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Sexual and Gender Identity Development in Young Adults and Implications for Healthcare

  • Female Sexual Dysfunction and Disorders (T Lorenz and R Nappi, Section Editors)
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Abstract

Purpose of Review

The purpose of this review is to update what is known about sexual orientation and gender identity development, including factors that facilitate positive development, and healthcare experiences of sexual and gender minority youth (SGMY) in relation to their identity.

Recent Findings

Models of identity development have been proposed that draw on the experiences of young people and their families rather than adult models of identity development. Family support can both help and hinder identity development, and healthcare providers are in a unique position to intervene. However, SGMY and their families experience significant barriers to accessing appropriate and affirming healthcare.

Summary

Key improvements in provider knowledge, healthcare systems, quality of care, and support for SGMY and their families are needed.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. Charlton BM, Gordon AR, Reisner SL, Sarda V, Samnaliev M, Austin SB. Sexual orientation-related disparities in employment, health insurance, healthcare access and health-related quality of life: a cohort study of US male and female adolescents and young adults. BMJ Open. 2018;8:e020418.

    PubMed  PubMed Central  Google Scholar 

  2. Eisenberg ME, Gower AL, McMorris BJ, Nicole Rider G, Shea G, Coleman E. Risk and protective factors in the lives of transgender/gender nonconforming adolescents. J Adolesc Health. 2017;61:521–6.

    PubMed  PubMed Central  Google Scholar 

  3. Fallin-Bennett A, Lisha NE, Ling PM. Other tobacco product use among sexual minority young adult bar patrons. Am J Prev Med. 2017;53:327–34.

    PubMed  PubMed Central  Google Scholar 

  4. Lowry R, Johns MM, Robin LE, Kann LK. Social stress and substance use disparities by sexual orientation among high school students. Am J Prev Med. 2017;53:547–58.

    PubMed  Google Scholar 

  5. Puhl RM, Himmelstein MS, Watson RJ. Weight-based victimization among sexual and gender minority adolescents: findings from a diverse national sample. Pediatr Obes. 2019;14:e12514.

    PubMed  Google Scholar 

  6. Watson RJ, Veale JF, Saewyc EM. Disordered eating behaviors among transgender youth: probability profiles from risk and protective factors. Int J Eat Disord. 2017;50:515–22.

    PubMed  Google Scholar 

  7. Dai H. Tobacco product use among lesbian, gay, and bisexual adolescents. Pediatrics. 2017;139:e20163276.

    PubMed  Google Scholar 

  8. Kann L, Olsen EO, McManus T, et al. Sexual identity, sex of sexual contacts, and health-related behaviors among students in grades 9–12 — United States and selected sites, 2015. MMWR Surveill Summ. 2016;65:1–202.

    PubMed  Google Scholar 

  9. Meyer IH. Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: conceptual issues and research evidence. Psychol Bull. 2003;129:674–97.

    PubMed  PubMed Central  Google Scholar 

  10. Price-Feeney M, Ybarra ML, Mitchell KJ. Health indicators of lesbian, gay, bisexual, and other sexual minority (LGB+) youth living in rural communities. J Pediatr. 2019;205:236–43.

    PubMed  Google Scholar 

  11. Hatzenbuehler ML, Pachankis JE. Stigma and minority stress as social determinants of health among lesbian, gay, bisexual, and transgender youth. Pediatr Clin N Am. 2016;63:985–97.

    Google Scholar 

  12. Hatzenbuehler ML. Advancing research on structural stigma and sexual orientation disparities in mental health among youth. J Clin Child Adolesc Psychol. 2017;46:463–75.

    PubMed  Google Scholar 

  13. Charlton BM, Hatzenbuehler ML, Jun HJ, Sarda V, Gordon AR, Raifman JRG, et al. Structural stigma and sexual orientation-related reproductive health disparities in a longitudinal cohort study of female adolescents. J Adolesc. 2019;74:183–7.

    PubMed  Google Scholar 

  14. Graham LF, Padilla MB, Lopez WD, Stern AM, Peterson J, Keene DE. Spatial stigma and health in postindustrial detroit. Int Q Community Health Educ. 2016;36:105–13.

