Healthcare Experiences of Transgender and Gender Minority Migrants in the US: A Scoping Review

Background and Purpose: There are approximately 47.8 million immigrants in the US, making up 14.3% of the population. Within this population are around 175,000 transgender immigrants fleeing from violence and discrimination, seeking gender-affirming freedom and economic opportunity. Gender minorities, which include trans and gender nonconforming people, who are migrants, refugees, or asylum seekers are vulnerable to gender-based violence, transphobia, and limited protection in public spaces. Studies show that stressors from being a gender minority exacerbate health disparities. Gender minorities can experience mistreatment, misgendering, and administrative barriers when seeking healthcare. There is increasing literature on healthcare of LGBTQIA+ migrants, but gender minority populations are frequently grouped in with sexual minorities despite their unique differences. While sexual minorities are distinguished by their sexual orientation, gender minorities are defined as individuals whose gender identity does not align with their gender assigned at birth. Studies solely focused on gender minority immigrants are extremely limited, leaving a critical gap in the literature on this population’s unique challenges and experiences. Hence, this scoping review examined research on experiences of gender minority migrants in the US healthcare system.

Methods: This scoping review followed Arksey and O’Malley’s five-stage framework. Peer-reviewed articles and gray literature published between 2014 and 2025 were identified through PubMed, Google Scholar, EBSCO, and ProQuest. Studies that a) focused solely on transgender and gender non-conforming migrants, 2) were based in the US, and 3) covered US healthcare experiences were included. Keywords such as transgender, migrants, and healthcare were searched to retrieve 811 study reports. A two-staged review, a title and abstract review followed by a full-text review, was conducted by two independent researchers to select the final 13 studies for synthesis. The findings sections from the selected studies were extracted and coded using NVivo 14. Codes were assembled to establish relationships among themes and sub-themes. A diagram was then created to represent the findings.

Results: The thematic analysis revealed individual and systemic factors that contribute to gender minority migrants’ experiences in the American healthcare system. These themes were organized by pre-migration and post-migration factors. Pre-migration factors included trauma, country of origin, and violence. Post-migration factors included substance abuse, internalized assimilation, resettlement location, and immigration status. This scoping review summarized barriers to continuous and gender-affirming healthcare, such as cost, transportation, stigma, and distrust. Protective factors included self-acceptance and being further along in one’s transition. These factors contributed to outcomes in healthcare experiences of discrimination, fear, poor health, hesitancy, and unsafe/non-medical care.

Conclusion and Implications: This review synthesized fragmented and limited research on gender minority migrants and their experiences seeking and utilizing healthcare in the US. Participants expressed the need for more expertise in trans and immigrant health in clinics. Other recommendations included non-stigmatized sexual health promotion, accessible and competent healthcare, and gender-affirming facilities and care. With these findings, health clinics and policymakers can implement change to provide gender-affirming and culturally appropriate healthcare. Future research should further explore the varying experiences of migrants’ healthcare experiences based on immigration status, resettlement location, and reason for migrating.