A practice trying to welcome these questions will have thought about what is communicated on the website, at the counter and on the forms to be filled out, as well as in the exam room. So parents should listen to the way questions are asked on intake forms and in initial interviews: “Are they asking questions in a way that allows someone who isn’t straight and binary and cisgender to answer?” asked Dr. Sherr. “Do they understand that gays, straights and bisexuals are not the only choices?” Look for doctors who ask open-ended questions and who understand the diversity of child development, she said, and be wary of comments that “gender kids needlessly — do they give a boy a He-Man sticker or let him pick?”
dr. Sherer cares for many families with transgender and gender diverse children, some who have been in her practice since early childhood, and others who find her because she speaks and writes about this population. “I hear that transgender is being talked about as if it were a disorder,” she said. “My transgender kids are some of the nicest, bravest kids I have.” She tries to model parents on how to help and support their children, while also dealing with their own emotions, which can be complex, she said: “There is clearly a loss to the parent, but it is not a loss to their child – it is a loss of who they thought the child was.”
For parents whose children have doubts about their gender identity, “don’t be afraid to check with your pediatrician,” says Dr. Paria Hassouri, a Los Angeles pediatrician who provides gender-affirming care and has written about her own experience as a parent of a transgender child. “Information will empower you to support your child and make decisions.”
The proportion of adolescents reporting that they identify other than heterosexual has increased. dr. Patterson was the corresponding author of a commentary published in late May in the journal JAMA Pediatrics that discussed recent data — in one study, 14.3 percent of adolescents in 2017 claimed an identity that was “lesbian, gay, bisexual, different or questions,” up from 7.3 percent in 2009. The article argued that while greater civic openness may have led to more honest answers, these adolescents are still vulnerable to stigma, bullying and abuse, and the resulting mental health problems. strong and supportive relationship with a medical provider can be very important in helping an adolescent get through these years.
What can you expect from your pediatrician?
Parents should expect pediatricians to promise adolescents confidentiality. But there are situations – especially if the child is at risk of harming himself – in which a doctor cannot promise confidentiality; we explain this clearly with children.
Parents should expect their children’s doctors to be trained in asking and answering questions about sexual behavior and sexual health, as well as identification and identity issues.
In adolescents, we also ask about identity, self-image, body changes, mental health, friendships, academic achievement, risky behavior (smoking, drugs, alcohol) – the whole complex mix of adolescent activity and adaptation. When talking to patients in the general pediatric clinic, Dr. Hassouri, she begins by asking, “Do you feel comfortable in your body, how do you identify, what are the gender or genders of the people you are attracted to, rather than ‘Are you gay, straight or bisexual?’”