Design, implementation, and evaluation of group peer support programs run by and for trans people: a scoping review

Introduction: Peer support between trans people in group settings can improve mental health. Understanding what programs exist is key to the future design, implementation, and evaluation of trans group peer support programs.Methods: A scoping review mapped available literature regarding design, implementation, and evaluation of trans group peer support programs by systematically searching MEDLINE, CINAHL, PsycINFO, EMBASE, Google Advanced, and 40 websites of trans community organizations from Australia, Aotearoa/NZ, UK, Europe, USA, and Canada (date range: 2004–2024).Results: In total, 12 articles were included, nine of which detailed eight unique interventions. Weekly 1.5 hr sessions over 6 to 18 wk were most common. Discussion-based activities were a hallmark feature of programs, typically about sex, relationships, dating; legal, medical, social affirmation; community connection; and coping skills. Duty of care considerations included group agreements, facilitator interventions during group sessions, eligibility criteria, and rules for contact outside sessions. Attendance issues were repeatedly highlighted. Lack of diversity was prevalent: trans femme overrepresentation, trans masc underrepresentation, non-binary invisibility, lack of older trans people and trans people of color. Quantitative evaluation demonstrated reduced depression and anxiety, and increased community connectedness, though comparison groups and adjustment for covariates were seldom employed. Qualitative evaluation revealed benefits beyond symptom reduction, including improved capacity to live with distress.Discussion: Future work should document decision-making regarding duty of care needs, retention, diversity, and methodological rigor and draw on best practice guidelines authored by trans people to guide program design and evaluation. These findings highlight the potential and unmet opportunities of trans group peer support programs for mental health promotion.