To map the existing literature on transgender and gender-diverse (TGD) people’s experiences of healthcare in the UK, summarising key findings and characteristics of current research.

This scoping review was guided by the Arksey and O’Malley framework and reported in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines.

MEDLINE, Embase, PsycINFO and Web of Science were searched on 29 October 2024. Reference lists of included studies were searched to identify further relevant literature.

Primary research of any design reporting the healthcare experiences of TGD people in the UK from 2019 onwards was included.

Relevant data were extracted using a data charting form guided by the research questions and the Arksey and O’Malley framework. Results were narratively synthesised to provide a comprehensive overview of the literature.

52 studies were included, comprising qualitative (n=38), mixed-methods (n=12) and quantitative (n=2) designs. TGD people reported varying experiences across general and transition-related healthcare settings. Positive experiences were often attributed to individual clinicians. Negative experiences were common, including transphobic discrimination, insufficient clinician knowledge and barriers to effective transition-related care. Strategies for navigating healthcare, such as information sharing within the TGD community and educating clinicians about trans health needs, reflected adaptive responses to systemic barriers.

The findings highlight a need for greater recognition of diverse gender identities, more inclusive approaches in healthcare education and practice and further targeted research. This is especially urgent in light of the recent UK Supreme Court judgement regarding definitions of ‘sex’ under the Equality Act 2010, the emerging implications of which risk compounding existing barriers by reinforcing exclusionary practices within healthcare settings and further limiting recognition and protections for TGD people in the UK.

To explore the challenges experienced by people with intellectual disability, their carers and health and social care professionals when using and managing medication.

A synthesis of qualitative research using meta-ethnography.

We searched seven databases: MEDLINE, Embase, CINAHL, Science, Social Science and Conference Proceedings Citation Indices (Web of Science), Cochrane Library, PsycINFO and Proquest Dissertations and Theses from inception to September 2022 (updated in July 2023).

We included studies exploring the challenges and perceptions of people with intellectual disability, their carers and health and social care professionals regarding medication management and use.

We reviewed 7593 abstracts and 475 full texts, resulting in 45 included papers. Four major themes were identified: (1) Medication-related issues, (2) navigating autonomy and relationships, (3) knowledge and training needs and (4) inequalities in the healthcare system. We formulated a conceptual framework centred around people with intellectual disability and described the interconnectedness between them, their carers and health and social care professionals in the process of managing and using medication. We identified challenges that could be associated with the person, the medication and/or the context, along with a lack of understanding of these challenges and a lack of capability or resources to tackle them. We developed an overarching concept of ‘collective collaboration’ as a potential solution to prevent or mitigate problems related to medication use in people with intellectual disability.

The effective management of medication for people with intellectual disability requires a collaborative and holistic approach. By fostering person-centred care and shared decision-making, providing educational and practical support, and nurturing strong relationships between all partners involved to form a collective collaboration surrounding people with intellectual disability, improved medication adherence and optimised therapeutic outcomes can be achieved.

CRD42022362903.