Health-related needs and barriers in transgender populations: a systematic review study
Authors: Moradi Yousef , Mahboobi Marzieh , Moradi Ghobad 
Published: September 2021

Purpose
Identifying the health-related needs in transgender (TG) people can help to formulate strategies for providing appropriate and accessible health services and promoting health and social justice, as well as human rights in these populations. This systematic review aims to determine health-related needs, problems and barriers, as well as ways to solve them in TG people from the viewpoint of TG individuals and health policymakers.

Design/methodology/approach
All international electronic databases such as PubMed (Medline), Embase, CINAHL, Scopus, Web of Sciences, Cochrane, PsycInfo and Google Scholar (Gray Literature) were searched from December 1990 to December 2019. After the search, the articles were screened based on their title, abstract and full text. The quality of articles was assessed using the Strengthening the reporting of observational studies in epidemiology (STROBE), Consolidated Standards of Reporting Trials (CONSORT) and Standards for Reporting Qualitative Research (SRQR) checklists. The search strategy, data extraction and quality evaluation of articles were independently performed by two researchers.

Findings
The general health-related needs identified in TG individuals from the viewpoint of themselves included access to legal hormone therapy, psychological and psychiatric counseling, privacy, health and hygiene needs, equality and freedom of expression. General health-related needs in TG individuals from the viewpoint of health policymakers included screening tests to detect sexually transmitted diseases, especially HIV, cancers and other diseases, as well as training service providers (physicians, nurses, health workers, etc.).

Research limitations/implications
One of the limitations of this study was nonreporting of health-related needs in initial articles by different TG groups because these groups have had different needs and different barriers to accessing health-care services. In this study, health-related needs and barriers to satisfy them were categorized from the viewpoint of TG populations and health policymakers around the world, which may influence future decisions to provide services to TG populations. The results of this systematic review can help to develop different strategies by considering all TGs from individual, family and social aspects to better provide services for this group. However, given the dynamics and changes in the existing communities and the limited studies on gender minorities in developing countries, further research is required to comprehensively address the subject.

Originality/value
The findings can be used as an incentive to improve existing conditions and to address problems and shortcomings. The results of this systematic review formulate strategies for providing appropriate and accessible health services and better lives for TGs, planning for more effective participation of these individuals in local communities, improving their physical problems and mental health through counseling, as well as promoting health and social justice, and human rights for these populations.