Gender diversity and mental health: a systematic review of the Impact of childhood trauma

Gender-diverse populations are at a higher risk of experiencing adverse childhood experiences (ACEs) and social stigma, with a significant impact on both mental and overall health. This systematic review, conducted in accordance with PRISMA guidelines, included 14 studies published between 2016 and 2024. Observational studies were extracted from MEDLINE, CINAHL, APA PsycInfo, and APA PsycArticles to explore the prevalence of ACEs and their effects on mental and physical health in gender-diverse individuals. Studies were assessed for quality using the AXIS tool. The studies included revealed elevated rates of ACEs, particularly in the form of abuse. ACEs were strongly associated with an increased risk of depression, anxiety, stress-related disorders, and suicidality. Discrimination further amplified these effects, particularly among racial and ethnic minorities, leading to a higher engagement in risky behaviors and poorer physical health outcomes. Protective factors identified included secure attachment, access to gender-affirming care, and strong social support. The findings emphasize the urgent need for trauma-informed and culturally sensitive interventions that address both the immediate and long-term effects of ACEs in gender-diverse populations. Future studies should prioritize longitudinal designs and tailored interventions to meet the healthcare needs of these communities and develop mental health prevention strategies.