Supporting and advocating for transgender and gender diverse youth and their families within the sociopolitical context of widespread discriminatory legislation and policies.

Abstract

Objective: The aims of this commentary are to: (a) provide an overview of the current sociopolitical context experienced by transgender and gender diverse (TGD) youth and caregivers, (b) summarize the research that has been conducted about how the sociopolitical context impacts the mental health and wellbeing of TGD youth and caregivers, (c) discuss the clinical implications of these findings, and (d) identify steps mental health providers can take to be advocates for TGD youth and their families. Methods: Authors include a psychologist and adolescent medicine physician working within a multidisciplinary gender program for youth and a psychologist in independent practice who specializes in working with LGBTQ+ (lesbian, gay, bisexual, transgender, and/or queer) youth, especially TGD youth. Clinical implications and advocacy steps were informed by our synthesis of the research literature as well as our own experiences working within the field of TGD health. Results: TGD youth and families have identified a range of stressors and coping strategies associated with the sociopolitical climate. Existing guides to clinical practice with TGD people can be adapted to incorporate these findings. We propose a “menu” of advocacy steps for providers to consider. Conclusions: Awareness of the larger sociopolitical context is crucial to providing high quality care to TGD youth and their families. By participating in advocacy efforts, mental health providers can have a unique and meaningful impact on the social and structural factors that impact the mental health and wellbeing of this population. Ethical principles within the field of psychology highlight how advocacy efforts are an important component of practice.

Gender Dysphoria: Optimizing Healthcare for Transgender and Gender Diverse Youth with a Multidisciplinary Approach

“…Even at the pediatric level, TGD individuals are disproportionately impacted by health-care inequity and discrimination. 62 To reduce stigmatizing health-care experiences for TGD youth, innovative and sustainable strategies (eg, web-based learning collaboratives) are needed to disseminate culturally responsive, gender-affirming care training to licensed community providers who work outside of gender specialty clinics. 63 Pediatric providers in health-care settings can implement changes in clinical practices and collaborate with health-care administration to implement policy changes that shift system-wide practices (eg, offering options to include chosen name, gender identity in electronic medical records).…”

“…In recent years, the proliferation of misinformation and mischaracterization of gender-affirming health care has led to harmful legislative efforts that included banning TGD youth from participating in sports and accessing gender-affirming medical care in the United States. 62 Beyond ensuring that TGD youth and their families can access evidence-based gender-affirming health care there are many ways to advocate for TGD youth within professional, organizational and community settings. 62 Health-care providers can dispel misinformation and myths about TGD youth and their families, and provide research-supported information about the negative impact of denying access to care on the mental health and well-being of TGD youth.…”

“… 62 Beyond ensuring that TGD youth and their families can access evidence-based gender-affirming health care there are many ways to advocate for TGD youth within professional, organizational and community settings. 62 Health-care providers can dispel misinformation and myths about TGD youth and their families, and provide research-supported information about the negative impact of denying access to care on the mental health and well-being of TGD youth. Kuper et al 62 offer a summary of advocacy action items while considering the substantial amount of time and effort advocacy work requires, and potential negative consequences (eg, online harassment and threats).…”

“… 62 Health-care providers can dispel misinformation and myths about TGD youth and their families, and provide research-supported information about the negative impact of denying access to care on the mental health and well-being of TGD youth. Kuper et al 62 offer a summary of advocacy action items while considering the substantial amount of time and effort advocacy work requires, and potential negative consequences (eg, online harassment and threats). In addition to family advocacy that occurs in the provision of medical and mental healthcare, providers can join professional organizations to draw awareness to gender diversity and emerging research related to gender-affirming care.…”

Incorporating DEI informed-frameworks and increasing access to parent-focused interventions in pediatric psychology.

“…While daunting, the manuscripts included within this special edition demonstrate how pediatric psychologists can improve access to culturally sensitive and trauma informed care in primary care and medical subspecialty environments while working with the parents of pediatric patients. The commentary provides further action steps which clinicians and trainees can take to advocate for vulnerable patients and their families (Kuper et al, 2022).…”