Psychological and Medical Care of Gender Nonconforming Youth

Abstract

This is the 5th in our series on Adolescent Health. abstract Gender nonconforming (GN) children and adolescents, collectively referred to as GN youth, may seek care to understand their internal gender identities, socially transition to their affirmed genders, and/or physically transition to their affirmed genders. Because general pediatricians are often the first point of contact with the health care system for GN youth, familiarity with the psychological and medical approaches to providing care for this population is crucial. The objective of this review is to provide an overview of existing clinical practice guidelines for GN youth. Such guidelines emphasize a multidisciplinary approach with collaboration of medical, mental health, and social services/advocacy providers. Appropriate training needs to be provided to promote comprehensive, culturally competent care to GN youth, a population that has traditionally been underserved and at risk for negative psychosocial outcomes.

Mental Health and Self-Worth in Socially Transitioned Transgender Youth

“…1 In most cases, these children have asserted their gender identity as different from their natal sex for months or years, during which they often express dissatisfaction and/or disgust with their anatomy, which in extreme cases can trigger threats or attempts at self-harm. 2–5 Parent decisions to allow transgender children to socially transition have received significant media attention, 6–8 with many lay and scientific skeptics asserting concern for the wellbeing of these children in the short and long term. 9–13 In contrast, one small qualitative study described the intervention, from the perspective of parents, as having been transformative for their children by alleviating mental health problems and improving the child’s wellbeing almost immediately.…”

Psychiatric Diagnoses and Comorbidities in a Diverse, Multicity Cohort of Young Transgender Women

“…35 Improving access to culturally competent primary care, diagnostic screening, psychotherapy, and pharmacologic treatments, and retention in care in clinical community-based, pediatric, and adolescent and young adult medicine settings are urgently needed to address the adverse mental health and substance dependence disorders in this population, with attention to differences by race or ethnicity. 36–38 Further research is needed, particularly longitudinal studies that examine the antecedents and health sequelae of mental health, substance dependence, and psychiatric comorbidities across adolescent and young adult development to identify optimal timing and targets for psychosocial interventions in relation to gender affirmation and gender role transitions. 39,40 …”

“…Pediatric, adolescent, or young adult primary care providers may be a first resource for families needing education and support and play a critical role in supporting transgender youth, including screening for psychosocial problems and health risks, referring for gender-specific mental health and medical care, and providing advocacy and support. 36,42 Research suggests that medical intervention such as hormone therapy may reduce mental health distress in transgender youth. 43 The majority (72%) of our sample reported cross-sex hormones; however, a high prevalence of psychiatric diagnoses and comorbidities was still observed.…”

Student Access to Mental Health Information on California College Campuses

“…In addition, we excluded students from CCC campuses that did not receive campus-based grants from CalMHSA to enhance PEI activities for student mental health (n = 5,678). And we excluded students who identified their genders as "other" (e.g., transgender), because transgender individuals commonly experience unique mental health treatment issues distinct from lesbian, gay, bisexual, and queer (LGBQ) and other students (e.g., for individuals who are considering gender affirmation surgery, diagnosis of gender dysphoria and counseling may be required) that would likely systematically influence the outcomes we are examining (Vance, Ehrensaft, and Rosenthal, 2014). After applying all exclusion criteria, a total of 28,982 students from the first survey and 13,968 students from the second across 26 campuses were included in the analytic sample.…”