Skip to main content
Log in

Advocacy in gender affirming care

  • Mini symposium: Imaging of intersex and gender diverse youth
  • Published:
Pediatric Radiology Aims and scope Submit manuscript

Abstract

Healthcare advocacy is the duty and privilege of all healthcare providers, but especially for those who care for children. Intersex and gender diverse youth face significant barriers across many aspects of life, with access to competent gender affirming healthcare chief among them. Understanding the importance of both institutional and individual efforts in healthcare advocacy is paramount to improving healthcare access and outcomes for this population.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Guss CE, Pitts S (2023) Advocacy: caring for teens beyond the bedside. Curr Opin Pediatr 35:399–400. https://doi.org/10.1097/MOP.0000000000001268

    Article  PubMed  Google Scholar 

  2. Hubinette M, Dobson S, Scott I, Sherbino J (2017) Health advocacy. Med Teach 39:128–135. https://doi.org/10.1080/0142159X.2017.1245853

    Article  PubMed  Google Scholar 

  3. Gruen RL, Pearson SD, Brennan TA (2004) Physician-citizens–public roles and professional obligations. JAMA 291:94–98. https://doi.org/10.1001/jama.291.1.94

    Article  CAS  PubMed  Google Scholar 

  4. Gunderman RB (2020) Inspiring advocacy: Abraham Jacobi. Pediatr Radiol 50:164–165. https://doi.org/10.1007/s00247-019-04528-9

    Article  PubMed  Google Scholar 

  5. Joshi A, Heller RE, Acharya PT et al (2022) Pediatric radiology and advocacy: a professional responsibility. Pediatr Radiol 52:1412–1419. https://doi.org/10.1007/s00247-022-05369-9

    Article  PubMed  PubMed Central  Google Scholar 

  6. Dodsworth A, Hirsh DA, Alberti H et al (2023) A remedy for discontinuity? Advocating for patient advocacy in undergraduate medical education. Med Educ 57:600–603. https://doi.org/10.1111/medu.15080

    Article  PubMed  Google Scholar 

  7. James SE, Herman JL, Rankin S et al (2015) The Report of the 2015 U.S. Transgender Survey. National Center for Transgender Equality, Washington DC

  8. Grant J, Mottet L, Tanis J et al (2011) Injustice at every turn: a report of the national transgender discrimination survey. National Center for Transgender Equality and National Gay and Lesbian Task Force, Washington

  9. Lee PA, Nordenström A, Houk CP et al (2016) Global disorders of sex development update since 2006: perceptions, approach and care. Horm Res Paediatr 85:158–180. https://doi.org/10.1159/000442975

    Article  CAS  PubMed  Google Scholar 

  10. Carpenter M (2018) The “normalization” of intersex bodies and “othering” of intersex identities in Australia. J Bioethical Inq 15:487–495. https://doi.org/10.1007/s11673-018-9855-8

    Article  Google Scholar 

  11. Moreno-Begines MdeLN, Arroyo-Rodríguez A, Borrallo-Riego Á, Guerra-Martín MD (2022) Intersexuality/differences of sex development through the discourse of intersex people, their relatives, and health experts: a descriptive qualitative study. Healthc Basel Switz 10:671. https://doi.org/10.3390/healthcare10040671

    Article  Google Scholar 

  12. Carpenter M (2016) The human rights of intersex people: addressing harmful practices and rhetoric of change. Reprod Health Matters 24:74–84. https://doi.org/10.1016/j.rhm.2016.06.003

    Article  PubMed  Google Scholar 

  13. Agarwal K (2018) What is trans history? From activist and academic roots, a field takes shape. In: Perpsectives Hist. https://www.historians.org/research-and-publications/perspectives-on-history/may-2018/what-is-trans-history-from-activist-and-academic-roots-a-field-takes-shape. Accessed 15 Jul 2023

  14. Seven things about transgender people you didn’t know. Hum. Rights Campaign. https://www.hrc.org/resources/seven-things-about-transgender-people-that-you-didnt-know. Accessed 27 Jul 2023

  15. Carswell JM, Lopez X, Rosenthal SM (2022) The evolution of adolescent gender-affirming care: an historical perspective. Horm Res Paediatr 95:649–656. https://doi.org/10.1159/000526721

    Article  CAS  PubMed  Google Scholar 

  16. Campanile D, Carla-Uhink F, Facella M (2017) Trans antiquity: cross dressing and transgender dynamics. Routledge, New York, NY

  17. Beyond Gender: Indigenous Perspectives, Muxe. Natural History Museum, LA County. https://nhm.org/stories/beyond-gender-indigenous-perspectives-muxe. Accessed 27 Jul 2023

  18. Stip E (2015) RaeRae and Mahu: third polynesian gender. Sante Ment Que 40:193–208

    Article  PubMed  Google Scholar 

  19. Coleman E, Radix AE, Bouman WP et al (2022) Standards of care for the health of transgender and gender diverse people, version 8. Int J Transgender Health 23:S1–S259. https://doi.org/10.1080/26895269.2022.2100644

    Article  CAS  Google Scholar 

  20. Turban JL, Kraschel KL, Cohen IG (2021) Legislation to criminalize gender-affirming medical care for transgender youth. JAMA 325:2251–2252. https://doi.org/10.1001/jama.2021.7764

