Youth and Caregiver Perspectives on Barriers to Gender-Affirming Health Care for Transgender Youth.
J Adolesc Health
; 59(3): 254-261, 2016 09.
Article
in En
| MEDLINE
| ID: mdl-27235374
ABSTRACT
PURPOSE:
Few transgender youth eligible for gender-affirming treatments actually receive them. Multidisciplinary gender clinics improve access and care coordination but are rare. Although experts support use of pubertal blockers and cross-sex hormones for youth who meet criteria, these are uncommonly offered. This study's aim was to understand barriers that transgender youth and their caregivers face in accessing gender-affirming health care.METHODS:
Transgender youth (age 14-22 years) and caregivers of transgender youth were recruited from Seattle-based clinics, and readerships from a blog and support group listserv. Through individual interviews, focus groups, or an online survey, participants described their experiences accessing gender-affirming health care. We then used theoretical thematic analysis to analyze data.RESULTS:
Sixty-five participants (15 youth, 50 caregivers) described barriers spanning six themes (1) few accessible pediatric providers are trained in gender-affirming health care; (2) lack of consistently applied protocols; (3) inconsistent use of chosen name/pronoun; (4) uncoordinated care and gatekeeping; (5) limited/delayed access to pubertal blockers and cross-sex hormones; and (6) insurance exclusions.CONCLUSIONS:
This is the first study aimed at understanding perceived barriers to care among transgender youth and their caregivers. Themed barriers to care led to the followingrecommendations:
(1) mandatory training on gender-affirming health care and cultural humility for providers/staff; (2) development of protocols for the care of young transgender patients, as well as roadmaps for families; (3) asking and recording of chosen name/pronoun; (4) increased number of multidisciplinary gender clinics; (5) providing cross-sex hormones at an age that permits peer-congruent development; and (6) designating a navigator for transgender patients in clinics.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Parents
/
Caregivers
/
Transgender Persons
/
Health Services for Transgender Persons
/
Health Services Accessibility
Type of study:
Guideline
/
Qualitative_research
Aspects:
Determinantes_sociais_saude
/
Implementation_research
Limits:
Adolescent
/
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
J Adolesc Health
Journal subject:
PEDIATRIA
Year:
2016
Document type:
Article