We all have to start somewhere! The resources provided under foundational concepts and terminology are curated for providers who are starting off on their journey, or needing a quick refresher. The resources here can help you understand core language, ideas, and health needs of TGD children and adolescents, and how to address these needs through practices like implicit bias training and trauma-informed care. If you don’t know where to start, this section is for you!

When people think about gender-affirming care, there is often a focus on the medical aspects of gender-affirmation. However, for many TGD people, social gender affirmation, which can include changes to name, pronouns, hairstyle, and voice, is the first and perhaps only method of gender affirmation that they seek. This section includes resources on non-medical gender affirmation, such as binding, tucking, and voice modification.

TGD children and adolescents may face discrimination in employment and education, which can affect their health and wellbeing. Therefore, patients may need legal services to address the institutional and societal abuses that impact their health. This section provides information on forming medical-legal practices as well as information on name and gender marker changes on identity documents, a legal aspect of social gender affirmation, that can be integral to a patient’s ability to feel safe and affirmed in their identity.

Gender-affirming care is patient-centered care that aims to support TGD patients on their journey to align their primary and secondary sex characteristics with their gender identity. This section highlights key aims to provide knowledge on important aspects of medical gender affirmation, such as pubertal suppressants, hormone therapy, and surgical interventions that TGD children, adolescents, and their families may have questions about and choose to embark on at appropriate developmental stages.

The cost of gender-affirming care such as hormone therapy and gender-affirming surgeries is often a barrier that can stop TGD children and adolescents from accessing lifesaving care. While many major insurance companies cover gender-affirming care, many TGD people remain uninsured or are unable to find coverage for gender-affirming care due to the refusal of some medical insurance companies to cover gender-affirming care. This is an opportunity for providers to be the best advocates for their TGD patients, ease fears, and overcome economic barriers with TGD patients. This section includes resources that can help patients and providers better understand insurance policies and the process of getting coverage for gender-affirming care.   

Mental health care is an important aspect of gender-affirming care for TGD children and adolescents. Transgender and gender diverse identities have historically been and are currently pathologized, and the requirement for a psychiatric diagnosis for TGD patients to receive gender-affirming care often leads to gatekeeping, especially for TGD youth who do not fit into the binary expectations of gender. Furthermore, TGD children and adolescents are more likely to have mental health concerns, related to stigma and discrimination they face. This section provides information to enable providers and behavioral health practitioners to be partners by supporting the mental and gender-affirming care needs of TGD children and adolescents.

TGD children and adolescents need more than gender-affirming care to support their wellbeing. Multiple factors such as discrimination, minority stress, and homelessness can affect the health and wellbeing of TGD children and adolescents. This section seeks to highlight how social determinants of health, the effects of economic and social factors on the health status of individuals and specific populations, affect LGBTQIA+ patients. While these resources are not all specific to TGD youth, they are integral to understanding the impact of social and economic factors on health outcomes.

Pediatricians provide essential support for the families that they care for. Caregivers often come to the pediatrician for information about their child’s gender identity and these questions may be difficult to navigate depending on the level of support. While some caregivers may be supportive, others might be dismissive and fearful. TGD children, adolescents, and their families will have a wide range of needs and providers need to be ready to support them. This section provides helpful information to guide providers in that process.

Many providers struggle with how to collect sexual orientation and gender identity (SOGI) information in a respectful way and answer the questions that may arise when they attempt to do so. This section provides information that providers can use when collecting SOGI data. 

TGD children and adolescents are more than just their transgender identities. Like everyone, TGD children and adolescents have intersecting identities impacting the stigma and bias they experience, which should be considered when providing care. This section provides resources that highlight the effects of intersecting identities on LGBTQIA+ people.

TGD children and youth need environments that are safe and affirm their identities. While providers play an essential role in that process, all aspects of a health center must be assessed to determine methods that can be employed to increase accessibility for TGD children, adolescents, and their families. This section includes information that health centers can utilize to review their systems and practices.