Pride in transgender and gender diverse identity and mental health: a systematic literature review

Background: Transgender and gender diverse (TGD) people experience higher rates of mental health difficulties than the general population, largely linked to gender minority stress within cisnormative environments. Pride in transgender identity (PTGDI) is proposed as a protective factor, but has rarely been examined as a distinct construct. Aims: Systematically review and appraise the literature on how PTGDI relates to mental health in TGD populations. Methods: A PICO-informed search was conducted in PsycINFO, CINAHL, and MEDLINE (EBSCO), in which terms to define transgender population and PTGDI were searched in combination with terms referring to mental health illness such as anxiety or depression in addition to gender minority stress terms. Results from the searches (1960 to August 2025) were screened for applicability to the review though examination of title, then abstract, then body of the article. Data was extracted by two reviewers into a single table. Included articles were analyzed through narrative synthesis. Results: Forty-three studies met inclusion criteria for this review. Most studies were quantitative and based in the USA. Five measures were identified, none designed to assess PTGDI alone. Higher PTGDI was generally associated with lower depression, anxiety, psychological distress, PTSD symptoms, and fewer trans-specific body image concerns, and often moderated the effects of stigma and internalized transphobia. Findings for suicidality and eating disorders were inconsistent. Discussion: PTGDI appears to support mental health by buffering gender minority stress, but current methods of measurement for PTGDI are limited. Clinicians should consider the protective nature of PTGDI and community support while supporting TGD individuals as well as being aware of the detrimental impact of cisnormativity. Further research is needed to develop tools specifically designed and validated to measure PTGDI and a larger focus on PTGDI in those with multiple marginalized identities.