Promoting Access of Transgender and Gender Diverse People to Primary Care: A systematic review of activist literature

International audienceBACKGROUND. The visibility and number of the transgender and gender diverse (TGD) population is increasing. They presenttransdisciplinary needs and face systemic barriers to accessing care. Primary care is promoted as a neworganizational entry point for care pathways. Yet, a signi?cant number of TGD individuals report poor experiencesand avoid seeking help. The objective of this study is to highlight the ecological barriers and levers of access to primary health care forTGD people to improve practices.METHODS.We conducted a systematic review of activist literature from European organizations. Following quality analysis,we performed a thematic analysis aiming at identifying the courses of action and strategies to be used for healthpromotion.OUTCOMES. Results highlight the expertise of TGD organizations in identifying ecological problems and solutions.Discrimination appears as a central factor in access to care, as lack of training and information of professionals.These elements appear all the more important as TGD people evolve outside the norms of heterosexual genderbinarity.DISCUSSION. Building a common knowledge and information foundation appears to be a ?rst step towards promoting access tocare for TGD people, as well as developing professional and associative networks. Structural changes in caredelivery could easily alleviate some of the di?culties and also bene?t a large part of the cisgender population