Body Image Satisfaction and Gender-Affirming Healthcare in Gender-Diverse Individuals: A Systematic Review and Meta-Analysis

Abstract

Background: There are numerous studies on the need for gender-affirming healthcare and body dissatisfaction in the gender-diverse population. This research often connects these topics with mental health outcomes for the gender-diverse community. However, a succinct summary is needed about how receiving gender-affirming care impacts this population's body satisfaction and mental health. Understanding the connection between body image satisfaction and gender-affirming healthcare may help inform psychological practice and interventions when working with gender-diverse populations.

Objective: This study aims to fill this gap by conducting a systematic review and meta- analysis on the impact of gender-affirming care on body image for gender-diverse individuals.

Methods: A systematic search of Medline, PsycINFO, Emcare, CINAHL, and Scopus was conducted, searching for articles published between 2000-2022. Studies on body image outcomes before and after gender-affirming medical care for gender-diverse individuals were included. The ROBINS-I assessment was used to evaluate the risk of bias. Data was synthesised via a narrative summary and meta-analysis.

Results: The total number of studies included was 13, with a total number of participants of 839 across studies with pre- and post-data. Key results indicate varying effects on body image satisfaction for binary gender-diverse individuals undergoing hormone suppression; however, cross-sex hormone therapy, gender-affirming surgeries, and mixed interventions have a positive impact on body image.

Conclusion: Gender-affirming healthcare was found to have a positive impact on binary gender-diverse individuals’ body image. However, this study has several serious limitations which include high levels of heterogenous data and limited sample sizes that had a lack of diversity. It was also noted that there is a lack of research examining body image and impact of gender-affirming health care for non-binary gender-diverse individuals. Overall, these findings indicate that gender-affirming health care has a positive impact on gender-diverse individuals, however, this study may not be generalizable to the wider gender-diverse population due to the lack of diversity in the included studies.