As pediatricians, we need to assure that all patients we care for receive the care needed to give them every opportunity to succeed in life. Yet studies we have published suggest that unless we are aware of the social adversities and mental health concerns, that can be present in our patients who are lesbian, gay, bisexual, transgender, questioning, (LGBTQ) or gender non-conforming patients, we are not fulfilling our care responsibilities to these children and teenagers. This week, we add two more concerning studies to raise your awareness and in turn lead to better care for our patients.
The first study we are early releasing this week is a cross-sectional statewide analysis of students in Minnesota enrolled during 2016 in grades 9 and 11. The author of this study, Dr. Laura Baams (10.1542/peds.2017-3004) identified four different patterns of childhood adversity ranging from (1) low levels of abuse to (2) household dysfunction to (3) psychological and physical abuse to (4) polyvictimization, and finds that teenagers who are LGBTQ or gender nonconforming were more likely to be polyvictimized and experience psychological and physical abuse when compared to heterosexual adolescents. In addition, students who self-reported as gender-nonconforming had an overall higher adversity profile.
A second study by Becerra-Culqui et al. (10.1542/peds.2017-3845) looked closely at the prevalence of mental health problems in transgender and gender non-conforming (TGNC) youth, comparing 588 transfeminine and 745 transmasculine children and adolescents in California and Georgia to matched cisgender children and teens by year of birth. Sadly, the TGNC youth were more likely to have depression, attention deficit hyperactivity disorder, self-inflicted injury, or suicidal ideation than their cisgender counterparts.
So what can we do about these findings in our offices? We asked Drs. Stanley Vance, Jr., and Stephen Rosenthal to weigh in with an accompanying commentary (10.1542/peds.2018-0361) regarding these studies. They remind us of the importance of making patients who are LGBTQ or gender non-conforming first and foremost feel comfortable enough to share their concerns with us, so we can develop a management plan and also focus on how to build strength and resiliency. These two articles and commentary are important reads for all of us to review and reflect upon how we can all improve the care delivery to these individuals.
