Transgender Healthcare Saves Lives: Impacts of Access on Suicidality

Main Article Content

Vincent So
Josh Smalley

Abstract

Transgender care amongst youth has received media and political attention in recent years, with broad impacts on transgender patients, especially in the field of pediatrics. Barriers to accessing transgender health care has broad implications on health outcomes such as suicidality and should be prioritized by all healthcare professionals. We discuss strategies for all providers to ensure equitable access and highlight some important considerations for medical trainees and early career physicians.


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Les soins transgenres chez les jeunes ont retenu l’attention des médias et des politiques ces dernières années, ce qui a eu des vastes répercussions sur les patients transgenres, en particulier dans le domaine de la pédiatrie. Les obstacles au soins contribuent à de mauvais résultats, y compris l’augmentation de la suicidalité, soulignant la nécessité d’un accès équitable aux soins de santé pour les personnes transgenres. Cet article présente des stratégies permettant aux prestataires de soins de santé de surmonter ces obstacles et souligne les points importants à prendre en compte par les stagaires en médecine et les médecins en début de carrière.

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References

Dhejne C, Van Vlerken R, Heylens G, Arcelus J. Mental health and gender dysphoria: A review of the literature. Int Rev Psychiatry. 2016;28(1):44–57.

Tordoff DM, Wanta JW, Collin A, Stepney C, Inwards-Breland DJ, Ahrens K. Mental Health Outcomes in Transgender and Nonbinary Youths Receiving Gender-Affirming Care. JAMA Netw Open. 2022;5(2):1–13.

Gridley SJ, Crouch JM, Evans Y, Eng W, Antoon E, Lyapustina M, et al. Youth and Caregiver Perspectives on Barriers to Gender-Affirming Health Care for Transgender Youth. J Adolesc Heal [Internet]. 2016;59(3):254–61. Available from: http://dx.doi.org/10.1016/j.jadohealth.2016.03.017

Scheim AI, Coleman T, Lachowsky N, Bauer GR. Health care access among transgender and nonbinary people in Canada, 2019: a cross-sectional survey. C open. 2021;9(4):E1213–22.

Hunt QA, Morrow QJ, McGuire JK. Experiences of Suicide in Transgender Youth: A Qualitative, Community-Based Study. Arch Suicide Res [Internet]. 2020;24(sup2):S340–55. Available from: https://doi.org/10.1080/13811118.2019.1610677

Levine DA. Office-based care for lesbian, gay, bisexual, transgender, and questioning youth. Pediatrics. 2013;132(1).

Rotondi NK, Bauer GR, Scanlon K, Kaay M, Travers R, Travers A. Nonprescribed hormone use and self-performed surgeries: “do-it-yourself” transitions in transgender communities in Ontario, Canada. Am J Public Health. 2013;103(10):1830–6.

Navabi B, Tang K, Khatchadourian K, Lawson ML. Pubertal suppression, bone mass, and body composition in youth with gender dysphoria. Pediatrics. 2021;148(4).

Olson KR, Durwood L, Horton R, Gallagher NM, Devor A. Gender Identity 5 Years After Social Transition. Pediatrics. 2022;150(2).

MacKinnon KR, Kia H, Salway T, Ashley F, Lacombe-Duncan A, Abramovich A, et al. Health Care Experiences of Patients Discontinuing or Reversing Prior Gender-Affirming Treatments. JAMA Netw Open. 2022;5(7):E2224717.

Soled KRS, Dimant OE, Tanguay J, Mukerjee R, Poteat T. Interdisciplinary clinicians’ attitudes, challenges, and success strategies in providing care to transgender people: a qualitative descriptive study. BMC Health Serv Res [Internet]. 2022;22(1):1–15. Available from: https://doi.org/10.1186/s12913-022-08517-x

Dubin SN, Nolan IT, Streed CG, Greene RE, Radix AE, Morrison SD. Transgender health care: Improving medical students’ and residents’ training and awareness. Adv Med Educ Pract. 2018;9:377–91.

Katzenellenbogen R. HEADSS: The “Review of Systems” for Adolescents. Am J Ethics- Virtual Mentopr [Internet]. 2005;7(3):231–3. Available from: https://journalofethics.ama-assn.org/article/headss-review-systems-adolescents/2005-03

Goldenring BJM, Rosen DS. Getting into adolescent heads : An essential update Getting into adolescent heads : An essential update. Contemp Pediatr [Internet]. 2004;21(64):1–19. Available from: http://www2.aap.org/pubserv/PSVpreview/pages/Files/HEADSS.pdf

CMPA. Treating transgender and non-binary individuals-Legal and regulatory proceedings: Navigating legal or regulatory processes. Can Med Prot Assoc [Internet]. 2023; Available from: https://www.cmpa-acpm.ca/en/advice-publications/browse-articles/2015/treating-transgender-and-non-binary-individuals

Kelley L, Chou CL, Dibble SL, Robertson PA. A critical intervention in lesbian, gay, bisexual, and transgender health: Knowledge and attitude outcomes among second-year medical students. Teach Learn Med. 2008;20(3):248–53.

Safer J, Pearce E. A simple curriculum content change increased medical student comfort with transgender medicine. Endocr Pract. 2013;19(4):633–7.

Russell ST, Pollitt AM, Li G, Grossman AH. Chosen Name Use Is Linked to Reduced Depressive Symptoms, Suicidal Ideation, and Suicidal Behavior Among Transgender Youth. J Adolesc Heal. 2018;63(4):503–5.

Turban J, Ferraiolo T, Martin A, Olezeski C. Ten Things Transgender and Gender Nonconforming Youth Want Their Doctors to Know. J Am Acad Child Adolesc Psychiatry. 2017;56(4):275–7.

de Vries ALC, Klink D, Cohen-Kettenis PT. What the Primary Care Pediatrician Needs to Know About Gender Incongruence and Gender Dysphoria in Children and Adolescents. Pediatr Clin North Am [Internet]. 2016;63(6):1121–35. Available from: http://dx.doi.org/10.1016/j.pcl.2016.07.011

Caring for Kids C. Gender identity. Can Paediatr Soc. 2023;