Position paperPromoting Health Equality and Nondiscrimination for Transgender and Gender-Diverse Youth
Section snippets
Positions of the Society for Adolescent Health and Medicine
The Society for Adolescent Health and Medicine (SAHM) supports the following positions:
- ●
Providers of health care to adolescents and young adults need to ensure patient-centered, culturally effective practices when treating transgender and gender-diverse (TGD) youth (evidence and consensus).
- ●
SAHM recognizes that variation in gender identity and expression is normal, recognizes that incongruence between gender identity and genotypic/phenotypic sex is one of many developmental trajectories that
Statement of the Problem
Many providers for adolescents and young adults have reported an increased number of TGD youth seeking care [1]. However, many providers also lack the knowledge required to address the needs of this unique patient population. Therefore, there is an unmet need for providers to learn the skills necessary to care for TGD youth.
The American Psychological Association defines gender identity as a person's “deeply-felt, inherent sense of being a boy, a man, or male; a girl, a woman, or female; or an
Methods
The authors conducted a literature review on peer-reviewed publications and policy papers from national and international organizations obtained from databases including PubMed, PyschINFO, and SCOPUS using key terms such as “transgender,”“gender identity,” and “gender-affirming care.” We reviewed all articles relating to pediatric and adolescent transgender health, employing a perspective of adolescent health, public health, policy, and advocacy. The evidence presented by consensus is based on
Training in the care for TGD youth
Most health professional training curricula lack content about transgender health, resulting in limited provider comfort and knowledge in this area [3]. Multidisciplinary guidelines exist that can provide foundational and continuing educational training for providers [[4], [5], [6], [7]]. This position paper does not recommend a specific guideline for adolescent and young adult health-care providers.
Culturally effective care for TGD youth
Although guidelines describe minimal cultural competency standards for working with TGD youth,
Summary
Health-care providers must acknowledge that TGD youth have unique health-care needs compared to their cisgender peers. Nascent research and collective clinical experience strongly suggest that gender affirmation is the best approach for working with TGD youth. However, because anti-transgender stigma and discrimination are major drivers for adverse health outcomes among TGD youth, health-care providers must also advocate for medical institutional and governmental policies that promote equitable
References (26)
- et al.
Mental health disparities among Canadian transgender youth
J Adolesc Health
(2017) - et al.
Puberty suppression in adolescents with gender identity disorder: A prospective follow-up study
J SexMed
(2011) - et al.
Synergies in health and human rights: A call to action to improve transgender health
Lancet
(2016) - et al.
Patterns of referral to a gender identity service for children and adolescents (1976-2011): Age, sex ratio, and sexual orientation
J Sex Marital Ther
(2013) Guidelines for psychological practice with transgender and gender nonconforming people
Am Psychol
(2015)- et al.
Gaps in transgender medical education among healthcare providers: A major barrier to care for transgender persons
Rev Endocr Metab Disord
(2018) - et al.
Australian standards of care and treatment guidelines for trans and gender diverse Children and adolescents version 1.1
(2018) - et al.
Endocrine treatment of gender-Dysphoric/gender-incongruent persons: An Endocrine society clinical practice guideline
J Clin Endocrinol Metab
(2017) - et al.
Standards of care for the health of Transsexual, transgender, and gender-nonconforming people, version 7
Int J Transgenderism
(2012)
Integrating cultural humility into health care professional education and training
Adv Health Sci Educ Theor Pract
APA Caucaus of lesbian G, and bisexual psychiatrist, position statement on discrimination against transgender and gender variant individuals
Gender dysphoria. Diagnostic and Statistical Manual of mental Disorders
Cited by (21)
Complex Psychiatric Histories and Transgender and Gender Diverse Youth
2023, Child and Adolescent Psychiatric Clinics of North AmericaThe Journal of Adolescent Health's Commitment to Diversity, Equity, and Inclusion
2023, Journal of Adolescent HealthThe health needs and experiences of justice system involved youth
2023, Encyclopedia of Child and Adolescent Health, First EditionState of Transgender Health Education and Provision of Gender-Affirming Care to Transgender and Gender Diverse Adolescents
2022, Journal of Adolescent HealthBone density and bone marrow composition in transgender girls prior to pubertal blockade: A case series
2022, BoneCitation Excerpt :This was also a single-site study and the data may not be generalizable to all AMAB populations. Additionally, we did not measure other external factors that affect health, such as access to care or nutrients, stigma, and discrimination [24,25]. However, there are several strengths to this study.
Clinician and Ethicist Perspectives: Understanding Moral Distress in Gender-Affirming Care for Pediatric Patients
2022, Journal of PediatricsCitation Excerpt :We are also aware of gender clinics receiving anonymous threats related to the care they provide. The recently overturned Tavistock decision in the United Kingdom, which characterized pubertal suppression as “experimental,”32,33 received much media attention and contributed to a narrative that this kind of care is suspect or potentially harmful even though such care is endorsed by leading professional societies.13-17 As such, clinicians providing pediatric gender-affirming services can often feel like the care they provide is under scrutiny.