Role of Family Environment on Recognition of Diverse Gender Identities and Presentation to Care

In 2018, the American Academy of Pediatrics recommended that all transgender and gender-diverse (TGGD) youth “have access to comprehensive, gender-affirming, and developmentally appropriate health care.” In its position statement, The American Academy of Pediatrics acknowledges mounting evidence that gender-affirming medical care (GAMC) for TGGD youth improves health and developmental outcomes and describes the critical role that pediatricians play in diagnosing, supporting, and facilitating access to care for TGGD youth. Furthermore, the timing of presentation to care for peripubertal youth is critical because delays in care impact whether and to what extent a youth can benefit from treatment with pubertal suppression. Access to puberty suppression may have an impact not only on mental health outcomes, but also on the need for or type of future surgical interventions. It is vital that providers who care for youth understand the factors that impact youth’s timing of presentation to gender-affirming care so that we may facilitate timely access to GAMC for all youth, particularly those with intersectional identities that have an additional impact on access to health care.