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...

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Main Authors: Jan Francesco Arena, Barbara Adriani, Serena Mancino, Francesca Sarno, Martina Nicole Modesti, Antonio Del Casale, Stefano Ferracuti
Format: Article
Language:English
Published: MDPI AG 2025-02-01
Series:Psychiatry International
Subjects:
Online Access:https://www.mdpi.com/2673-5318/6/1/13
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author Jan Francesco Arena
Barbara Adriani
Serena Mancino
Francesca Sarno
Martina Nicole Modesti
Antonio Del Casale
Stefano Ferracuti
author_facet Jan Francesco Arena
Barbara Adriani
Serena Mancino
Francesca Sarno
Martina Nicole Modesti
Antonio Del Casale
Stefano Ferracuti
author_sort Jan Francesco Arena
collection DOAJ
description 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.
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spelling doaj-art-72d8a29283d1496786c23dd1999271e42025-08-20T01:48:54ZengMDPI AGPsychiatry International2673-53182025-02-01611310.3390/psychiatryint6010013Gender Diversity and Mental Health: A Systematic Review of the Impact of Childhood TraumaJan Francesco Arena0Barbara Adriani1Serena Mancino2Francesca Sarno3Martina Nicole Modesti4Antonio Del Casale5Stefano Ferracuti6Department of Dynamic and Clinical Psychology and Health Studies, Faculty of Medicine and Psychology, Sapienza University of Rome, 00185 Rome, ItalyDepartment of Neuroscience, Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University of Rome, 00189 Rome, ItalyDepartment of Neuroscience, Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University of Rome, 00189 Rome, ItalyDepartment of Neuroscience, Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University of Rome, 00189 Rome, ItalyDepartment of Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, 00185 Rome, ItalyDepartment of Dynamic and Clinical Psychology and Health Studies, Faculty of Medicine and Psychology, Sapienza University of Rome, 00185 Rome, ItalyDepartment of Human Neuroscience, Faculty of Medicine and Dentistry, Sapienza University of Rome, 00185 Rome, ItalyGender-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.https://www.mdpi.com/2673-5318/6/1/13gender identitytransgenderadverse childhood experiencemental healthsocial stigmapsychological discrimination
spellingShingle Jan Francesco Arena
Barbara Adriani
Serena Mancino
Francesca Sarno
Martina Nicole Modesti
Antonio Del Casale
Stefano Ferracuti
Gender Diversity and Mental Health: A Systematic Review of the Impact of Childhood Trauma
Psychiatry International
gender identity
transgender
adverse childhood experience
mental health
social stigma
psychological discrimination
title Gender Diversity and Mental Health: A Systematic Review of the Impact of Childhood Trauma
title_full Gender Diversity and Mental Health: A Systematic Review of the Impact of Childhood Trauma
title_fullStr Gender Diversity and Mental Health: A Systematic Review of the Impact of Childhood Trauma
title_full_unstemmed Gender Diversity and Mental Health: A Systematic Review of the Impact of Childhood Trauma
title_short Gender Diversity and Mental Health: A Systematic Review of the Impact of Childhood Trauma
title_sort gender diversity and mental health a systematic review of the impact of childhood trauma
topic gender identity
transgender
adverse childhood experience
mental health
social stigma
psychological discrimination
url https://www.mdpi.com/2673-5318/6/1/13
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