Transgender youth continue to face numerous disparities in health outcomes and healthcare delivery. Patients have limited access to safe, welcoming, and knowledgeable mental health and medical care. We present an integrated care pathway at a Federally Qualified Health Center in Washington State based on the Primary Care Behavioral Health (PCBH) model. Our integrated group of primary care physicians, psychologists, pharmacists, nurses, and medical assistants support pediatric patients and their families with non-medical and medical gender-affirming care while also supporting their primary care needs. Our model undermines several systemic barriers to care and aims to alleviate the health disparities faced by this underserved, and frequently politically maligned population of children.
Olson, K. R., Durwood, L., DeMeules, M., & McLaughlin, K. A. (2016). Mental health of transgender children who are supported in their identities. Pediatrics, 137(3), e20153223. https://doi.org/10.1542/peds.2015-3223
Gridley, S. J., Crouch, J. M., Evans, Y., Eng, W., Antoon, E., Lyapustina, M., Schimmel-Bristow, A., Woodward, J., Dundon, K., Schaff, R., McCarty, C., Ahrens, K., & Breland, D. J. (2016). Youth and Caregiver Perspectives on Barriers to Gender-Affirming Health Care for Transgender Youth. Journal of Adolescent Health, 59(3), 254–261. https://doi.org/10.1016/j.jadohealth.2016.03.017
Sequeria G.M., Guler J., Ryes V., Asante P.G., Kahn N., Ana Y., Bocek K., Kidd K., Christakis D., Pratt W., Richardson L.P. (2023) Adolescent and Caregiver Perspectives on Receiving Gender-Affirming Care in Primary Care. Pediatrics 152(4) https://doi.org/10.1542/peds.2023-062210
Clark, B. A., & Virani, A. (2021). "This wasn’t a split-second decision”: An empirical ethical analysis of transgender youth capacity, rights, and authority to consent to hormone therapy. Journal of Bioethical Inquiry. https://doi.org/10.1007/s11673-020-10086-9
Flynn, A. W. P., Domínguez Jr., S., Jordan, R. A. S., Dyer, R. L., & Young, E. I. (2021). When the political is professional: Civil disobedience in psychology. American Psychologist, 76(8), 1217–1231. https://doi.org/10.1037/amp0000867