    PubMed  Google Scholar 

  15. Lagos D. Looking at population health beyond “Male” and “Female”: implications of transgender identity and gender nonconformity for population health. Demography. 2018;55:2097–117. https://doi.org/10.1007/s13524-018-0714-3.

    Article  PubMed  Google Scholar 

  16. Gordon AR, Meyer IH. Gender nonconformity as a target of prejudice, discrimination, and violence against LGB individuals. J LGBT Health Res. 2007;3:55–71.

    PubMed  Google Scholar 

  17. Miller LR, Grollman EA. The social costs of gender nonconformity for transgender adults: implications for discrimination and health. Sociol Forum (Randolph N J). 2015:1. https://doi.org/10.1111/socf.12193.

    PubMed  Google Scholar 

  18. Nicolazzo Z. ‘It’s a hard line to walk’: black non-binary trans* collegians’ perspectives on passing, realness, and trans*-normativity. Int J Qual Stud Educ. 2016;29:1173–88.

    Google Scholar 

  19. Rubin JD, McClelland SI. ‘Even though it’s a small checkbox, it’s a big deal’: stresses and strains of managing sexual identity(s) on Facebook. Cult Health Sex. 2015;17:512–26.

    PubMed  Google Scholar 

  20. Clark BA, Veale JF, Townsend M, Frohard-Dourlent H, Saewyc E, El Ene F-DH. Non-binary youth: access to gender-affirming primary health care. Int J Transgenderism. 2018;19:158–69.

    Google Scholar 

  21. Cruz TM. Assessing access to care for transgender and gender nonconforming people: a consideration of diversity in combating discrimination. Soc Sci Med. 2014. https://doi.org/10.1016/j.socscimed.2014.03.032.

    Google Scholar 

  22. Macapagal K, Bhatia R, Greene GJ. Differences in healthcare access, use, and experiences within a community sample of racially diverse lesbian, gay, bisexual, transgender, and questioning emerging adults. LGBT Health. 2016;3:434–42.

    PubMed  PubMed Central  Google Scholar 

  23. Wilchins RA. Queerer bodies. Bin: Genderqueer Voices from Beyond Sex; 2002.

    Google Scholar 

  24. Austin A. “There I am”: a grounded theory study of young adults navigating a transgender or gender nonconforming identity within a context of oppression and invisibility. Sex Roles. 2016;75:215–30.

    Google Scholar 

  25. Bornstein K. My gender workbook: how to become a real man, a real woman, the real you, or something else entirely. New York: Routledge; 1998.

    Google Scholar 

  26. • Goldhammer H, Malina S, Keuroghlian AS. Communicating with patients who have nonbinary gender identities. Ann Fam Med. 2018;16:559–62 Highlights best practices for clinical interaction with a nonbinary identified individual and provides rationale for recommended actions.

    PubMed  PubMed Central  Google Scholar 

  27. Richards C, Bouman WP, Seal L, Barker MJ, Nieder TO, Tsjoen G. Non-binary or genderqueer genders. Int Rev Psychiatry. 2016;28:95–102.

    PubMed  Google Scholar 

  28. Leibowitz S, de Vries ALC. Gender dysphoria in adolescence. Int Rev Psychiatry. 2016. https://doi.org/10.3109/09540261.2015.1124844.

    PubMed  Google Scholar 

  29. Oost KM, Livingston NA, Gleason HA, Cochran BN. Gender performance stress and risk for psychopathology: looking beyond sexual orientation. J LGBT Youth. 2016;13:231–48.

    Google Scholar 

  30. Klein F, Sepekoff B, Wolf TJ. Sexual orientation. J Homosex. 1985;11:35–49.

    CAS  PubMed  Google Scholar 

  31. Leonardi M, Frecker H, Scheim AI, Kives S. Reproductive health considerations in sexual and/or gender minority adolescents. J Pediatr Adolesc Gynecol. 2019;32:15–20.

