Mental Health of Gender Minority Older Adults in the United States: A Systematic Review

While the mental health of gender minority (GM) individuals has garnered increased attention in recent years, GM older adults (i.e., aged 50 and older) remain overlooked in research. Thus, we conducted a systematic review with the aim of synthesizing and evaluating existing research regarding mental health concerns and disparities, risk factors, and protective factors among GM older adults in the United States. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement, we conducted a search in PubMed, PsycINFO, PsychiatryOnline, Gender Studies Database, GenderWatch, Scopus, and Web of Science. We included peer-reviewed journal articles that were published in English from 2010 onwards, reported research conducted in the United States, and presented data on mental health-related outcomes among GM adults aged 50 years or older. The 31 studies included in this review identified disparities in suicidality, depression and other specific mental health conditions, and general measures of mental health among GM older adults. Studies highlighted risk factors including stigma, violence, and discrimination, along with protective factors including access to social support and affirming health care resources. However, patterns of methodological characteristics (e.g., unrepresentative samples, cross-sectional designs, and measures and analyses that obscured GM older adults' diverse identities) presented important limitations, while the small and heterogeneous nature of the literature yielded limited evidence regarding specific mental health outcomes. There is a critical need for further research that addresses existing methodological gaps and investigates how intersecting forms of marginalization impact the mental health of GM older adults across the life course.