Recognized in custom, unseen in care: a scoping review of bugis gender plurality ( oroané, makkunrai, calabai, calalai, bissu ) and transgender health in Indonesia

Background Bugis society in South Sulawesi recognizes five gender categories, but whether this plurality shapes transgender health research and care has not been mapped.Method Following JBI guidance and PRISMA-ScR, we searched OpenAlex, Consensus, Garuda and SINTA-indexed sources in English and Indonesian and screened 960 records.Results We included 183 sources: 62 on Bugis gender concepts, 94 on transgender health elsewhere in Indonesia and 27 bridging sources. HIV and sexually transmitted infections dominated the health evidence (54 of 121 sources), mostly framed as biomedical risk. Health studies in Makassar and Palopo used the label waria, not Bugis categories. We found no study of calalai health and no transmasculine health study from South Sulawesi.Conclusions In the evidence identified, customary recognition has not translated into culturally grounded care. Health research should record local categories alongside national labels and use community-led designs.