    PubMed  Google Scholar 

  32. Bosse JD. Transgender young adults, sibling relationships, and mental health. 2019. https://doi.org/10.7275/nh2f-nk82.

  33. Bockting W, Benner A, Coleman E. Gay and bisexual identity development among female-to-male transsexuals in North America: emergence of a transgender sexuality. Arch Sex Behav. 2009;38:688–701.

    PubMed  Google Scholar 

  34. Rowniak S, Chesla C. Coming out for a third time: transmen, sexual orientation, and identity. Arch Sex Behav. 2013;42:449–61.

    PubMed  Google Scholar 

  35. Bosse JD, Chiodo L. It is complicated: gender and sexual orientation identity in LGBTQ youth. J Clin Nurs. 2016;25:3665–75.

    PubMed  Google Scholar 

  36. Macapagal K, Bhatia R, Greene GJ. Differences in healthcare access, use, and experiences within a community sample of racially diverse lesbian, gay, bisexual, transgender, and questioning emerging adults. LGBT Heal. 2016;3:434–42.

    Google Scholar 

  37. Katz-Wise SL, Reisner SL, White Hughto JM, Budge SL. Self-reported changes in attractions and social determinants of mental health in transgender adults. Arch Sex Behav. 2016;46:1–15.

    Google Scholar 

  38. Kuper LE, Nussbaum R, Mustanski B. Exploring the diversity of gender and sexual orientation identities in an online sample of transgender individuals. J Sex Res. 2012;49:244–54.

    PubMed  Google Scholar 

  39. Berona J, Stepp SD, Hipwell AEB, Keenan KE. Trajectories of sexual orientation from adolescence to young adulthood: results from a community-based urban sample of girls. 2018. https://doi.org/10.1016/j.jadohealth.2018.01.015.

    PubMed  Google Scholar 

  40. Katz-Wise SL, Reisner SL, Hughto JW, Keo-Meier CL. Differences in sexual orientation diversity and sexual fluidity in attractions among gender minority adults in massachusetts. J Sex Res. 2016;53:74–84.

    PubMed  Google Scholar 

  41. Galupo MP, Henise SB, Mercer NL. “The labels don’t work very well”: transgender individuals’ conceptualizations of sexual orientation and sexual identity. Int J Transgenderism. 2016;17:93–104.

    Google Scholar 

  42. Katz-Wise SL. Sexual fluidity in young adult women and men: associations with sexual orientation and sexual identity development. Psychol Sex. 2014;6:1–20.

    Google Scholar 

  43. Bosse JDJD, Chiodo LM. It’s complicated: gender and sexual orientation identity in LGBTQ youth. J Clin Nurs. 2016. https://doi.org/10.1111/jocn.13419.

    PubMed  Google Scholar 

  44. Frohard-Dourlent HH, Dobson S, Clark BA, Doull M, Saewyc EM. “I would have preferred more options”: accounting for non-binary youth in health research. Nurs Inq. 2016;24:1–9.

    Google Scholar 

  45. Harrison-Quintana J, Grant JM, Rivera IG. Boxes of our own creation: a trans data collection Wo/Manifesto. TSQ Transgender Stud Q. 2015;2:166–74.

    Google Scholar 

  46. Khaleeli H (2014) Hijra: India’s third gender claims its place in law | Society | The Guardian. https://www.theguardian.com/society/2014/apr/16/india-third-gender-claims-place-in-law. Accessed 10 Jan 2017.

  47. Movement Advancement Project (2018) Snapshot: LGBT equality by state. http://www.lgbtmap.org/equality-maps/legal_equality_by_state. Accessed 7 Dec 2018.

  48. Kann L, O’Malley Olson E, McManus T, et al (2016) Sexual identity, sex of sexual contacts, and health-related behaviors among students in grades 9–12 — United States and selected sites, 2015. Morbidity and Mortality Weekly Report, 65(9). Retrieved: https://www.cdc.gov/mmwr/volumes/65/ss/pdfs/ss6509.pdf.

