Inequality in accessing sexual and reproductive health for transgender people in South Asia through an intersectional lens: A scoping review.

Background: Transgender individuals face significant barriers to accessing sexual and reproductive health (SRH) services globally. These challenges are exacerbated in South Asian countries, where stigma, discrimination, and a lack of specialized healthcare support prevail. Countries such as India, Nepal, Bangladesh, and Pakistan fall behind in ensuring equal healthcare rights and access for the transgender community. Aim: This scoping review aims to identify and map the existing literature on the barriers faced by transgender adults in South Asia when accessing SRH services. Methods: A comprehensive search was conducted across six databases, focusing on studies addressing the SRH concerns of transgender adults in South Asia. From an initial pool of 410 studies, 16 full-text articles and relevant grey literature were selected for review. Data were analyzed and categorized into three key themes. Results: The review revealed three main themes: (a) Barriers to accessing SRH services, including social rejection, stigma, and healthcare provider gaps; (b) Strategies to improve SRH services, such as community-based interventions and healthcare provider training; and (c) Ethical dilemmas, focusing on patient confidentiality and respectful care. Sub-themes explored the intersectionality of gender identity and access to healthcare, highlighting the urgent need for SRH resources and support. Conclusion: The findings underscore the need for tailored SRH programs and policies to address the disparities faced by transgender adults in South Asia. International support and advocacy are essential to ensure the provision of quality healthcare to this underserved population.