Youth and Caregiver Perspectives on Barriers to Gender-Affirming Health Care for Transgender Youth

Journal of Adolescent Health

Volumn 59, Issue 3, 2016, Pages 254-261

  Gridley, Samantha J ^a,b   Crouch, Julia M ^b   Evans, Yolanda ^b,c   Eng, Whitney ^c   Antoon, Emily ^c   Lyapustina, Melissa ^d   Schimmel Bristow, Allison ^b,e   Woodward, Jake ^b,f   Dundon, Kelly ^c   Schaff, RaNette ^g   McCarty, Carolyn ^b,c   Ahrens, Kym ^b,c   Breland, David J ^b  

^a VANDERBILT UNIVERSITY SCHOOL OF MEDICINE   (United States)

^b SEATTLE CHILDREN S RESEARCH INSTITUTE   (United States)

^c UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE   (United States)

^d UNIVERSITY OF WASHINGTON   (United States)

^e LOYOLA UNIVERSITY MARYLAND   (United States)

^f CARLETON COLLEGE   (United States)

^g SEATTLE CHILDREN S HOSPITAL   (United States)

Author keywords

Adolescents; Barriers; Cross sex hormones; Gender dysphoria; Gender incongruence; Multidisciplinary gender clinic; Preferred name; Puberty suppression; Qualitative study; Transgender

Indexed keywords

SEX HORMONE;

ADOLESCENT; ADULT; AGED; ARTICLE; CAREGIVER; FEMALE; HEALTH CARE; HEALTH INSURANCE; HUMAN; INFORMATION PROCESSING; INTERVIEW; JUVENILE; MALE; PATIENT REFERRAL; PRIORITY JOURNAL; SUPPORT GROUP; THEMATIC ANALYSIS; TRANSGENDER; HEALTH CARE DELIVERY; HEALTH CARE QUALITY; HEALTH PERSONNEL ATTITUDE; HEALTH SERVICE; MIDDLE AGED; PARENT; PSYCHOLOGY; QUALITATIVE RESEARCH; SUPPLY AND DISTRIBUTION; YOUNG ADULT;

ADOLESCENT; ADULT; AGED; ATTITUDE OF HEALTH PERSONNEL; CAREGIVERS; FEMALE; HEALTH SERVICES ACCESSIBILITY; HEALTH SERVICES FOR TRANSGENDER PERSONS; HUMANS; MALE; MIDDLE AGED; PARENTS; QUALITATIVE RESEARCH; QUALITY OF HEALTH CARE; TRANSGENDER PERSONS; YOUNG ADULT;

EID: 84971657229     PISSN: 1054139X     EISSN: 18791972     Source Type: Journal    
DOI: 10.1016/j.jadohealth.2016.03.017     Document Type: Article

References (34)

