Training pediatricians critical to improving quality of care for transgender youth
Two new studies reveal the importance of better understanding the health care utilization of transgender children and adolescents and the need to train pediatricians to care for this population's unique needs.
Nadia Dowshen, MD, MSHP, and Siobhan Gruschow, MPH, MEd, researchers at PolicyLab at Children's Hospital of Philadelphia, will present their findings on trends in transgender youth's health care utilization and primary care providers' knowledge, comfort and experience caring for transgender youth during the Pediatric Academic Societies (PAS) 2018 Meeting in Toronto.
The first study focused on measuring the knowledge, attitudes and skills of primary care providers in treating transgender children and adolescents. Researchers designed a cross-sectional survey aimed to learn more about the readiness of pediatricians to care for transgender or gender non-conforming youth.
"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 knowledgable and comfortable in caring for this population of youth with unique health care needs," said Ms. Gruschow, lead author of the study. "The results of our research show that we critically need educational interventions to prepare pediatricians in supporting transgender youth's health, well-being and early development."
The research team recruited survey participants either via email or in-person based on where their health care practice was located. Participating primary care pediatricians responded to 18 questions related to their knowledge, experience and comfort in providing care for transgender youth.
They found that among the 161 participants, prior professional or personal experience with transgender youth was associated with an increased comfort in providing care for this population of children and adolescents. Researchers also discovered that primary care pediatricians have poor knowledge of existing guidelines for care including that only half were aware of when it is indicated to prescribe puberty blockers; however, respondents expressed high levels of interest in additional training.
In the second study, researchers identified prevalence and patterns of youth accessing care for gender dysphoria (GD) through a retrospective analysis of medical administration claims from Clinformatics Data Mart, a large database of privately insured enrollees. Analyzing inpatient and outpatient claims of 18.4 million transgender youth ages 5-21 between 2010-2014, the researchers discovered a significant increase in GD-related claims from 113 to 464 in children or adolescents. While the rate of claims in age groups did not vary, they saw a variation year by year in the geographic regions where claims were made.
"Our study revealed significant increases in the prevalence of insurance claims among children and adolescents related to GD across the U.S.," said Dr. Nadia Dowshen, lead author of the study. "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 youth's physical and mental health needs."
Ms. Gruschow will present "Pediatric Primary Care Provider Knowledge, Attitudes, and Skills in Caring for Transgender Youth" and Dr. Dowshen will present "Trends in Prevalence of Medical Claims Related to Gender Dysphoria Among Children and Adolescents in the US from 2010 to 2014" on Monday, May 7 at 10:30 a.m. EDT.