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Religiosity/spirituality confer protective mental health benefits in adolescents, although the relationship between the two in transgender youths is unclear. This systematic review of the literature sought to clarify this relationship. We searched five databases for quantitative and qualitative studies exploring the relationship between religiosity/spirituality and mental health in transgender youths. Eighteen articles met criteria. Six showed a negative relationship between religion/spirituality and mental health, seven showed a mixed relationship, two showed a positive relationship, and three showed a neutral relationship. Only four studies exclusively evaluated transgender youths’ experiences of religiosity/spirituality and mental health. The 14 other studies more broadly evaluated the experiences of LGBTQ youths, where participation among transgendered adolescents was low. Twelve studies were cross-sectional cohort studies, while six were qualitative studies. The relationship between religiosity/spirituality and mental health in adolescents identifying as transgender is complex. Quantitative studies were mixed regarding the association between religion/spirituality and mental health. Qualitative studies showed a more nuanced relationship between the two in which religiously motivated stigma from parents or communities resulted in worsened mental health outcomes, while intrinsic religiosity appeared to correspond to improved psychological well-being. Implications of these findings for mental health providers and religious leaders are described.

Systematic review: The relationship between religion, spirituality and mental health in adolescents who identify as transgender