Gender-Affirming Care Is Not Standard Care in Occupational Therapy: A Scoping Review

Importance: The transgender and gender-diverse (TGD) community faces significant health care disparities,including elevated rates of mental health issues, poverty, and barriers to accessing affirming care. Occupational therapy practitioners are ethically obligated to provide gender-affirming care, yet there are no practice guidelines for such care.Objective: To examine the landscape of gender-affirming care within occupational therapy practice, aiming to identify gaps for future research and guidelines.Data Sources: Six databases (MEDLINE, EMBASE, Scopus, PsycINFO, CINAHL, Web of Science). Search dates ranged from database inception to September 19, 2023.Study Selection and Data Collection: We followed Preferred Reporting Items for Systematic reviews and MetaAnalyses extension for Scoping Reviews (PRISMA -ScR) and Joanna Briggs Institute guidelines for all methodologies.Studies were included if they described gender-affirming care, included language related to the transgender and gender-diverse community, and mentioned occupational therapy. Studies were excluded if they were not peerreviewed or did not include an intervention.Findings: A total of 614 studies were identified, and 17 were included. Of the included studies, the majority were qualitative (n 5 9) and from the United States or Canada. Published research highlighted clinicians’ need for more training in gender-affirming care and suggested diverse modalities to bridge gaps in working with TGD individuals.Conclusions and Relevance: This review underscores the urgent need for targeted research to address TGD individuals’ specific needs in occupational therapy practice. Future efforts should focus on developing and evaluating gender-affirming care interventions, expanding training modalities, and promoting inclusive care within occupational therapy.