Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Pediatrics
Published in: BMC Pediatrics 1/2015

Open Access 01-12-2015 | Research article

Improving transgender health by building safe clinical environments that promote existing resilience: Results from a qualitative analysis of providers

Authors: Carlos G. Torres, Megan Renfrew, Karey Kenst, Aswita Tan-McGrory, Joseph R. Betancourt, Lenny López

Published in: BMC Pediatrics | Issue 1/2015

Login to get access

Abstract

Background

Transgender (TG) individuals experience discordance between their sex at birth and their gender identity. To better understand the health care needs and characteristics of TG youth that contribute to resilience, we conducted a qualitative study with clinical and non-clinical providers.

Methods

In-depth interviews were conducted of providers (n = 11) of TG youth (ages 13–21). Convenience and purposive sampling were used to recruit participants in the Boston area. All interviews were audio-recorded and transcribed verbatim. An interview guide of 14 open-ended questions was used to guide the discussion. A grounded theory approach was utilized to code and analyze the data, including double-coding to address issues of inter-rater reliability.

Results

Five primary themes emerged: 1) resilience of TG youth 2) lack of access to services that influence health, 3) the critical role of social support, 4) challenges in navigating the health care system, and 5) the need for trans-affirming competency training for providers and frontline staff.

Conclusion

The findings of this study show that providers recognize multiple barriers and challenges in the care of TG youth. However, they also identify the resilience exhibited by many youth. We propose that providers can further enhance the resilience of TG youth and help them flourish by offering them necessary resources via the creation of safe and welcoming clinical environments.
Appendix
Available only for authorised users
Literature
1.
Mayer KH, Bradford JB, Makadon HJ, Stall R, Goldhammer H, Landers S. Sexual and gender minority health: what we know and what needs to be done. Am J Public Health. 2008;98(6):989–95.CrossRefPubMedPubMedCentral
2.
Olson J, Forbes C, Belzer M. Management of the transgender adolescent. Arch Pediatr Adolesc Med. 2011;165:171–6.CrossRefPubMed
3.
Meier S, Labuski C. The demographics of the transgender population. In: Baumle A, editor. The international handbook on the demography of sexuality. New York: Springer Press; 2013.
4.
Institute of Medicine. “The health of lesbian, gay, bisexual, and transgender people: Building a foundation for better understanding”. 2011.
5.
Garofalo R, Deleon J, Osmer E, Doll M, Harper GW. Overlooked, misunderstood and at-risk: Exploring the lives and HIV risk of ethnic minority male-to-female transgender youth. J Adolesc Health. 2006;38(3):230–6.CrossRefPubMed
6.
Remafedi G, Farrow JA, Deisher RW. Risk factors for attempted suicide in gay and bisexual youth. Pediatrics. 1991;87:869–75.PubMed
7.
Grossman AH, D’Augelli AR. Transgender youth: invisible and vulnerable. J Homosex. 2006;51(1):111–28.CrossRefPubMed
8.
9.
Ahern NR, Ark P, Byers J. Resilience and coping strategies in adolescents–additional content. Paediatric Care. 2008;20(10):S1–8.CrossRef
10.
Fergus S, Zimmerman MA. Adolescent resilience: A framework for understanding healthy development in the face of risk. Annu. Rev. Public Health. 2005;26:399–419.CrossRef
11.
Mannes M, Roehlkepartain EC, Benson PL. Unleashing the power of community to strengthen the well-being of children, youth, and families: An asset-building approach. Child Welfare. 2005;84(2):233.PubMed
12.
Stieglitz KA. Development, risk, and resilience of transgender youth. J Assoc Nurses AIDS Care. 2010;21(3):192–206.CrossRefPubMed
13.
Grossman AH, D’augelli AR, Frank JA. Aspects of psychological resilience among transgender youth. Journal of LGBT Youth. 2011;8(2):103–15.CrossRef
14.
Snelgrove JW, Jasudavisius AM, Rowe BW, Head EM, Bauer GR. “Completely out-at-sea” with “two-gender medicine”: A qualitative analysis of physician-side barriers to providing healthcare for transgender patients. BMC Health Serv Res. 2012;12(1):110.CrossRefPubMedPubMedCentral
15.
Vance SR, Halpern-Felsher BL, Rosenthal SM. Health care providers’ comfort with and barriers to care of transgender youth. J Adolesc Health. 2015;56(2):251–3.CrossRefPubMed
16.
Strauss A, Corbin J. Basics of qualitative research: grounded theory procedures and techniques. Newbury Park: CAL Sage; 1990.
17.
