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July 19, 2021

Access to Care for Transgender and Nonbinary Youth: Ponder This, Innumerable Barriers Exist

Author Affiliations
  • 1Rady Children’s Hospital, University of California, San Diego School of Medicine, San Diego
  • 2NYU Grossman School of Medicine, New York, New York
  • 3Seattle Children’s Hospital, University of Washington School of Medicine, Seattle
JAMA Pediatr. 2021;175(11):1112-1114. doi:10.1001/jamapediatrics.2021.2068

Access to equitable health care, including gender-affirming medical care (eg, pubertal blockers, sex hormones), continues to be a struggle for transgender and nonbinary youth, especially those who are in racial and ethnic minority groups.1,2 Barriers to accessing comprehensive health care may contribute to the many health disparities transgender and nonbinary youth face, such as higher rates of substance misuse, burden of sexually transmitted infections, bullying, being bullied, anxiety, depression, suicidal ideation, and suicidal behaviors compared with their aged-matched cisgender peers.3 Looking at 1 disparity, mental health, there is clear evidence that access to pubertal suppression and gender-affirming hormones can be lifesaving.4,5 Yet, barriers to this care continue to exist, and many transgender and nonbinary people avoid accessing health care because of experiences of discrimination and/or fear of breaches in confidentiality.2

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