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Transgender and gender-diverse individuals experience elevated mental health harms, including high lifetime prevalence of suicide attempts, binge drinking, and tobacco use. These risks are linked to stigma, discrimination, pathologization, economic marginalization, violence, and health-provider denial, making communication-centered supportive care 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supportive gap  \nSidhant Ochani, MBBSa,*, Syeda Ilsa Aaqil, MBBSb, Alishba Adnan, MBBSc, Abubakar Nazir, MBBSd,  \nArpit Mago, MBBSe, Sumran Azam, MBBSc, Kaleem Ullah, FCPS, FACSf, Md. Asaduzzaman Nur, MBBS, MRCS, MSg  \nAbstract  \nGender-affirming healthcare is a comprehensive approach that aims to support individuals in transitioning from the gender  \nassigned to them at birth to their affirmed gender, aligning with their gender identity. This type of care involves medically necessary and scientifically supported interventions within a multidisciplinary framework. Gender dysphoria, also known as gender incongruence or transsexuality, refers to the experience of a mismatch between an individual’s biological sex and their internal sense of gender, known as gender identity. Gender identity can encompass a range of expressions and may include identifying as neither exclusively male nor female, allowing for a spectrum of gender diversity. Studies conducted in the past have revealed alarming statistics, showing that transgender and gender-diverse (TGD) individuals face a 41% lifetime prevalence of suicide attempts, a lifetime prevalence of binge drinking ranging from 7% to 61%, and a 33% prevalence of tobacco use. The increased vulnerability to adverse mental health outcomes among TGD individuals can be attributed to a variety of factors, including the presence of stigma, discrimination, pathologization, economic marginalization, violence, and the distress arising from a misalignment between their gender identity and societal expectations rooted in their assigned sex at birth. Research reveals that a significant proportion of gender and sexual minority adults have experienced discrimination from healthcare providers, with approximately 8% of sexual minorities and 25% of transgender individuals reporting being denied healthcare services. This review outlines the bridging of the communication and supportive gap in gender-affirming care to improve patient outcomes and overall quality of care. Keywords: gender affirming care, gender dysphoria, gender minority, LGBTQIA, mental health  \nIntroduction  \nGender-affirming healthcare is a multidisciplinary approach that supports individuals transitioning from their sex assigned at birth to their affirmed gender, aligning with their gender identity[1] . Gender dysphoria, also called gender incongruence, is the distress caused by a mismatch between biological sex and internal gender identity [2] . A transgender woman identifies as female but was assigned male at birth, while a transgender man identifies as male but was assigned female.  \naDepartment of Medicine, Khairpur Medical College, Khairpur Mir’s, Pakistan, bDepartment of Medicine, Jinnah Sindh Medical University, Karachi, Pakistan, cDepartment of Medicine, Karachi Medical and Dental College, Karachi, Pakistan, dDepartment of Medicine, King Edward Medical University, Lahore, Pakistan, eDepartment of Medicine, Jawarharlal Nehru Medical College, Belgaum, Karnataka, India, fDepartment of Hepatobiliary Surgery, Al-Amiri Hospital, Kuwait and gFaculty of HPB Surgery, Enam Medical College, Dhaka, Bangladesh  \nSponsorships or competing interests that may be relevant to content are disclosed at the end of this article.  \n*Corresponding author. Address: Department of Medicine, Khairpur Medical College, Khairpur Mir’s, Sindh 66020, Pakistan. Tel.: +923362467667.  \n[E-mail: sidhantochani1@gmail.com](E-mail: sidhantochani1@gmail.com) (S. Ochani).  \nCopyright © 2025 The Author(s). Published by Wolters Kluwer Health, Inc. This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.  \nAnnals of Medicine & Surgery (2026) 88:554–560  \nReceived 12 October 2025; Accepted 17 November 2025  \nPublished online","cbCaihbb2JnUzPoV","https://ap.wps.com/l/cbCaihbb2JnUzPoV","pdf",277869,"English","# Introduction\n## Gender-affirming healthcare and gender dysphoria\n## Mental health burdens in transgender and gender-diverse people\n## Barriers in healthcare access and provider communication","[{\"question\":\"What does gender-affirming healthcare aim to achieve?\",\"answer\":\"It supports individuals transitioning from their sex assigned at birth to their affirmed gender, aligning care with their gender identity through medically necessary, scientifically supported interventions within a multidisciplinary framework.\"},{\"question\":\"How is gender dysphoria defined in the review?\",\"answer\":\"Gender dysphoria (gender incongruence) is distress caused by a mismatch between an individual’s biological sex and their internal sense of gender (gender identity).\"},{\"question\":\"Why do transgender and gender-diverse individuals face higher adverse mental health outcomes?\",\"answer\":\"The review links vulnerability to factors such as stigma, discrimination, pathologization, economic marginalization, violence, and distress from incongruence between identity and societal expectations.\"}]","Mental health implications of gender affirming care - bridging the communication and supportive gap | PDF",1790690503,18]