PAS 2018: Studies find increasing gender dysphoria, need for provider training

More youths are seeking medical care for gender dysphoria (GD), but many health care providers say they need more training in caring for them, according to two new studies being presented at the Pediatric Academic Societies meeting in Toronto.

Researchers performed a retrospective analysis of medical administrative claims from 18.4 million youths ages 5-21 related to GD. They found the number of children and adolescents with such a claim increased from 113 to 464 between 2010-’14. During that period, total claims rose from 576 to 3,495.

Claims were lowest in the East and West South Central regions of the U.S., according to the abstract “Trends in Prevalence of Medical Claims Related to Gender Dysphoria Among Children and Adolescents in the US from 2010 to 2014.”

“Our study revealed significant increases in the prevalence of insurance claims among children and adolescents related to GD across the U.S.,” lead author Nadia Dowshen, M.D., M.S.H.P., said in a news release. “More studies like ours are needed to describe health care utilization by transgender youth and to inform the development of policies to ensure that providers are adequately trained and equipped with the resources they need to meet these youths’ physical and mental health needs.”

In another study, several of the same researchers found providers may not be prepared to care for these youths.

The team conducted a cross-sectional survey of pediatric primary care providers in 2017, asking about their knowledge and comfort in working with transgender patients. About 54% of the 161 respondents were not aware of professional guidelines on puberty blocking medications, according to the abstract “Pediatric Primary Care Provider Knowledge, Attitudes, and Skills in Caring for Transgender Youth.”

Roughly 68% of providers with experience caring for lesbian, gay, bisexual or transgender youths said they knew where to refer patients compared to 23% of those with no experience. About 86% said they need more training.

“Pediatricians may be the first or only contact for many transgender youth in the health care system, and therefore it is essential that pediatric providers be knowledgeable and comfortable in caring for this population of youth with unique health care needs,” lead author Siobhan Gruschow, M.P.H., M.Ed., said in a news release. “The results of our research show that we critically need educational interventions to prepare pediatricians in supporting transgender youths’ health, well-being and early development.”

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