Neglected gaps in improving the health, wellbeing, and care for sexual and gender minority young people living in low- and lower-middle- income countries: a scoping review

Abstract

Abstract Background There is a lack of reliable data on the size, characteristics, and experiences of sexual and gender minority (SGM) young people (ages 10–24) in low- and lower-middle- income countries (LMICs). This review examines the scant research conducted in the last decade with and about SGM young people living in low-income settings and seeks to answer the question: What is known about the mental and physical health needs, safety, and wellbeing of SGM young people living in LMICs? Methods We conducted a scoping review informed by the methodological frameworks put forth by Arksey and O’Malley and the Joanna Briggs Institute. We systematically searched two general social science databases and one topic-specific database for peer-reviewed papers, of any research design, that included SGM young people or explored attitudes toward SGM young people in LMICs. We included papers that reported on factors influencing the health and wellbeing of SGM populations, including physical and mental health, healthcare-seeking behaviors, substance use, experiences of discrimination and/or stigma, experiences of violence and abuse (emotional, physical, and/or sexual), economically motivated paid sex practices, housing or economic security, and attitudes of others toward SGM populations. Results Of the 3,729 unique records identified, 47 papers drawing from data collected from 44 unique studies met the inclusion criteria. Only 26 of the 47 papers included SGM young people as participants, with just 10 exclusively focusing on young people ages 10–24. The included papers were classified into three thematic groupings: attitudes toward SGM populations (n = 20), risks to the health of SGM populations (n = 19), and experiences of stigma and discrimination among SGM populations (n = 8). Conclusion The findings indicate that the research that does exist for SGM young people in LMICs is disjointed and sparse, and often studies are about SGM young people, rather than with and for them. Our review highlights the need for more and better research, more accurate and disaggregated demographic data, and leadership and participation of SGM-led community-based organizations in the co-design of studies that are about them.