@article{ref1,
title="Youth and caregiver perspectives on barriers to gender-affirming health care for transgender youth",
journal="Journal of Adolescent Health",
year="2016",
author="Gridley, Samantha J. and Crouch, Julia M. and Evans, Yolanda and Eng, Whitney and Antoon, Emily and Lyapustina, Melissa and Schimmel-Bristow, Allison and Woodward, Jake and Dundon, Kelly and Schaff, RaNette and McCarty, Carolyn and Ahrens, Kym and Breland, David J.",
volume="59",
number="3",
pages="254-261",
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. <br><br>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. <br><br>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. <br><br>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 following recommendations: (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.<br><br>Copyright © 2016 The Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.<p /> <p>Language: en</p>",
language="en",
issn="1054-139X",
doi="10.1016/j.jadohealth.2016.03.017",
url="http://dx.doi.org/10.1016/j.jadohealth.2016.03.017"
}