Improving Equitable Transition to Adult Care for Transgender and Gender Expansive Adolescents and Young Adults

Abstract

Transgender and gender expansive (TGE) adolescents and young adults are a marginalized group who have many health disparities in relation to their cisgender peers secondary to transphobia and cis-normativity, with TGE people of racially minoritized identities also having to navigate the intersection of racism. One area of TGE care with little to no research, yet that has the potential to help improve overall wellbeing of TGE individuals, is transitioning care from pediatric to adult care. In other medical specialties, such as diabetes management and mental health, transition of care (ToC) interventions have been correlated with positive health outcomes. In this paper, we explore how ToC may be tailored for TGE adolescents and young adults through an anti-racist and health equity lens using a current review of ToC interventions in other realms of care. Four domains of ToC were identified in the review: planning for transition, transfer assistance, integration into adult care, and care coordination. We explore TGE specific intervention recommendations for each domain, with additional recommendations for how to approach research in this area. ToC from pediatrics to adult care is a vital time for all patients, and improved ToC has been correlated with better health outcomes. Tailoring ToC interventions to TGE adolescents and young adults may help to address health disparities in this group.