Transgender and gender nonconforming people's vulnerability to food insecurity: systematic review and meta-synthesis

Transgender, travesti, and gender nonconforming (TGNC) people are more vulnerable to food insecurity due to stigma and discrimination related to their gender identity. However, there is a lack of qualitative research on this topic. Therefore, this study examines the vulnerability and experiences of trans people with respect to food insecurity. A qualitative systematic review was conducted by searching seven electronic databases for studies in March 2024. Qualitative studies on the experience of food insecurity among trans people were included. The quality of studies was assessed using CASP, while the GRADE-CERQual approach evaluated the reliability of findings, which were then analyzed using meta-synthesis with thematic analysis. A total of 673 records were identified, of which five were selected. The most applied technique was semi-structured interviews. In total, four categories emerged from the meta-synthesis: vulnerability to food insecurity, experience of hunger, repercussions, and coping strategies. The results showed that TGNC people face high levels of stigma, discrimination, and victimization, which impact their food insecurity across different areas of life. Structural barriers, such as limited access to food and stable employment, exacerbate this insecurity, with negative consequences for physical and mental health. Factors such as skin color/ethnicity, gender, gender-based violence and lack of safe housing also contribute to this situation, including forced prostitution as a result of social barriers. Support networks such as the "chosen family" play an important role in reducing these effects. For trans people, the complexity of experiencing food insecurity is linked to transphobia, which creates barriers and violates the right to adequate food. They cope with hunger by activating support networks and seeking food assistance from institutions.