Reframing hematologic and thrombovascular care for transgender and gender-diverse individuals: a scoping review
- 1Department of Medicine, McMaster University, Hamilton, Canada
- 2Faculty of Health Sciences, McMaster University, Hamilton, Canada
Abstract
Transgender and gender-diverse (TGD) individuals experience well-documented inequities in health care access and quality. Within hematologic and thrombovascular (thrombosis and vascular medicine) care, existing literature has largely emphasized physiologic risk, particularly thromboembolic risk associated with gender-affirming hormone therapy, whereas less attention has been paid to how care is delivered, experienced, and operationalized across clinical settings. The objective of this review was to map and synthesize the literature describing the delivery of hematologic and thrombovascular care for TGD individuals, with a focus on care gaps, facilitators, provider preparedness, and patient experience. We conducted a scoping literature review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines. MEDLINE, Embase, EmCare, and PsycINFO were searched from inception to 1 July 2025. Eligible sources included qualitative, quantitative, and mixed-methods studies addressing hematologic or thrombovascular care in TGD populations. Findings were synthesized descriptively and thematically. A total of 31 articles met the inclusion criteria. The following 4 dominant themes emerged: (1) narrow biomedical framing of thrombovascular risk; (2) variability and uncertainty in clinical decision-making; (3) patient-reported barriers related to stigma, misgendering, and fragmented care; and (4) limited provider training and system-level preparedness. Evidence addressing longitudinal management, shared decision-making, and interdisciplinary care models was sparse. The existing literature on TGD hematologic and thrombovascular care is limited in scope and heavily weighted toward risk reporting/management rather than care delivery. Substantial gaps remain in evidence informing best practices, provider education, and system design. These findings underscore the need for inclusive clinical guidance, education, and consensus-building initiatives.
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BibTeX
@article{sandre2026reframing,
title = {{Reframing hematologic and thrombovascular care for transgender and gender-diverse individuals: a scoping review}},
author = {Anthony R. Sandre and Spruha Joshi and Menaka Pai and Shannon M. Bates},
journal = {Blood Advances},
year = {2026},
month = jul,
doi = {10.1182/bloodadvances.2026020735},
url = {https://doi.org/10.1182/bloodadvances.2026020735},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Reframing hematologic and thrombovascular care for transgender and gender-diverse individuals: a scoping review
AU - Anthony R. Sandre
AU - Spruha Joshi
AU - Menaka Pai
AU - Shannon M. Bates
PY - 2026
DA - 2026/07/28
JO - Blood Advances
DO - 10.1182/bloodadvances.2026020735
UR - https://doi.org/10.1182/bloodadvances.2026020735
AB - Transgender and gender-diverse (TGD) individuals experience well-documented inequities in health care access and quality. Within hematologic and thrombovascular (thrombosis and vascular medicine) care, existing literature has largely emphasized physiologic risk, particularly thromboembolic risk associated with gender-affirming hormone therapy, whereas less attention has been paid to how care is delivered, experienced, and operationalized across clinical settings. The objective of this review was to map and synthesize the literature describing the delivery of hematologic and thrombovascular care for TGD individuals, with a focus on care gaps, facilitators, provider preparedness, and patient experience. We conducted a scoping literature review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines. MEDLINE, Embase, EmCare, and PsycINFO were searched from inception to 1 July 2025. Eligible sources included qualitative, quantitative, and mixed-methods studies addressing hematologic or thrombovascular care in TGD populations. Findings were synthesized descriptively and thematically. A total of 31 articles met the inclusion criteria. The following 4 dominant themes emerged: (1) narrow biomedical framing of thrombovascular risk; (2) variability and uncertainty in clinical decision-making; (3) patient-reported barriers related to stigma, misgendering, and fragmented care; and (4) limited provider training and system-level preparedness. Evidence addressing longitudinal management, shared decision-making, and interdisciplinary care models was sparse. The existing literature on TGD hematologic and thrombovascular care is limited in scope and heavily weighted toward risk reporting/management rather than care delivery. Substantial gaps remain in evidence informing best practices, provider education, and system design. These findings underscore the need for inclusive clinical guidance, education, and consensus-building initiatives.
SN - 2473-9529
SN - 2473-9537
ER -