  49. Herman J, Flores A, Brown T NT, Wilson BDM, Conron K (2017) Age of individuals who identify as transgender in the United States. Los Angeles: The Williams Institute. Retrieved: https://williamsinstitute.law.ucla.edu/wp-content/uploads/TransAgeReport.pdf.

  50. Johns MM, Lowry R, Andrzejewski J, Barrios LC, Demissie Z, McManus T, et al. Transgender identity and experiences of violence victimization, substance use, suicide risk, and sexual risk behaviors among high school students — 19 States and large urban school districts, 2017. MMWR Morb Mortal Wkly Rep. 2019;68:67–71.

    PubMed  PubMed Central  Google Scholar 

  51. Clark BA, Veale JF, Greyson D, Saewyc E. Primary care access and foregone care: a survey of transgender adolescents and young adults. Fam Pract. 2018;35:302–6.

    PubMed  Google Scholar 

  52. Twist J, De Graaf NM. Gender diversity and non-binary presentations in young people attending the United Kingdom’s National Gender Identity Development Service. Clin Child Psychol Psychiatry. 2019;24:277–90.

    PubMed  Google Scholar 

  53. Wilson C (2019) London gender clinic reports rising number of non-binary attendees | New Scientist. In: New Sci. https://www.newscientist.com/article/2210488-london-gender-clinic-reports-rising-number-of-non-binary-attendees/. Accessed 7 Sep 2019

  54. Rider GN, McMorris BJ, Gower AL, Coleman E, Eisenberg ME. Health and care utilization of transgender and gender nonconforming youth: a population-based study. Pediatrics. 2018. https://doi.org/10.1542/peds.2017-1683.

    PubMed  PubMed Central  Google Scholar 

  55. Crissman HP, Berger MB, Graham LF, Dalton VK. Transgender demographics: a household probability sample of US adults, 2014. Am J Public Health 107(2):213–215. https://doi.org/10.2105/AJPH.2016.303571.

    PubMed  PubMed Central  Google Scholar 

  56. Kaltiala-Heino R, Lindberg N. Gender identities in adolescent population: methodological issues and prevalence across age groups. Eur Psychiatry. 2019;55:61–6.

    PubMed  Google Scholar 

  57. Stieglitz KA. Development, risk, and resilience of transgender youth. J Assoc Nurses AIDS Care. 2010;21:192–206.

    PubMed  Google Scholar 

  58. Katz-Wise SL, Hyde JS. Sexual fluidity and related attitudes and beliefs among young adults with a same-gender orientation. Arch Sex Behav. 2015;44:1459–70.

    PubMed  Google Scholar 

  59. Dierckx M, Motmans J, Mortelmans D, T’sjoen G. Families in transition: a literature review. Int Rev Psychiatry. 2016;28:36–43.

    PubMed  Google Scholar 

  60. van Anders SM. Beyond sexual orientation: integrating gender/sex and diverse sexualities via sexual configurations theory. Arch Sex Behav. 2015;44:1177–213.

    PubMed  Google Scholar 

  61. Cass VC. Homosexual identity formation. J Homosex. 1979;4:219–35.

    CAS  PubMed  Google Scholar 

  62. Sophie J. A critical examination of stage theories of lesbian identity development. J Homosex. 12:39–51 https://doi.org/10.1300/J082v12n02_03.

    CAS  Google Scholar 

  63. Devor AH. Witnessing and mirroring: a fourteen stage model of transsexual identity formation. J Gay Lesbian Ment Health. 2004;8:41–67.

    Google Scholar 

  64. Lev AI. Transgender emergence: therapeutic guidelines for working with gender-variant people and their families. Binghamton: Hawthorne Clinical Practice Press; 2004.

    Google Scholar 

  65. Raj R. Transforming couples and families: a trans-formative therapeutic model for working with the loved ones of gender-divergent youth and trans-identified adults. J LGBT Fam Stud. 2008;4:133–63.

    Google Scholar 

  66. Zamboni BD. Therapeutic considerations in working with the family, friends, and partners of transgendered individuals. Fam J Couns Ther Couples Fam. 2006;14:174–9.

