The concept of a tertiary gender, encompassing non-binary, transgender, and gender-nonconforming identities, has attracted increased scholarly attention and public discourse.This systematic review seeks to synthesise the existing body of knowledge regarding the socio-economic, psychological, and healthcare challenges faced by individuals who identify as tertiary gender.The review evaluates 33 academic articles across diverse cultural settings, including India, Pakistan, and the United States, illuminating persistent issues such as stigma, discrimination, legal disenfranchisement, and inadequate healthcare provisions.Mental health concerns, such as heightened instances of depression, anxiety, and suicidal ideation, are prevalent among individuals of the third gender, primarily due to social alienation and marginalisation.The review underscores the critical necessity for inclusive methodologies, encompassing gender-affirming healthcare, mental health support, and legal acknowledgement, to foster social inclusion and improve the overall quality of life for individuals identifying as third gender.The thematic analysis reveals enduring socio-economic disadvantages, including limited employment opportunities and barriers to educational access, compounded by cultural and religious marginalization.The Social Support Systems Model (SSSM) articulated in the study emphasizes the importance of familial, communal, peer, and religious support in enhancing the well-being of individuals within the third gender category.This research highlights gaps in the current literature and proposes new directions for future inquiries, providing a comprehensive framework for developing strategies to mitigate the socio-cultural and psychological challenges faced by this marginalized demographic.
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