Caring for Lesbian, Gay, Bisexual, Transgender, and Questioning Youth in Inclusive and Affirmative Environments

Dermatologic care of sexual and gender minority/LGBTQIA youth, Part I: An update for the dermatologist on providing inclusive care

“…Multiple barriers exist for SGM youth seeking comprehensive and compassionate medical care. Specifically, finding available, knowledgeable, and compassionate providers who understand the unique developmental and emotional needs of SGM youth, who are easily accessible, who provide acceptable, culturally humble, and confidential care, and whose care is equitable, regardless of patients' sexual or gender identification, is often a challenge for this population . Recently established gender clinics are an encouraging development in the comprehensive care of transgender youth, although the majority do not have a dermatologist directly integrated into patient care .…”

“…Recently established gender clinics are an encouraging development in the comprehensive care of transgender youth, although the majority do not have a dermatologist directly integrated into patient care . Moreover, for many SGM children and adolescents, providers who recognize and are facile in managing the unique or more frequent challenges facing this population (increased mental health and body image problems, high‐risk substance use or sexual activity, homelessness, bullying) are missing in their communities …”

“…Studies examining SGM adolescents' preferences when receiving medical care demonstrate that this population's needs and expectations for quality care do not differ considerably from their cisgender/heterosexual counterparts . Namely, SGM youth desire health care that is accessible, that respects patient confidentiality and autonomy, and that delivers counseling in a private, nonjudgmental manner .…”

“…Confidentiality is of the utmost importance in this population, however, as children and adolescents who trust their provider to maintain privacy (especially around issues of gender identity, sexuality, and sexual practices) are more likely to divulge personal details that are relevant to their health care . One‐on‐one time without parents is recommended during visits with adolescent patients in general and SGM adolescents specifically; during this time, the patient's privacy should be reassured, and providers should inquire about to whom the patient has disclosed their sexual and/or gender identity . Inappropriate disclosure of such personal details by physicians to family members or others not only harms the doctor‐patient relationship but can also lead to negative acute and long‐term physical and mental health outcomes for these patients if the recipient of this information regards it negatively .…”

“…Seeking out and advocating for more SGM‐specific educational experiences are ways that dermatologists and professional organizations can remedy this practice gap. Table summarizes specific ways that pediatric dermatologists can further provide and advocate for accessible, acceptable, and equitable care for SGM patients …”