    Article  PubMed  Google Scholar 

  21. Blackless M, Charuvastra A, Derryck A et al (2000) How sexually dimorphic are we? Review and synthesis. Am J Hum Biol 12:151–166. https://doi.org/10.1002/(SICI)1520-6300(200003/04)12:2%3c151::AID-AJHB1%3e3.0.CO;2-F

    Article  PubMed  Google Scholar 

  22. Kuper LE, Cooper MB, Mooney MA (2022) Supporting and advocating for transgender and gender diverse youth and their families within the sociopolitical context of widespread discriminatory legislation and policies. Clin Pract Pediatr Psychol 10:336–345. https://doi.org/10.1037/cpp0000456

    Article  Google Scholar 

  23. Kidd KM, Sequeira GM, Paglisotti T et al (2021) “This could mean death for my child”: parent perspectives on laws banning gender-affirming care for transgender adolescents. J Adolesc Health Off Publ Soc Adolesc Med 68:1082–1088. https://doi.org/10.1016/j.jadohealth.2020.09.010

    Article  Google Scholar 

  24. Kraschel KL, Chen A, Turban JL, Cohen IG (2022) Legislation restricting gender-affirming care for transgender youth: politics eclipse healthcare. Cell Rep Med 3:100719. https://doi.org/10.1016/j.xcrm.2022.100719

    Article  PubMed  PubMed Central  Google Scholar 

  25. Mapping Attacks on LGBTQ Rights in U.S. State Legislatures. ACLU.org https://www.aclu.org/legislative-attacks-on-lgbtq-rights?impact=health. Accessed 23 Jul 2023

  26. van der Miesen AIR, Steensma TD, de Vries ALC et al (2020) Psychological functioning in transgender adolescents before and after gender-affirmative care compared with cisgender general population peers. J Adolesc Health Off Publ Soc Adolesc Med 66:699–704. https://doi.org/10.1016/j.jadohealth.2019.12.018

    Article  Google Scholar 

  27. Turban JL, King D, Kobe J et al (2022) Access to gender-affirming hormones during adolescence and mental health outcomes among transgender adults. PLoS ONE 17:e0261039. https://doi.org/10.1371/journal.pone.0261039

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Park BC, Das RK, Drolet BC (2021) Increasing criminalization of gender-affirming care for transgender youths-a politically motivated crisis. JAMA Pediatr 175:1205–1206. https://doi.org/10.1001/jamapediatrics.2021.2969

    Article  PubMed  Google Scholar 

  29. Ludewigs S, Narchi J, Kiefer L, Winkler EC (2022) Ethics of the fiduciary relationship between patient and physician: the case of informed consent. J Med Ethics 0:1–8. https://doi.org/10.1136/jme-2022-108539

  30. Samuels J, Keisling M (2019) The anti-trans memo - abandoning doctors and patients. N Engl J Med 380:111–113. https://doi.org/10.1056/NEJMp1814406

    Article  PubMed  Google Scholar 

  31. Grimstad FW, Stowell JT, Gaddis M (2020) Survey of experiences of transgender and gender nonbinary patients during imaging encounters and opportunities for improvement. AJR Am J Roentgenol 215:1136–1142. https://doi.org/10.2214/AJR.19.22558

    Article  PubMed  Google Scholar 

  32. Perry H, Fang AJ, Tsai EM, Slanetz PJ (2021) Imaging health and radiology care of transgender patients: a call to build evidence-based best practices. J Am Coll Radiol 18:475–480

    Article  PubMed  Google Scholar 

  33. Russell ST, Pollitt AM, Li G, Grossman AH (2018) Chosen name use is linked to reduced depressive symptoms, suicidal ideation, and suicidal behavior among transgender youth. J Adolesc Health Off Publ Soc Adolesc Med 63:503–505. https://doi.org/10.1016/j.jadohealth.2018.02.003

    Article  Google Scholar 

  34. Kirkpatrick DL, Stowell J, Grimstad F et al (2019) Creating a transgender-inclusive interventional radiology department. J Vasc Interv Radiol JVIR 30:928–931. https://doi.org/10.1016/j.jvir.2018.12.033

    Article  PubMed  Google Scholar 

  35. Pedersen S, Sanders V (2018) A new and inclusive intake form for diagnostic imaging departments. J Med Imaging Radiat Sci 49:371–375. https://doi.org/10.1016/j.jmir.2018.10.001

    Article  PubMed  Google Scholar 

  36. Menashe S, Wright J (2023) Gender inclusivity toolkit. In: seattlechildrens.org. https://www.seattlechildrens.org/globalassets/documents/healthcare-professionals/education/gender-inclusivity-toolkit.pdf

  37. Garcia AD, Lopez X (2022) How cisgender clinicians can help prevent harm during encounters with transgender patients. AMA J Ethics 24:E753-761. https://doi.org/10.1001/amajethics.2022.753

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Sarah J. Menashe.

Ethics declarations

Conflicts of interest

None

Additional information

Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Menashe, S.J., Zavaletta, V., McCoy, M.N. et al. Advocacy in gender affirming care. Pediatr Radiol (2024). https://doi.org/10.1007/s00247-024-05885-w

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s00247-024-05885-w

Keywords

Navigation