The health and wellbeing of incarcerated trans, gender diverse, and non-binary people: an international scoping review

Globally there is a growing visibility of trans, gender diverse, and non-binary people in contact with prison systems, and growing questions raised by stakeholders about the health and wellbeing of these populations under state care. This scoping review aims to map the global evidence on the key health and wellbeing issues of incarcerated trans, gender diverse, and non-binary adults and young people to enhance researchers, community and policy makers' capacity to use international evidence to develop locally relevant policies and care models. The review follows Arksey and O'Malley's (2005) five-stage iterative process and PRISMA-ScR guidelines. Eight academic databases and grey literature were searched in May 2024 and again in June 2025. Articles published in all languages were considered. After screening, 57 articles were included and categorised into four themes: (1) general and gender-affirming healthcare; (2) violence; (3) mental health and wellbeing; (4) sexual health and infectious disease; and (5) gender embodiment. Despite geographic, thematic, methodological, and subpopulation knowledge gaps, there is consistent evidence on restricted access to gender-affirming healthcare, systemic mental health challenges and exposure to violence, sexual health risks and HIV care gaps, and creativity and resilience among trans, gender diverse, and non-binary people in the face of gender-affirming attire and grooming restrictions. These findings highlight the need for clear and consistently implemented prison policies and prison diversion strategies. Policies and interventions must be evidence-based, integrated, culturally responsive, sustainably resourced in the face populist discourse, and involve community experts and incarcerated people in their design and evaluation.