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 Now the authors of a new report have suggested steps to correct that
problem.
Transgender people, whose gender does not align with their sex
assigned at birth, experience higher rates of anxiety, depression,
substance abuse and suicide than other people, the researchers write
in the Journal of Adolescent Health.
Timely access to gender-affirming healthcare, such as puberty
blockers and cross-sex hormones, is tied to improved body image and
a lower risk of long term mental health problems, according to
Samantha Gridley of the Vanderbilt University School of Medicine in
Nashville and colleagues.
For the new study, the researchers surveyed 15 transgender youths
and 50 caregivers of transgender youths in 2015. Participants were
recruited from Seattle clinics, a blog and a support group.
Barriers to appropriate care, according to the youths and the
caregivers, included providers untrained in gender-affirming
healthcare, inconsistently applied protocols, inconsistent use of a
youth's chosen name or pronoun, uncoordinated care, limited and
delayed access to treatments and insurance issues.
For example, one youth said it was difficult to find doctors who
were accepting new patients, worked with adolescents and took their
insurance, adding, "Finding someone who was trans-friendly made it
all but impossible."
A caregiver reported that a doctor repeatedly called a child by the
wrong name and pronoun. "I keep saying 'he,' 'Jack,' and she starts
getting angry with me and flipping her head at me, like I was
causing her to be annoyed . . . She gave me a look to kill."
To improve healthcare access for transgender youths, Gridley's team
recommends mandatory training for pediatric providers and staff on
gender affirming healthcare and awareness. They recommend developing
protocols for the care of transgender youths and a roadmap for their
families.
They also recommend that a child's chosen name and pronoun be
recorded in medical records, and that clinics designate patient
navigators to help transgender patients.
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In addition, they call for more gender clinics, and they urge
doctors to provide gender-affirming treatments to youths so they
develop alongside their peers.
The study's senior author Dr. David Breland, of Seattle Children's
Research Institute, was unable respond to a request for comment by
press time.
Dr. Aron Janssen, who directs the Gender and Sexuality Service at
NYU Langone’s Child Study Center in New York City and wasn't
involved in the study, told Reuters Health that access to healthcare
for transgender youths is generally moving in the right direction.
But still, he said, there are things in medical education that need
to change.
He said some organizations are helping to train doctors to care for
transgender youths and adults. Doctors who don't feel equipped to
provide competent care should take steps to get educated, he said.
"The important piece about the study is that it incorporates the
patient's family's voice," said Janssen. "All too often, services
are developed without the perspective of patients and their
families. I think it’s a vital piece and a piece that we haven’t
heard much of."
He added, "Too often the patient and family voices are absent in the
scientific literature and they’re the ones who are most affected by
treatment and access issues, and they’re crucial to the research we
do."
SOURCE: http://bit.ly/1Xd4cw3 Journal of Adolescent Health, online
May 24, 2016.
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