peer-reviewed literature across the US and Latin America to identify biological, psychological and social factors that impact health among Latinx TGNC adults.

Methods: We conducted a scoping review with support of a professional librarian. Five electronic bibliographic databases (e.g., Medline, PsychInfo, Pubmed etc.) were used, along with manual searches, to systematically locate articles. Our search strategy included terms for race/ethnicity, country, gender minority status, and physical and mental health. We considered that scholars may use diverse language to refer to Latinx (e.g., Hispanic, Latino, Chicano etc.) and TGNC identities (e.g., genderqueer, trans, travesti etc.,) in the US and Latin America. We included articles that: (1) were English/Spanish peer-reviewed and published after 1990, (2) described biological, psychological, or social factors that impact physical or mental health and (3) described findings from a sample of 50% or more Latinx TGNC individuals, 18 years and over, or explicitly reported on a subsample of Latinx TGNC adults. Two reviewers abstracted key study factors (e.g., aims, designs, findings). Findings were identified via individual readings, iterative dialogue and consensus.

Results: Twenty-six articles met our inclusion criteria. Research was conducted in Mexico (6), Argentina (4), Colombia, Puerto Rico, Peru and US (3 each), and Guatemala, Ecuador, Dominican Republic and Brazil (1 each). The studies used quantitative approaches (12), qualitative methods (9) and mixed-methods (5). Quantitative samples ranged from 56 to 6,451 and qualitative from 10 to 39. Most studies (88%) were conducted in Spanish and most participants (95%) were under 50 years(range:18-98). Gender identities varied widely (e.g., Transgender Male to Female, Intersex, “Draga”, “Transformista”, transvestite/transvesti etc.). Participants’ faced violence, discrimination and stigma that contributed to HIV and STD infection/transmission, poor physical health, gender dysphoria, depression, anxiety and trauma. These stressors were exacerbated by cultural and contextual factors including cisheteronormative social and clinical perspectives, migration, poverty, lack of standardized gender-affirmative medical and mental health services and few employment opportunities. Participants coped with stressors by enhancing their ability to “pass” via the use of unregulated silicone and hormone injections, sex work to meet basic needs, and creating chosen families among other TGNC individuals.

Implications: Latinx TGNC individuals face multiple stressors that are magnified by cultural and contextual factors. More intersectional and localized studies are necessary to advance the knowledge base in this emerging literature that will support the development of culturally-sensitive, trauma-informed, and gender-affirmative medical and mental health services across the lifespan in the US. Future research should employ Community Based Participatory Research principles to enhance acceptability and feasibility of interventions as well as explore other important research areas (e.g., Grand Challenges).