Wednesday, November 30, 2016

Good News

I had to go back to August to find it, but it is good news.
Letter from the President: Pediatricians should not be transgender children’s first bully
By Benard P. Dreyer, M.D., FAAP, President, American Academy of Pediatrics
August 3, 2016

As I sat at the AAP Districts II and VIII joint meeting in late June listening to two families talk about their experiences with their young transgender children, I felt privileged to witness such love and acceptance — and such normal, happy children who just happened not to fit their “assigned” or birth gender. I was proud to be an AAP member and a pediatrician, just as I was proud in April, when the North Carolina Chapter and national AAP called for repeal of North Carolina’s so-called “bathroom bill,” a law that denies transgender students access to gender-segregated spaces such as restrooms and locker rooms in schools.

I’ve learned so much from these children and their families. First, gender dysphoria can start very early. Both children experienced strong opinions about their gender at the age of 4 or 5. Second, there is a continuum in gender dysphoria. Both children had natal male genders. Yet one child changed her name to reflect a female gender and insisted she was a girl, while the other child wanted to be addressed with male pronouns in spite of a preference to dress like a girl and choose play and roles traditionally engaged in by girls.

Both families stressed how important it is for home to be a safe and accepting space for the transgender child. When those children walk through the door of their homes at the end of a school day, they should be able to be themselves without any judgment. As one of the fathers passionately said, “I won’t be my child’s first bully!”

The pediatrician’s office, and the entire health care setting, should be a safe, accepting place as well. I was sad to receive an email from one of the parents telling of another family’s encounters with the health care system when they bring their 5-year-old transgender daughter in for care for her serious chronic disease. The doctors refuse to treat her as a girl until she is older, and some have even called child protective services claiming the mother is harming her child for allowing her to live as a girl.
In another article in the AAP News & Journal…
Transgender youths may struggle to find gender-affirming care
Melissa Jenco, News Content Editor
August 3, 2016

Transgender youths report multiple barriers to receiving gender-affirming health care, according to a new study.

Delaying such care comes with a price as it is connected to increased risk of psychiatric issues like anxiety and depression, which already are higher in transgender youths than in their peers.
Researchers set out to see if these youths were able to find gender-affirming care. They used surveys, interviews and focus groups to garner input from 15 youths ages 14-22 and 50 caregivers of transgender youths. They found six common barriers:
  • limited number of providers trained in supporting transgender youths who were accessible in terms of insurance coverage and distance;
  • lack of office protocols or awareness of professional guidelines;
  • providers who did not use the patient’s chosen name or pronoun;
  • lack of coordination between providers;
  • trouble accessing pubertal blockers and cross-sex hormones due to age, parental approval or lack of provider training; and
  • insurance exclusions.
The team suggested remedies for each barrier, including training providers and staff, developing office protocols, opening multidisciplinary gender clinics and providing cross-sex hormones at an age that allows adolescents to develop at the same time as their peers.
Maybe we will be getting better healthcare for the children.

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