Volume 129, Issue 10 p. 1630-1643
SYSTEMATIC REVIEW

LGBTQ2S+ childbearing individuals and perinatal mental health: A systematic review

Abirami Kirubarajan

Corresponding Author

Abirami Kirubarajan

University of Toronto Faculty of Medicine, Toronto, ON, Canada

University of Toronto Institute of Health Policy, Management, and Evaluation, Toronto, ON, Canada

Correspondence

Abirami Kirubarajan, University of Toronto Faculty of Medicine, Toronto, ON M5S 1A8, Canada.

Email: [email protected]

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Lucy C. Barker

Lucy C. Barker

University of Toronto Institute of Health Policy, Management, and Evaluation, Toronto, ON, Canada

University of Toronto Department of Psychiatry, Toronto, ON, Canada

Department of Psychiatry, Women's College Hospital, Toronto, ON, Canada

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Shannon Leung

Shannon Leung

University of Toronto Faculty of Medicine, Toronto, ON, Canada

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Lori E. Ross

Lori E. Ross

University of Toronto Dalla Lana School of Public Health, Toronto, ON, Canada

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Juveria Zaheer

Juveria Zaheer

University of Toronto Department of Psychiatry, Toronto, ON, Canada

Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, ON, Canada

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Bomi Park

Bomi Park

University of Toronto Faculty of Medicine, Toronto, ON, Canada

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Alex Abramovich

Alex Abramovich

University of Toronto Dalla Lana School of Public Health, Toronto, ON, Canada

Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, ON, Canada

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Mark H. Yudin

Mark H. Yudin

University of Toronto Department of Obstetrics and Gynaecology, Toronto, ON, Canada

Department of Obstetrics and Gynaecology, Unity Health, St Michael's Hospital, Toronto, ON, Canada

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June Sing Hong Lam

June Sing Hong Lam

University of Toronto Institute of Health Policy, Management, and Evaluation, Toronto, ON, Canada

University of Toronto Department of Psychiatry, Toronto, ON, Canada

Centre for Addiction and Mental Health, Toronto, ON, Canada

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First published: 19 January 2022
Citations: 5

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.

CONFLICT OF INTEREST

None. Completed disclosure of interests form available to view online as supporting information.

DATA AVAILABILITY STATEMENT

Data sharing not applicable - no new data generated, or the article describes entirely theoretical research.