A thematic synthesis of the experiences of transgender and gender diverse people who have waited for gender-affirming care, and an empirical study of the lived experiences of non-binary people who have or had an eating disorder

Noonan, Joshua 2026. A thematic synthesis of the experiences of transgender and gender diverse people who have waited for gender-affirming care, and an empirical study of the lived experiences of non-binary people who have or had an eating disorder. ClinPsy Thesis, Cardiff University. Item availability restricted.

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Abstract

Abstract Background: Transgender and gender diverse (TGD) people face increasingly long wait times to access gender-affirming care. This is of particular concern given the high levels of mental health difficulties reported in this community. A small evidence base has highlighted that prolonged waiting for gender-affirming care may contribute to poorer mental health, functioning and lower quality of life in TGD individuals. This review aimed to synthesise the limited qualitative literature concerning TGD individuals’ experiences of waiting for gender-affirming care. Method: A Thematic Synthesis was used to systematically analyse qualitative studies. Search terms were used to screen papers on relevant databases; full text reviews were conducted on shortlisted papers against the inclusion/exclusion criteria. Ten studies were included in the final analysis. Quality appraisals for the included studies were conducted using the Critical Appraisal Skills Programme (CASP). Findings: Four overarching analytical themes were generated: 1. Uncertain silence - systemic disempowerment and neglect, 2. Liminality – being stuck prevents life moving forward, 3. Waiting is harmful and 4. Enduring the wait and catalysts for action. Conclusion: The findings highlighted experiences of prolonged waiting and associated negative impacts on TGD individuals’ psychological, social and physical wellbeing. Individual adaptive and harmful coping strategies, and community resilience were identified as mitigating the negative effects of waiting. Healthcare systems were perceived as complicated and disempowering, rooted in transnormative and discriminatory systems. The review highlights the importance of timely access to gender-affirming care and psychosocial support for those on waiting lists. The need for improved provider awareness and training in providing genderaffirming care is also recommended. Review limitations and future research recommendations are discussed.

Item Type:	Thesis (DClinPsy)
Date Type:	Completion
Status:	Unpublished
Schools:	Schools > Psychology
Subjects:	B Philosophy. Psychology. Religion > BF Psychology
Date of First Compliant Deposit:	16 September 2026
Last Modified:	16 Sep 2026 11:13
URI:	https://orca.cardiff.ac.uk/id/eprint/189544

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