Mental health experiences amid climate change and sexual and reproductive health challenges: A scoping review focused on low-and middle-income countries

Social roles shape differential exposure to climate hazards and access to sexual and reproductive health (SRH) services and supports, posing distinct mental and emotional challenges. Yet, the gendered mental health consequences of these intersections remain largely unknown. We conducted a scoping review of empirical studies examining mental health experiences in low- and middle-income countries (LMICs) where climate-related events are related to SRH outcomes. Using a comprehensive search strategy across four databases (Medline, Embase, Web of Science, Scopus), we screened 40,503 qualitative, quantitative, and mixed methods records to include 50 peer-reviewed studies across 43 countries. Studies were analyzed using thematic meta-synthesis to identify patterns in gendered mental health responses to climate change and SRH stressors. Climate change is a structural determinant of mental health and SRH, with gender and age mediating exposure and vulnerability. The social identities of motherhood, fatherhood, and adolescence intersect in distinct ways with climate change hazards and unmet SRH needs to shape mental health experiences. Three thematic domains emerged: (1) motherhood under intensified domestic burdens, (2) fatherhood and coping under resource scarcity, (3) adolescent girls' mental and menstrual distress under water and sanitation inequities. Climate-induced psychological distress, manifesting as anxiety, depression, trauma, and social withdrawal, are linked to disrupted care giving, increased gender-based violence, and compromised menstrual dignity. Mental health burdens at the intersection of climate change and SRH are deeply gendered and shaped by the ways climate change impacts social determinants of health. Despite growing evidence, integrated responses remain scarce. Addressing these challenges requires multi-sectoral collaboration, gender-sensitive mental health frameworks, and inclusive SRH policies that reflect the lived realities of LMIC populations.