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Behavioral Sciences
Volume 16
Issue 2
10.3390/bs16020265
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Article

Social Determinants of Health Influence on Trans and Gender-Diverse People: A Qualitative Photovoice Study

by
Miguel García-Hernández
1,
María Marín-Rodríguez
1,
Ismael Jiménez-Ruiz
1,2,
José Antonio Jiménez-Barbero
1,2,
María Sánchez-Muñoz
3 and
María del Mar Pastor-Bravo
1,2,*
1
Faculty of Nursing, University of Murcia, 30120 Murcia, Spain
2
Biomedical Research Institute of Murcia Pascual Parrilla–IMIB, 30120 Murcia, Spain
3
Mental Health Centre of Cartagena, Murcia Health Service, 30201 Cartagena, Spain
*
Author to whom correspondence should be addressed.
Behav. Sci. 2026, 16(2), 265; https://doi.org/10.3390/bs16020265
Submission received: 27 December 2025 / Revised: 28 January 2026 / Accepted: 7 February 2026 / Published: 11 February 2026
(This article belongs to the Special Issue The Impact of Social Stigma on Marginalized Populations)
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Abstract

Despite the introduction of inclusive and gender-affirming approaches in healthcare, transgender and non-binary people continue to show poorer physical, psychological, and social outcomes, shaped by social determinants within historically pathologizing and stigmatizing contexts. This study used qualitative participatory action research with photovoice among seven transgender individuals residing in Murcia, Spain; data were generated through semi-structured interviews and focus group dialogue, applying the SHOWED technique to the visual and discursive narratives of the participants, and analyzed with Atlas.ti v8. Educational, employment, and healthcare contexts significantly condition well-being. Well-being was determined by the circumstances and support in which gender identity is constructed, within sociocultural environments marked by gender stereotypes, exclusion from social spaces, and fears regarding the irreversibility of certain transition steps. Reported lifetime negative events, social barriers, exclusion, and persistent questioning of identity were associated with increased anxiety, depressive symptoms, and insomnia. At the same time, the relevance of resilience and support networks also emerged during the sessions. Replicating photovoice in diverse settings may help identify social and territorial inequities and inform improvements in clinical practice, healthcare education, public policies, and legislation for transgender and gender-nonconforming people.
Keywords: social determinants of health; gender identity; transgender persons; gender-nonconforming persons; photovoice; nursing; social stigma social determinants of health; gender identity; transgender persons; gender-nonconforming persons; photovoice; nursing; social stigma

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MDPI and ACS Style

García-Hernández, M.; Marín-Rodríguez, M.; Jiménez-Ruiz, I.; Jiménez-Barbero, J.A.; Sánchez-Muñoz, M.; Pastor-Bravo, M.d.M. Social Determinants of Health Influence on Trans and Gender-Diverse People: A Qualitative Photovoice Study. Behav. Sci. 2026, 16, 265. https://doi.org/10.3390/bs16020265

AMA Style

García-Hernández M, Marín-Rodríguez M, Jiménez-Ruiz I, Jiménez-Barbero JA, Sánchez-Muñoz M, Pastor-Bravo MdM. Social Determinants of Health Influence on Trans and Gender-Diverse People: A Qualitative Photovoice Study. Behavioral Sciences. 2026; 16(2):265. https://doi.org/10.3390/bs16020265

Chicago/Turabian Style

García-Hernández, Miguel, María Marín-Rodríguez, Ismael Jiménez-Ruiz, José Antonio Jiménez-Barbero, María Sánchez-Muñoz, and María del Mar Pastor-Bravo. 2026. "Social Determinants of Health Influence on Trans and Gender-Diverse People: A Qualitative Photovoice Study" Behavioral Sciences 16, no. 2: 265. https://doi.org/10.3390/bs16020265

APA Style

García-Hernández, M., Marín-Rodríguez, M., Jiménez-Ruiz, I., Jiménez-Barbero, J. A., Sánchez-Muñoz, M., & Pastor-Bravo, M. d. M. (2026). Social Determinants of Health Influence on Trans and Gender-Diverse People: A Qualitative Photovoice Study. Behavioral Sciences, 16(2), 265. https://doi.org/10.3390/bs16020265

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