LGBT Primary Care and Gender Affirming Care for Children and Adolescents
By Alexis Victor, M.S.
In her 2023 APA Annual Meeting session “LGBT Primary Care and Gender Affirming Care for Children and Adolescents,” Dr. Shamieka Dixon provided a comprehensive look at gender-affirming care for youths and what that entails not only for young patients, but also for their families and caregivers. Dr. Dixon focused on understanding patient goals and providing realistic expectations on gender-affirming care options available to young patients. A standout quote from Dr. Dixon’s session that resonated with attendees was: “Follow the lead of your kid,” a note on how parental support leads to better outcomes across the board and mitigates risks significantly.
Dr. Dixon noted that 1.4% of the U.S. adolescent population currently identifies as transgender. She also noted that while new language has been adopted to more inclusively describe gender-nonconforming people and there has been more acceptance of transgender and gender-nonconforming individuals, there is still a lot to learn, especially for families and clinicians providing their care.
There's recently been a spotlight on transgender health care due to state laws that seek to limit or eliminate gender-affirming care for minors. LGBTQ+ youth are often discriminated against, and the rate of discrimination is even higher for LGBTQ+ youth of color. This stigma of discrimination further impacts health care disparities and inequities.
Effective strategies for psychiatrists to create a safe space for LGBTQ+ youth include LGBTQ+ positive inclusive messages; training staff to be respectful and nonjudgmental; visibly posting a nondiscrimination policy or image (such as a pride flag or pronoun pins for staff); and avoiding assumptions about the patients being treated. Dr. Dixon was asked what the key takeaway was for mental health providers to understand about this population: “We don't think about our biases, but they do come across in the care we provide,” she said.