LGBTQ2S + childbearing individuals and perinatal mental health: A systematic review
Abstract
Background: The perinatal period may uniquely impact the mental health and wellbeing of lesbian, gay, bisexual, transgender, queer, and Two‐Spirit (LGBTQ2S+) childbearing individuals. Objectives: To characterise and synthesise the experiences of LGBTQ2S+ childbearing individuals regarding perinatal mental health, including symptomatology, access to care and care‐seeking. Search strategy: We conducted and reported a systematic review following PRISMA guidelines of eight databases (EMBASE, MEDLINE‐OVID, CINAHL, Scopus, Web of Science: Core Collection, Sociological Abstracts, Social Work Abstract, and PsycINFO) from inception to 1 March 2021. Selection criteria: Original, peer‐reviewed research related to LGBTQ2S+ mental health was eligible for inclusion if the study was specific to the perinatal period (defined as pregnancy planning, conception, pregnancy, childbirth, and first year postpartum; includes miscarriages, fertility treatments and surrogacy). Data collection and analysis: Findings were synthesised qualitatively via meta‐aggregation using the Joanna Briggs Institute System for the Unified Management, Assessment and Review of Information (JBI SUMARI), and the ConQual approach. Main results: Our systematic search included 26 eligible studies encompassing 1199 LGBTQ2S+ childbearing participants. Using the JBI SUMARI approach, we reported 65 results, which we synthesised as six key findings. The studies described unique considerations for LGBTQ2S+ individuals’ perinatal mental health, including heteronormativity, cisnormativity, isolation, exclusion from traditional pregnancy care, stigma, and distressing situations from the gendered nature of pregnancy. Many participants described a lack of knowledge from healthcare providers related to care for LGBTQ2S+ individuals. In addition, LGBTQ2S+ individuals described barriers to accessing mental healthcare and gaps in health systems. Strategies to improve care include provider education, avoidance of gendered language, documentation of correct pronouns, trauma‐informed practices, cultural humility training and tailored care for LGBTQ2S+ people. Conclusions: Pregnancy, postpartum, and the perinatal period uniquely impacts the mental health and wellbeing of LGBTQ2S+individuals, largely due to systems‐level inequities and exclusion from perinatal care. Healthcare providers should implement the identified strategies to improve perinatal care and address inequities.
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Sexual and gender minority parents are at greater risk for internalizing problems and may experience stigma and discrimination in obstetrical settings.
“Exploring patterns and predictors of internalizing problems among a more diverse group of parents is particularly important given that sexual and gender minority parents are at greater risk for internalizing problems [108] and may experience stigma and discrimination in obstetrical settings [109].”
From Trajectories of Maternal and Paternal Internalizing Symptoms from Pregnancy to 2 Years Postpartum: Identifying Modifiable Risk and Protective Factors (2024) · cites this paper as [109]
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Laifer, L. M., Ramsdell, E. L., Stasik-O’Brien, S. M., Martin, R. C. B., & Brock, R. L. (2024) · Depression and Anxiety · doi:10.1155/2024/5164261
- Authors
- Kirubarajan, A., Barker, L. C., Leung, S., Ross, L. E., Zaheer, J., Park, B., Abramovich, A., Yudin, M. H., & Lam, J. S. H.
- Affiliations
- University of Toronto (CA)
- Centre for Addiction and Mental Health (CA)
- St. Michael's Hospital (CA)
- Corresponding author
- Kirubarajan, Abirami
- Venue
- BJOG: An International Journal of Obstetrics & Gynaecology
- Publisher
- Wiley
- Published
- 2022-02-08
- Volume
- 129
- Issue
- 10
- Pages
- 1630-1643
- ISSN
- 0306-5456 (ISSN-L)
- 1470-0328
- 1471-0528
- OpenAlex
- W4206756685
- Cited by
- 59
- References
- 69
- Citations by year
- 2026: 10 · 2025: 17 · 2024: 21 · 2023: 5 · 2022: 6
- FWCI
- 1.84
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- BJOG An International Journal of Obstetrics & Gynaecology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Social Psychology › LGBTQ Health, Identity, and Policy
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Social Sciences › Gender Studies › Gender and Feminist Studies
- Keywords
- perinatal mental health, perinatal care, access to mental health care, barriers to care, heteronormativity, cisnormativity, stigma, isolation, health professionals' knowledge, trauma-informed care, cultural humility, postpartum mental health, pregnancy, surrogacy, infertility treatment, miscarriage, health disparities
- MeSH terms
- Sexual and Gender Minorities, Female, Health Services Accessibility, Humans, Mental Health, Mental Health Services, Pregnancy, Perinatal Care
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