Qualitative Psychology, Vol 13(3), Oct 2026, 444-469; doi:10.1037/qup0000372
Transgender and gender-diverse (TGD) people can experience an incongruence between their gender identity and the sex assigned at birth, which for many results in gender dysphoria. International guidelines highlight the importance of gender-affirming interventions (GAIs), whether psychosocial or medical, in supporting mental health and fostering positive emotional change over time. In 2024, the publication of the Cass Review examining evidence on affirming medical treatments for TGD individuals, particularly hormonal interventions, sparked significant public debate. While both the report and subsequent critiques relied heavily on quantitative evidence, such approaches overlook the nuanced and deeply personal ways GAIs influence TGD people’s lives, relationships, and aspirations. This qualitative meta-analysis synthesized findings from 15 qualitative studies exploring the consequences of medical and psychosocial GAIs for TGD individuals with an age mean of 33.6 years for adult participants and 15.4 years for under 18 participants. We systematically searched PubMed, APA PsycInfo, Web of Science, and SCOPUS for studies in English, Spanish, or Portuguese, supplemented by reference list searches. Methodological quality was appraised using a 10-item Critical Appraisal Skills Programe Checklist. Data extraction covered methodological features and findings, which were analyzed through a thematic synthesis combining deductive and inductive approaches. This process yielded four domains of investigation: determinants of GAIs, constituents of GAIs, experiences of nonaffirming actions, and consequences of GAIs. Findings underscore the multilevel nature of GAIs, spanning individual, relational, clinical, and structural dimensions, and highlight both affirming practices and ongoing barriers. The results suggest the need to expand qualitative research in diverse contexts and regions to capture cultural differences and commonalities and to integrate qualitative insights into both mixed method research designs and the practice of GAIs. (PsycInfo Database Record (c) 2026 APA, all rights reserved)