Saldaña, J. The coding manual for qualitative researchers. London: Sage; 2013.
18.
19.
Rew L, Horner SD. Youth resilience framework for reducing health-risk behaviors in adolescents. J Pediatr Nurs. 2003;18(6):379–88.CrossRefPubMed
20.
Sesma Jr A, Mannes M, Scales PC. Positive adaptation, resilience and the developmental assets framework. In: Handbook of Resilience in Children. US: Springer; 2013. p. 427–42.CrossRef
21.
Tiet QQ, Bird HR, Davies M, Hoven C, Cohen P, Jensen PS, et al. Adverse life events and resilience. J Am Acad Child Adolesc Psychiatry. 1998;37(11):1191–200.CrossRefPubMed
22.
Lev AI. Disordering gender identity: Gender identity disorder in the DSM-IV-TR. J Psychol Hum Sex. 2006;17(3–4):35–69.CrossRef
23.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 2013.
24.
Ryan C, Russell ST, Huebner D, Diaz R, Sanchez J. Family acceptance in adolescence and the health of LGBT young adults. J Child Adolesc Psychiatr Nurs. 2010;23(4):205–13.CrossRefPubMed
25.
Menvielle EJ, Tuerk C, Jellinek MS. A support group for parents of gender-nonconforming boys. J Am Acad Child Adolesc Psychiatry. 2002;41(8):1010–3.CrossRefPubMed
26.
Menvielle E. A comprehensive program for children with gender variant behaviors and gender identity disorders. J Homosex. 2012;59(3):357–68.CrossRefPubMed
27.
Möller B, Schreier H, Li A, Romer G. Gender identity disorder in children and adolescents. Curr Probl Pediatr Adolesc Health Care. 2009;39(5):117–43.CrossRefPubMed
28.
29.
30.
Mallon GP. Practice with transgendered children. Journal of Gay & Lesbian Social Services. 2000;10(3–4):49–64.
31.
Legal, L. Creating Equal Access to Quality Health Care for Transgender Patients: Transgender Affirming Hospital Policies 2013. 2013.
32.
Dyer JG, Patsdaughter CA, McGuinness TM, O’Connor CA, DeSantis JP. Retrospective resilience: The power of the patient-provider alliance in disenfranchised persons with HIV/AIDS. J Multicult Nurs Health. 2004;10(1):57.
33.
34.
Hoffman ND, Freeman K, Swann S. Healthcare preferences of lesbian, gay, bisexual, transgender and questioning youth. J Adolesc Health. 2009;45(3):222–9.CrossRefPubMedPubMedCentral
35.
Sherer I, Rosenthal SM, Ehrensaft D, Baum J. Child and Adolescent Gender Center: a multidisciplinary collaboration to improve the lives of gender nonconforming children and teens. Pediatr Rev. 2012;33(6):273.CrossRefPubMed
36.
Coleman E, Bockting W, Botzer M, Cohen-Kettenis P, DeCuypere G, Feldman J et al. Standards of care for the health of transsexual, transgender, and gender-nonconforming people, version 7. International Journal of Transgenderism. 2012;13(4):165–232.CrossRef
37.
Spack NP, Edwards-Leeper L, Feldman HA, Leibowitz S, Mandel F, Diamond DA, et al. Children and adolescents with gender identity disorder referred to a pediatric medical center. Pediatrics. 2012;129(3):418–25.CrossRefPubMed
38.
Hsieh S, Leininger J. Resource list: clinical care programs for gender-nonconforming children and adolescents. Pediatr Ann. 2014;43(6):238.CrossRefPubMed
39.
Riley EA, Sitharthan G, Clemson L, Diamond M. The needs of gender-variant children and their parents: A parent survey. Int J Sex Health. 2011;23(3):181–95.CrossRef
40.
Metadata
Title
Improving transgender health by building safe clinical environments that promote existing resilience: Results from a qualitative analysis of providers
Authors
Carlos G. Torres
Megan Renfrew
Karey Kenst
Aswita Tan-McGrory
Joseph R. Betancourt
Lenny López
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Pediatrics / Issue 1/2015
Electronic ISSN: 1471-2431
DOI
https://doi.org/10.1186/s12887-015-0505-6

Other articles of this Issue 1/2015

BMC Pediatrics 1/2015 Go to the issue

Research article

Prediction of outcomes by early treatment responses in childhood T-cell acute lymphoblastic leukemia: a retrospective study in China

Research article

Comforting strategies and perceived barriers to pediatric pain management during IV line insertion procedure in Uganda’s national referral hospital: A descriptive study

Research article

Lung function in very preterm infants with patent ductus arteriosus under conservative management: an observational study

Research article

Acute and preventive management of anaphylaxis in German primary school and kindergarten children

Research article

Development and psychometric properties of the parent version of the Profile of Neuropsychiatric Symptoms (PONS) in children and adolescents

Research article

Effects of low-dose clonidine on cardiovascular and autonomic variables in adolescents with chronic fatigue: a randomized controlled trial