{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T04:10:56Z","timestamp":1788667856652,"version":"build-2803163510"},"reference-count":42,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T00:00:00Z","timestamp":1788480000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T00:00:00Z","timestamp":1788480000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000056","name":"National Institute of Nursing Research","doi-asserted-by":"publisher","award":["T32NR009356"],"award-info":[{"award-number":["T32NR009356"]}],"id":[{"id":"10.13039\/100000056","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Hosp Palliat Care"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Transgender and gender-diverse individuals experience higher mortality rates and elevated incidence of serious illness compared to cisgender populations. Despite these disparities, discrimination and stigma continue to create barriers to high-quality hospice and palliative care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>This scoping review identified the unmet needs of gender-diverse adults receiving hospice and palliative care in the United States.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Following PRISMA-ScR guidelines, we systematically searched seven databases between May and June 2025. Inclusion criteria required: English-language publications from US settings, exclusive focus on gender-diverse adults, and examination of unmet needs in serious illness, hospice, or palliative care contexts. Two reviewers independently screened titles, abstracts, and full texts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Five publications met eligibility criteria. A descriptive thematic analysis identified four categories of unmet needs: (1) competent healthcare professionals with gender-affirming training; (2) holistic, inclusive care delivery models; (3) family and chosen family engagement protocols; and (4) protective institutional policies and legal frameworks. Critical limitations include a small sample size; predominance of healthcare professional perspectives rather than transgender patient voices; reliance on descriptive and narrative-based approaches; and absence of intersectional analyses examining race, class, and disability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This review exposes substantial under-resourcing of research on gender-diverse patients\u2019 end-of-life needs. Urgent priorities include systematic competency training for hospice and palliative care professionals, development of evidence-based clinical guidelines, advocacy for protective legal frameworks, and most critically, conducting robust qualitative and quantitative research centering transgender patients\u2019 lived experiences and priorities in serious illness care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10499091261487374","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T18:21:50Z","timestamp":1788546110000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Unmet Needs of Transgender and Gender-Diverse Adults With Serious Illness Receiving Hospice and Palliative Care: A Thematic Scoping Review"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-4377-895X","authenticated-orcid":false,"given":"Emma","family":"Max","sequence":"first","affiliation":[{"name":"University of Pennsylvania"},{"name":"University of Pennsylvania"},{"name":"University of Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Meanley","sequence":"additional","affiliation":[{"name":"University of Pennsylvania"},{"name":"University of Pennsylvania"},{"name":"University of Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy A.","family":"Hodgson","sequence":"additional","affiliation":[{"name":"University of Pennsylvania"},{"name":"University of Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,4]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2015.1679"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2014.0164"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/1475-6773.12479"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1177\/10499091231212666"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/cir.0000000000001003"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/1475-6773.13229"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.copsyc.2022.101467"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.17226\/25877"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.dhjo.2024.101764"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.su7301a6"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2022.306963"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2018.0431"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.1177\/10499091221116634"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.3390\/geriatrics2010013"},{"key":"e_1_3_5_16_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.NAJ.0000925508.62666.99"},{"key":"e_1_3_5_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.copsyc.2023.101579"},{"key":"e_1_3_5_18_2","doi-asserted-by":"publisher","DOI":"10.1037\/0033-2909.129.5.674"},{"key":"e_1_3_5_19_2","doi-asserted-by":"publisher","DOI":"10.3390\/geriatrics2010013"},{"key":"e_1_3_5_20_2","doi-asserted-by":"publisher","DOI":"10.1111\/josi.12233"},{"key":"e_1_3_5_21_2","doi-asserted-by":"publisher","DOI":"10.1037\/a0029597"},{"key":"e_1_3_5_22_2","doi-asserted-by":"publisher","DOI":"10.7326\/M18-0850"},{"key":"e_1_3_5_23_2","doi-asserted-by":"publisher","DOI":"10.1080\/1364557032000119616"},{"key":"e_1_3_5_24_2","doi-asserted-by":"publisher","DOI":"10.1186\/1748-5908-5-69"},{"key":"e_1_3_5_25_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12874-018-0611-x"},{"key":"e_1_3_5_26_2","doi-asserted-by":"publisher","DOI":"10.46658\/JBIMES-20-12"},{"key":"e_1_3_5_27_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40609-016-0075-z"},{"key":"e_1_3_5_28_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2021.15468"},{"key":"e_1_3_5_29_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.1150"},{"key":"e_1_3_5_30_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.p2340"},{"key":"e_1_3_5_31_2","unstructured":"Covidence - better systematic review management. 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