Access to gender-affirming healthcare remains a significant challenge for transgender and gender-diverse individuals worldwide due to structural barriers, stigma, limited availability of trained providers, and geographic and financial constraints. Telehealth has emerged as a promising approach to address these issues by facilitating the remote healthcare delivery through digital technologies. A critical narrative review of literature published between 2019 and 2026 was conducted using databases including PubMed, Science Direct, and Google Scholar. Studies examining telehealth, telemedicine, mobile health, or digital health technologies used in gender-affirming healthcare were included. Quantitative, qualitative, and mixed-method studies were considered. After screening and applying the inclusion criteria, 24 studies were included in the final analysis. Findings were synthesised thematically. Five major themes emerged: telehealth tools & digital platforms; benefits of telehealth in improving healthcare access; patient satisfaction and acceptability; challenges and barriers to telehealth implementation; and strategies to overcome these challenges. The findings indicate that telehealth can reduce geographic and financial barriers, improve continuity of care, and enhance access to specialised providers. High patient satisfaction levels were consistently reported. However, challenges such as digital inequities, privacy concerns, technological limitations, and clinical constraints were also identified. Telehealth has significant potential to reduce disparities and improve access to gender-affirming healthcare services, and its effectiveness can be further strengthened through enhanced digital infrastructure, improved provider training, and the adoption of hybrid healthcare models.