Interacting with the medical system can be intimidating for all youth, including those who are transgender. The goal of this project was to provide information about community resources and medical terminology and treatments that transgender youth may encounter during the medical transition process. The target audience is those that attend a community center dedicated to LGBTQ youth.https://scholarworks.uvm.edu/fmclerk/1369/thumbnail.jp

Berkman, Amy M

English

UVM ScholarWorks

University of VermontScholarWorks @ UVMFamily Medicine Clerkship Student Projects Larner College of Medicine2017Medical Aspects of Transitioning - A Guide forTransgender YouthAmy M. BerkmanFollow this and additional works at: https://scholarworks.uvm.edu/fmclerkPart of the Pediatrics Commons, and the Primary Care CommonsThis Book is brought to you for free and open access by the Larner College of Medicine at ScholarWorks @ UVM. It has been accepted for inclusion inFamily Medicine Clerkship Student Projects by an authorized administrator of ScholarWorks @ UVM. For more information, please contactdonna.omalley@uvm.edu.Recommended CitationBerkman, Amy M., "Medical Aspects of Transitioning - A Guide for Transgender Youth" (2017). Family Medicine Clerkship StudentProjects. 308.https://scholarworks.uvm.edu/fmclerk/308Medical Aspects Transitioning – A Guide for Transgender YouthSouth Burlington Family PracticeAmy BerkmanNovember 20171Problem and Description of Need• The mission of Outright Vermont is to “build safe, healthy, and supportive environments for gay, lesbian, bisexual, transgender, queer, and questioning youth ages 13-22”• Friday Night Group (FNG) is a space for self-identified queer youth to drop in and chat about any issues they are facing in their lives• Youth at FNG have identified a desire to learn more about the transgender specific psychiatric and medical care available at UVMMC • Studies have demonstrated that it can be challenging for transgender youth and their caregivers to navigate online resources andfind information about transgender health• Peer groups dedicated as safe spaces for queer youth have been shown to be effective venues for discussing health education topics2The goal of this project was to create a brief guide for youth at Outright Vermont on what services are available for transgender medical care at UVMMC and what youth can expect at these appointments3Public Health Costs and Unique Cost Considerations• A recent study found that the prevalence of self-reported suicidal ideation was nearly twice as high in transgender compared to cis-gender youth• Transgender youth are also at heightened risk of substance abuse compared to cisgender peers • Appropriate medical interventions as well as a gender affirming environment have been shown to lead to improved health outcomes in the transgender communityExpanding availability of transgender specific healthcare services is an important part of reducing the health disparities faced by transgender youth. This project is simply designed to connect youth with information about the resources available in their community. However, if more transgender youth were connected to supportive medical communities it could lead to a significant decrease in at-risk behaviors and improvement in psychosocial functioning.4Community Perspective on Issue and Support for Project• Youth at Outright Vermont requested more information about the medical aspects of transitioning and what they could expect at the Transgender Youth Clinic. They rely on peers for information and have heard many conflicting stories about transgender medical care. (This came from a group discussion – individuals who access Outright will remain anonymous).• The Director of Programming at Outright agreed that this was a need that could be filled. There are binders filled with resources and information about many community groups that are accessed by youth at Outright. A binder with information on medical aspects of transitioning would be well received. Intervention and Methodology5• Providers in the Transgender Youth Program were contacted – including a Psychiatrist, Psychologist, Pediatrician, Endocrinologist, and Nurse Coordinator• Questions were posed to providers about their role and the services they offer, as well as general questions that were of concern to youth (ie parental involvement/consent and resources to help deal with insurance companies) via email or telephone call• Information was compiled and summarized and made into a binder that will be kept in the resource library at Outright Vermont. When youth have questions or are preparing for an upcoming appointment, or simply just browsing – they will be able to access the binder• Information about hormonal treatment, including hormone blockers, testosterone and estrogen was also gathered from transgender health resources around the country and included in the binder of educational material6Results/Response• Youth are excited to have more information about transgender medical care and what to expect at appointments• Providers were excited to talk to a medical student about the advances that have been made in addressing transgender care – they were hopeful that the interest in transgender care exhibited by our generation of students will lead to more services and better health outcomes7Evaluation of Effectiveness and Limitations• There is not an immediate outcome or evaluation to this project – ultimately the results will be whether youth feel more informed going into appointments and whether they feel more comfortable navigating transgender health information• This will be an ongoing process – hopefully the information will lead to more questions and discussion• I will check in with youth over the next few months and ask them if this resource helped them feel more comfortable going into medical appointments• Limitations include:1) This is not a comprehensive guide to medical transitioning and will not answer every question that comes up2)  Not all of the providers contacted responded to requests to be interviewed for a medical student community health project. The providers that did respond were enthusiastic and gave very detailed information about all aspects of transgender care in which they      had experience 8Future Interventions/Projects• A next step in this project could be moving the information to an online platform• Youth who have further questions or need clarification will be encouraged to bring these up and more information can be provided and/or researched• Ultimately, giving a greater proportion of gender questioning youth information about medical services will hopefully translate to more use of these services. Future projects could work with the Transgender Youth Clinic to connect youth who may not access Outright to information about their servicesReferences9http://www.outrightvt.org/mission-history/Evans YN, Gridley SJ, Crouch J, et al. Understanding Online Resource Use by Transgender Youth and Caregivers: A Qualitative Study. Transgender Health. 2017;2(1):129-139. doi:10.1089/trgh.2017.0011.Poteat VP, Heck NC, Yoshikawa H, Calzo JP. Gay-Straight Alliances as settings to discuss health topics: individual and group factors associated with substance use, mental health, and sexual health discussions. Health Educ Res. 2017 Jun 1;32(3):258-268. doi: 10.1093/her/cyx044.Insurance Coverage of Puberty Blocker Therapies for Transgender Youth. Jaime Stevens, Veronica Gomez-Lobo, Elyse Pine-Twaddell Pediatrics  Dec 2015,  136  (6)  1029-1031;  DOI: 10.1542/peds.2015-2849 Amaya Perez-Brumer, Jack K. Day, Stephen T. Russell, Mark L. Hatzenbuehler, Prevalence and Correlates of Suicidal Ideation Among Transgender Youth in California: Findings From a Representative, Population-Based Sample of High School Students, In Journal of the American Academy of Child & Adolescent Psychiatry, Volume 56, Issue 9, 2017, Pages 739-746, ISSN 0890-8567Jack K. Day, Jessica N. Fish, Amaya Perez-Brumer, Mark L. Hatzenbuehler, Stephen T. Russell, Transgender Youth Substance Use Disparities: Results From a Population-Based Sample, In Journal of Adolescent Health, 2017, , ISSN 1054-139XVancouver Transgender Health Program. Hormones: A Guide for MTFs. https://apps.carleton.edu/campus/gsc/assets/hormones_MTF.pdfSelva, Karin. TransActive Gender Center. Puberty Blockers and Puberty Inhibitors. https://www.transactiveonline.org/resources/youth/puberty-blockers.phpHudson’s FTM Resource Guide. Chest Surgery. http://www.ftmguide.org/chest.htmlHudson’s FTM Resource Guide. Testosterone Therapy Basics. http://www.ftmguide.org/ttherapybasics.htmlHudson’s FTM Resource Guide. Hormone Basics. http://www.ftmguide.org/hormonebasics.html

Medical Aspects of Transitioning - A Guide for Transgender Youth

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Medical Aspects of Transitioning - A Guide for Transgender Youth

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