    Google Scholar 

  67. Heatherington L, Lavner JA. Coming to terms with coming out: review and recommendations for family systems-focused research. J Fam Psychol. 2008;22:329–43.

    PubMed  Google Scholar 

  68. Katz-Wise SL, Budge SL, Orovecz JJ, Nguyen B, Nava-Coulter B, Thomson K. Imagining the future: perspectives among youth and caregivers in the trans youth family study. J Couns Psychol. 2017;64:26–40.

    PubMed  PubMed Central  Google Scholar 

  69. Bradford NJ, Rider GN, Catalpa JM, Morrow QJ, Berg DR, Spencer KG, et al. Creating gender: a thematic analysis of genderqueer narratives. Int J Transgenderism. 2018. https://doi.org/10.1080/15532739.2018.1474516.

    Google Scholar 

  70. McGuire JK, Kuvalanka KA, Catalpa JM, Toomey RB. Transfamily theory: how the presence of trans* family members informs gender development in families. J Fam Theory Rev. 2016;8:60–73.

    Google Scholar 

  71. Baiocco R, Fontanesi L, Santamaria F, Ioverno S, Marasco B, Baumgartner E, et al. Negative parental responses to coming out and family functioning in a sample of lesbian and gay young adults. J Child Fam Stud. 2015;24:1490–500.

    Google Scholar 

  72. Katz-Wise SL, Rosario M, Tsappis M. Lesbian, gay, bisexual, and transgender youth and family acceptance. Pediatr Clin N Am. 2016;63:1011–25.

    Google Scholar 

  73. Steensma TD, Kreukels BPC, de Vries ALC, Cohen-Kettenis PT. Gender identity development in adolescence. Horm Behav. 2013;64:288–97.

    PubMed  Google Scholar 

  74. Delay D, Carol ML, Cook RE, Hanish LD. The influence of peers during adolescence: does homophobic name calling by peers change gender identity? J Youth Adolesc. 2018;47:636–49.

    PubMed  Google Scholar 

  75. Morgan A, Saunders B, Dodge B, Harper G, Arrington Sanders R. Exploring the sexual development experiences of Black bisexual male adolescents over time. Arch Sex Behav. 2018;47:1839–51.

    PubMed  PubMed Central  Google Scholar 

  76. Schimmel-Bristow A, Haley SG, Crouch JM, Evans YN, Ahrens KR, McCarty CA, et al. Youth and caregiver experiences of gender identity transition: a qualitative study. Psychol Sex Orientat Gend Divers. 2018;5:273–81.

    Google Scholar 

  77. Katz-Wise SL. Sexual fluidity in young adult women and men: associations with sexual orientation and sexual identity development. Psychol Sex. 2015;6:189–208.

    Google Scholar 

  78. Ryan C, Russell ST, Huebner D, Diaz R, Sanchez J. Family acceptance in adolescence and the health of LGBT young adults. J Child Adolesc Psychiatr Nurs. 2010;23:205–13.

    PubMed  Google Scholar 

  79. Sansfaçon AP, Hébert W, Lee EOJ, Faddoul M, Tourki D, Bellot C. Digging beneath the surface: results from stage one of a qualitative analysis of factors influencing the well-being of trans youth in Quebec. Int J Transgenderism. 2018;19:184–202.

    Google Scholar 

  80. Elischberger HB, Glazier JJ, Verduzco-Baker L. ’Boys Don’t Cry’-or do they? Adult attitudes toward and beliefs about trans...: Find books, articles, DVDs & more. Sex Roles. 2016;75:197–214.

    Google Scholar 

  81. Rodgers SM. Transitional age lesbian, gay, bisexual, transgender, and questioning youth issues of diversity, integrated identities, and mental health. Child Adolesc Psychiatr Clin N Am. 2017;26:297–309.

    PubMed  Google Scholar 

  82. Catalpa JM, McGuire JK. Family boundary ambiguity among transgender youth. Fam Relat. 2018;67:88–103.

    Google Scholar 

  83. Koken JA, Bimbi DS, Parsons JT. Experiences of familial acceptance-rejection among transwomen of color. J Fam Psychol. 2009;23:853–60.

