Transgender lives in humanitarian crises: Health, vulnerability, and gendered survival across disasters, conflict, and displacement

Background Humanitarian scholarship has begun to attend to sexual and gender minorities, yet transgender and gender-diverse people remain marginal within its evidence base and its theory.Method This article reports a critical interpretive synthesis (CIS) of empirical and conceptual literature published between 2005 and 2025 on transgender experience across five humanitarian contexts: armed conflict, natural disaster, forced displacement and asylum, pandemic, and humanitarian governance. Following the approach of Dixon-Woods and colleagues, and reported against the PRISMA 2020 statement for transparency rather than as an aggregative logic, the review purposively synthesized 24 sources identified through five databases and structured grey-literature searching.Results Rather than pooling outcomes, the synthesis generated a mid-range interpretive framework, Humanitarian Gendered Precarity (HGP), which proposes four interrelated mechanisms through which crises appear to produce distinctly transgender forms of vulnerability and survival: administrative erasure, gendered abjection, humanitarian necropolitics, and queer survival assemblages. The four constructs are differentiated by ontological level and mechanism type to support conceptual discriminant validity. The framework integrates feminist accounts of precarity and grievability, recognition theory, and theories of biopolitics and necropolitics, and extends existing queer and trans necropolitical scholarship to the full humanitarian spectrum. The synthesis indicates that the documentary infrastructures of relief, the sex-segregation of shelter, and the household basis of aid distribution operate as primary technologies of exclusion, and that kinship and community networks constitute the principal infrastructure of survival where institutional recognition is withdrawn.Conclusions The limited availability of peer-reviewed evidence on armed conflict is treated as analytically significant in its own right. Boundary conditions under which the framework is not expected to hold, and implications for inclusive humanitarian practice, health-systems design, and future research, are specified.