Ambiguous Loss and Disenfranchised Grief in Cisgender Relatives of Transgender People: A Scoping Review

Background: The gender transition of a family member may reshape meanings, expectations, and relational positions within the family system, leading some cisgender relatives to describe experiences of loss, ambivalence, and relational rupture. Methods: A scoping review was conducted following Arksey and O’Malley, the Joanna Briggs Institute recommendations, and PRISMA-ScR guidelines. Searches were performed in PubMed/MEDLINE, Scopus, Web of Science Core Collection, PsycINFO, CINAHL Complete, and SciELO for original studies published between 2000 and February 2026 in English or Spanish. Studies were analysed through descriptive and thematic synthesis. Results: Three empirical studies were included. All included studies were qualitative and conducted in the United States and Spain. Ambiguous loss was the most frequent framework, followed by disenfranchised grief and models emphasizing family acceptance and support. Four recurrent thematic domains were identified: (1) experiences of ambiguous loss, characterised by the coexistence of continuity and change in family relationships; (2) disenfranchised grief and social invalidation of relatives’ suffering; (3) protective factors and processes of family adaptation, including progressive acceptance, open communication and participation in affirming supports; and (4) gaps in intervention and longitudinal research on trans-affirmative family care. Conclusions: Some cisgender relatives may experience complex relational loss during a loved one’s gender transition. Ambiguous loss and disenfranchised grief provide useful clinical language for trans-affirmative family care, allowing validation of non-death grief without pathologising trans identities. However, the predominance of US-based, observational evidence and the scarcity of longitudinal and intervention studies highlight the need for multicentre, culturally adapted research programmes to strengthen the evidence base and inform practice.