    PubMed  PubMed Central  Google Scholar 

  84. Graham LF (2013) Psychosocial health of black sexually marginalized men. In: Treadwell HM, Xanthos C, Holden KB (eds) Soc. Determ. Heal. among African-American men. Jossey Bass, San Francisco, pp 63–81

    Google Scholar 

  85. Bosse JD. Transgender young adults, sibling relationships, and mental health. Dr Diss. 2019. https://doi.org/10.7275/nh2f-nk82.

  86. Graham LF. Navigating community institutions: Black transgender women’s experiences in schools, the criminal justice system, and churches. Sex Res Soc Policy. 2014;11:274–87.

    Google Scholar 

  87. Sadowski M, Chow S, Scanlon CP. Meeting the needs of LGBTQ youth: a “Relational Assets” approach. J LGBT Youth. 2009;6:174–98.

    Google Scholar 

  88. Sterrett EM, Jones DJ, McKee LG, Kincaid C. Supportive non-parental adults and adolescent psychosocial functioning: using social support as a theoretical framework. Am J Community Psychol. 2011;48:284–95.

    PubMed  PubMed Central  Google Scholar 

  89. Rafferty J, Committee On Psychosocial Aspects Of Child And Family Health Copaocaf, Committee On Adolescence Co, Section On Lesbian, Gay, Bisexual, And Transgender Health And Wellness Gbathaw. Ensuring comprehensive care and support for transgender and gender-diverse children and adolescents. Pediatrics. 2018;142:e20182162.

    PubMed  Google Scholar 

  90. National Association of School Nurses. LGBTQ students: the role of the school nurse. NASN Sch Nurse. 2017;32:129–31.

    Google Scholar 

  91. Earnshaw VA, Menino DD, Sava LM, Perrotti J, Barnes TN, Humphrey DL, Reisner SL LGBTQ bullying: a qualitative investigation of student and school health professional perspectives. J LGBT Youth. 2019:1–18. https://doi.org/10.1080/19361653.2019.1653808

  92. Menkin D, Flores DD. Transgender students: advocacy, care, and support opportunities for school nurses. NASN Sch Nurse. 2019;34:173–7.

    PubMed  Google Scholar 

  93. Conrad LE. Supporting and caring for transgender and gender nonconforming youth in the urology practice. J Pediatr Urol. 2017;13:300–4.

    Google Scholar 

  94. Doty ND, Willoughby BLB, Lindahl KM, Malik NM. Sexuality related social support among lesbian, gay, and bisexual youth. J Youth Adolesc. 2010;39:1134–47.

    PubMed  Google Scholar 

  95. Bregman HR. Parental support of lesbian, gay, and bisexual youth following disclosure: a longitudinal, cohort-sequential study. Open Access Diss. 2013. 1080. https://scholarlyrepository.miami.edu/oa_dissertations/1080

  96. Hr B, Nm M, Mj P, et al. Identity profiles in lesbian, gay, and bisexual youth: the role of family influences. Sexual orientation, parental support, and health during the transition to young adulthood. youth: time for a new public health research and practice agenda. Fam. 2014;59:1–7.

    Google Scholar 

  97. Barr SM, Budge SL, Adelson JL. Transgender community belongingness as a mediator between strength of transgender identity and well-being. J Couns Psychol. 2016. https://doi.org/10.1037/cou0000127.

    PubMed  Google Scholar 

  98. Harper GW, Serrano PA, Bruce D, Bauermeister JA. The Internet’s multiple roles in facilitating the sexual orientation identity development of gay and bisexual male adolescents. Am J Mens Health. 2015 10(5):359–76. https://doi.org/10.1177/1557988314566227.

    PubMed  Google Scholar 

  99. Rosario M, Schrimshaw EW, Hunter J, Braun L. Sexual identity development among lesbian, gay, and bisexual youths: consistency and change over time. J Sex Res. 2006;43:46–58.

