Abstract
Awareness and visibility of transgender individuals have grown exponentially. However, conceptualizing sexual and reproductive health (SRH) as “women's” or “men's” health services further marginalizes transgender and gender-expansive (TGE) youth. Multiple reviews and commentaries have been published on the topic of SRH care for adults under the umbrella term of sexual and gender minorities, all with a call to action for more inclusive care and the need for more clinical research involving TGE individuals, and notably, TGE youth. Results from adult TGE studies are often translated to describe adolescent models. However, models specific to adolescent TGE populations are needed to understand their unique SRH needs. This review will describe the current literature relating to SRH needs of TGE youth and adults, highlighting key areas with significant disparities in need of further research. This comprehensive summary will also provide recommendations for clinicians and researchers with the goal of improving SRH care and obtaining wider representation in both clinical settings and research directed toward TGE youth.
Highlights
SRH healthcare is often conceptualized as “women’s” or “men’s” health services, which may be excluding many people from seeking care
As social stigma decreases and education surrounding sex and gender increases, [21] the prevalence of adolescents identifying as a gender other than cisgender has been increasing (3% in 2018) [22]
Researchers have responded by surveying clinicians about their knowledge and attitudes towards caring for TGE individuals. [33, 34] A 2015 survey of 141 obstetrician-gynecologists across nine academic hospitals found that 80% did not receive training in residency regarding the care of transgender patients; only 35% and 29% felt comfortable caring for male-to-female and female-tomale transgender patients, respectively [33]
Summary
SRH healthcare is often conceptualized as “women’s” or “men’s” health services, which may be excluding many people from seeking care. A recent study aimed at the development of an affirming and customizable electronic survey of SRH experiences found that: [1] TGE community input from initial conceptualization to final implantation is essential; [2] investigators need to be mindful of gender-diversity and differences in sexual orientation when defining study eligibility criteria to directly reduce selection bias; and [3] the ability to use individualized, affirming, customized language for sexual and reproductive body parts and processes may avoid gender dysphoria evoked for some by medical terms [101] Lessons learned from these findings may inspire other researchers to innovate and think more inclusively, thereby creating affirming research for marginalized groups, such as TGE youth and adults.
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