1. [1] Edwards-Leeper, L., Spack, N.P., Psychological evaluation and medical treatment of transgender youth in an interdisciplinary “Gender Management Service” (GeMS) in a major pediatric center. J Homosex 59 (2012), 321–336.
2. [2] Olson, J., Forbes, C., Belzer, M., Management of the transgender adolescent. Arch Pediatr Adolesc Med 165 (2011), 171–176.
3. [3] Society for Adolescent Health and Medicine (SAHM). Recommendations for promoting the health and well-being of lesbian, gay, bisexual, and transgender adolescents: A Position paper of the Society for Adolescent Health and Medicine. J Adoles Health 52 (2013), 506–510.
4. [4] de Vries, A.L., Doreleijers, T.A., Steensma, T.D., Cohen-Kettenis, P.T., Psychiatric comorbidity in gender dysphoric adolescents. J Child Psychol Psychiatry 52 (2011), 1195–1202.
5. [5] Cohen-Kettenis, P.T., Schagen, S.E., Steensma, T.D., Delemarre-van de Waal, H.A., Puberty suppression in a gender-dysphoric adolescent: A 22-year follow-up. Arch Sex Behav 40 (2011), 843–847.
6. [6] de Vries, A.L., Steensma, T.D., Doreleijers, T.A., Cohen-Kettenis, P.T., Puberty suppression in adolescents with gender identity disorder: A prospective follow-up study. J Sex Med 8 (2011), 2276–2283.
7. [7] de Vries, A.L., McGuire, J.K., Steensma, T.D., et al. Young adult psychological outcome after puberty suppression and gender reassignment. Pediatrics 134 (2014), 696–704.
8. [8] Hembree, W.C., Cohen-Kettenis, P.T., Delemarre-van de Waal, H.A., et al. Endocrine treatment of transsexual persons: An endocrine society clinical practice guideline. J Clin Endocrinol Metab 94 (2009), 3132–3315.
9. [9] Levine, D.A., the American Academy of Pediatrics Committee on Adolescence. Office-based care for lesbian, gay, bisexual, transgender, and questioning youth. Pediatrics 132 (2013), e297–e313.
10. [10] Adelson, S.L., American Academy of Child and Adolescent Psychiatry (AACAP) Committee on Quality Issues (CQI). Practice parameter on gay, lesbian, or bisexual orientation, gender nonconformity, and gender discordance in children and adolescents. J Am Acad Child Adolesc Psychiatry 51 (2012), 957–974.
11. [11] World Professional Association for Transgender Health (WPATH). Standards of care for the health of transsexual, transgender, and gender-nonconforming people, version 7. 2012, WPATH, Minneapolis, MN, 165–232.
12. [12] Shumer, D.E., Spack, N.P., Current management of gender identity disorder in childhood and adolescence: Guidelines, barriers and areas of controversy. Curr Opin Endocrinol Diabetes Obes 20 (2013), 69–73.
13. [13] Spack, N.P., Edwards-Leeper, L., Feldman, H.A., et al. Children and adolescents with gender identity disorder referred to a pediatric medical center. Pediatrics 129 (2012), 418–425.
14. [14] Reisner, S.L., Bradford, J., Hopweed, R., et al. Comprehensive transgender healthcare: The gender affirming clinical and public health model of Fenway health. J Urban Health 92 (2015), 584–592.
15. [15] Kitts, R.L., Barriers to optimal care between physicians and lesbian, gay, bisexual, transgender, and questioning adolescent patients. J Homosex 57 (2010), 730–747.
16. [16] Vance, S.R., Halpern-Felsher, B.L., Rosenthal, S.M., Health care providers' comfort with and barriers to care of transgender youth. J Adolesc Health 56 (2015), 251–253.
17. [17] Vrouenraets, L.J., Fredriks, A.M., Hannema, S.E., et al. Early medical treatment of children and adolescents with gender dysphoria: An empirical ethical study. J Adolesc Health 57 (2015), 367–373.
18. [18] Snelgrove, J.W., Jasudavisius, A.M., Rowe, B.W., et al. “Completely out-at-sea” with “two-gender medicine”: A qualitative analysis of physician-side barriers to providing healthcare for transgender patients. BMC Health Serv Res, 12, 2012, 110.
19. [19] Beagan, B., Fredericks, E., Bryson, M., Family physician perceptions of working with LGBTQ patients: Physician training needs. Can Med Educ J 6 (2015), e14–e22.
20. [20] Knight, R.E., Shoveller, J.A., Carson, A.M., Contreras-Whitney, J.G., Examining clinicians' experiences providing sexual health services for LGBTQ youth: Considering social and structural determinants of health in clinical practice. Health Educ Res 29 (2014), 662–670.
21. [21] Orel, N.A., Investigating the needs and concerns of lesbian, gay, bisexual, and transgender older adults: The use of qualitative and quantitative methodology. J Homosex 61 (2014), 53–78.
22. [22] Melendez, R.M., Pinto, R.M., HIV prevention and primary care for transgender women in a community-based clinic. J Assoc Nurses AIDS Care 20 (2009), 387–397.
23. [23] Sanchez, N.F., Sanchez, J.P., Danoff, A., Health care utilization, barriers to care, and hormone usage among male-to-female transgender persons in New York City. Am J Public Health 99 (2009), 713–719.
24. [24] Corliss, H.L., Belzer, M., Forbes, C., Wilson, E.C., An evaluation of service utilization among male to female transgender youth: Qualitative study of a clinic-based sample. J LGBT Health Res 3 (2007), 49–61.
25. [25] Braun, V., Clarke, V., Using thematic analysis in psychology. Qual Res Psychol 3 (2006), 77–101.
26. [26] Mizock, L., Lewis, T.K., Trauma in transgender populations: Risk, resilience, and clinical care. J Emotional Abuse 8 (2008), 335–354.
27. [27] Rosenthal, S., Approach to the patient: Transgender youth: Endocrine considerations. J Clin Endrocrinol Metab 99 (2014), 4379–4389.
28. [28] Cohen-Kettenis, P.T., van Goozen, S.H., Sex reassignment of adolescent transsexuals: A follow-up study. J Am Acad Child Adolesc Psychiatry 36 (1997), 263–271.
29. [29] Department of Health and Human Serivces. Nondiscrimination in health programs and activities. 2015.
30. [30] National Center for Transgender Equality. Nevada becomes tenth state to ban transgender health exclusions. 2015.
31. [31] Padula, W.V., Heru, S., Campbell, J.D., Societal implications of health insurance coverage for medically necessary services in the U.S. transgender population: A cost-effectiveness analysis. J Gen Intern Med 31 (2016), 394–401.
32. [32] Deutsch, M.B., Green, J., Keatley, J., et al. Electronic medical records and the transgender patient: Recommendations from the world professional association for transgender health EMR working group. J Am Med Inform Assoc 20 (2013), 700–703.
33. [33] Deutsch, M.B., Buchholz, D., Electronic health records and transgender patients–practical recommendations for the collection of gender identity data. J Gen Intern Med 30 (2015), 843–847.
34. [34] Hanneman, T., Healthcare equality index 2014: Promoting equitable and inclusive care for lesbian, gay, bisexual and transgender patients and their families. 2014, Human Rights Campaign, Washington, D.C.