    PubMed  PubMed Central  Google Scholar 

  100. Nuttbrock L, Bockting WO, Rosenblum A, Mason M, Macri M, Becker J. Gender identity conflict/affirmation and major depression across the life course of transgender women. Int J Transgenderism. 2012;13:91–103.

    Google Scholar 

  101. Legate N, Ryan RM, Rogge RD. Daily autonomy support and sexual identity disclosure predicts daily mental and physical health outcomes. Personal Soc Psychol Bull. 2017;43:860–73.

    Google Scholar 

  102. Bosse J, Dion K, Galman SC, LM C (2019) Siblings’ positive support for transgender and nonbinary young adults’ gender identity. GLMA 37th Annu. Conf. LGBTQ Heal.: New Orleans, LA.

  103. Pistella J, Salvati M, Ioverno S, Laghi F, Baiocco R. Coming-out to family members and internalized sexual stigma in bisexual, lesbian and gay people. J Child Fam Stud. 2016;25:3694–701.

    Google Scholar 

  104. Colpitts E, Gahagan J. The utility of resilience as a conceptual framework for understanding and measuring LGBTQ health. Int J Equity Health. 2016;15:1–8.

    Google Scholar 

  105. Rossman K, Salamanca P, Macapagal K. A qualitative study examining young adults’ experiences of disclosure and nondisclosure of LGBTQ identity to health care providers. J Homosex. 2017;64:1390–410.

    PubMed  PubMed Central  Google Scholar 

  106. Stupiansky NW, Liau A, Rosenberger J, Rosenthal SL, Tu W, Xiao S, et al. Young men’s disclosure of same sex behaviors to healthcare providers and the impact on health: results from a US national sample of young men who have sex with men. AIDS Patient Care STDs. 2017;31:342–7.

    PubMed  Google Scholar 

  107. Goldenberg T, Jadwin-Cakmak L, Popoff E, Reisner SL, Campbell BA, Harper GW. Stigma, gender affirmation, and primary healthcare use among Black transgender youth. J Adolesc Health. 2019. https://doi.org/10.1016/j.jadohealth.2019.04.029.

    PubMed  Google Scholar 

  108. Quinn K, Dickson-Gomez J, Zarwell M, Pearson B, Lewis M. “A Gay Man and a Doctor are Just like, a Recipe for Destruction”: How racism and homonegativity in healthcare settings influence PrEP uptake among young Black MSM. AIDS Behav. 2019;23:1951–63.

    PubMed  Google Scholar 

  109. Bosse JD. Determinants of preventative health care delay among transgender and gender non-conforming college students in the United States. Nurs Res. 2015;64:E66.

    Google Scholar 

  110. Reisner SL, Pardo ST, Gamarel KE, Hughto JMW, Pardee DJ, Keo-Meier CL. Substance use to cope with stigma in healthcare among U.S. female-to-male trans masculine adults. LGBT Heal. 2015;2:324–32.

    Google Scholar 

  111. Bry LJ, Mustanski B, Garofalo R, Burns MN. Management of a concealable stigmatized identity: a qualitative study of concealment, disclosure, and role flexing among young, resilient sexual and gender minority individuals. J Homosex. 2017;64:745–69.

    PubMed  Google Scholar 

  112. Budge SL, Belcourt S, Conniff J, Parks R, Pantalone D, Katz-Wise SL. A grounded theory study of the development of trans youths’ awareness of coping with gender identity. J Child Fam Stud. 2018;27:3048–61.

    Google Scholar 

  113. Lykens JE, Leblanc AJ, Bockting WO. Healthcare experiences among young adults who identify as genderqueer or nonbinary. LGBT Heal. 2018;5:191–6.

    Google Scholar 

  114. Coleman E, Bockting W, Botzer M, et al. Standards of care for the health of transsexual, transgender, and gender-nonconforming people, version 7. Int J Transgenderism. 2012;13:165–232.

    Google Scholar 

  115. American Psychiatric Association (2016) What is gender dysphoria? https://www.psychiatry.org/patients-families/gender-dysphoria/what-is-gender-dysphoria. Accessed 8 Sep 2019

  116. