Transgender kids know their gender and the AAP says doctors should offer care accordingly

The stigma that transgender children and youth often face can take a toll on their mental and physical health, but a new policy statement aims to makes at least one place safe for them: the doctor’s office. The new statement from the American Academy of Pediatrics says that paediatricians should support and offer comprehensive care for transgender and gender diverse kids.

“Maintaining a safe clinical space can provide at least one consistent, protective refuge for patients and families, allowing authentic gender expression and exploration that builds resiliency,” write the authors of the statement.

The report outlines best practices for everything from using patient-asserted names and pronouns in person and on medical charts to suppressing puberty in order to prevent the development of sexual characteristics and the distress that comes with them. It also educates paediatricians on some of the harsh realities trans kids might face at home or in schools, and encourages them to become advocates for gender-diverse children within their own communities.

“I’m really impressed with the steps the AAP is making,” says Amanda Jette Knox, an LGBTQ advocate who has a trans daughter and trans wife, “and while they don’t call them guidelines, I know a lot of healthcare providers will be using them as such and so it’s really important to see that validation for trans youth.”

We’ve long known that transgender individuals of all ages are more susceptible to depression, anxiety, eating disorders and self-harm, but many are also likely to avoid their doctor’s office because they’re afraid of being mistreated.

The AAP statement aims not only to ensure that transgender and gender diverse kids get the care they need, but also to dispel myths that exist about gender identity. For example, being transgender is not the cause of any mental health condition, but stigma and social rejection along with limited access to care can play a role in depression and other issues. The statement also makes clear that any kind of conversion therapy or other intervention that aims to change a child’s gender expression is inappropriate and harmful. And it asserts that transgender kids “know their gender as clearly and consistently as their developmentally equivalent peers who identify at cisgender.” In other words, there’s no need for “watchful waiting” to see if they’ll change their minds.

While many in the trans community already know this, having the affirmation of the medical community can make a big difference for families, says Knox. “Seeing the AAP acknowledge that gives room for parents to breathe a little bit and not feel like they’re leading their children in any particular direction. They’re just giving them the safety and support and room to be themselves.”

Though there’s no one-size-fits-all approach for helping gender-diverse kids, the statement advocates for a gender-affirmative care model in which “pediatric providers offer developmentally appropriate care that is oriented toward understanding and appreciating the youth’s gender experience.”

It also encourages more education for healthcare providers about LGBTQ issues, and suggests that insurance plans should cover care that’s specific to gender-diverse youth, including interventions like gender-affirming surgery.

The direction is clear: Accepting kids for who they are is important, not just in their personal lives but in their medical care. The authors write: “Rather than focusing on who a child will become, valuing them for who they are, even at a young age, fosters secure attachment and resilience, not only for the child but also for the whole family.”

That's a commitment that we should all be able to get behind.