<p>Passing is a contentious issue within the trans community. Some trans people strive to pass as cisgender as an inherent goal or to reduce dysphoria, enhance safety, and potentially to facilitate acceptance. Others argue that trans people should not need to pass and that expectations to do so can cause harm to the trans community. This review aimed to systematically source and synthesize the existing qualitative literature that explores the costs and benefits of passing for trans people. Searches were conducted in PsycINFO, PsycEXTRA, ProQuest Psychology Database, Web of Science, Scopus, and EBSCO Psychology and Behavioral Sciences Collection to obtain articles in English. Studies that met the inclusion criteria presented qualitative data, were conducted with binary trans participants, referred directly to passing, and presented costs and/or benefits of passing for trans people. The search yielded 24 studies, and thematic analysis revealed nine costs and five benefits of passing for trans people. More costs than benefits were identified, but many of these costs were typically associated with not having adequate knowledge of, or access to, safe gender affirming techniques, or engaging in risky practices to pass. Passing was consistently identified as gender-affirming, and as reducing gender dysphoria and suicide risk, but also acknowledged as re-enforcing the gender binary and cisnormative expectations of gender. These findings have important implications for public healthcare and considerations for trans people and their support networks when considering medical interventions or other forms of gender affirmation.</p>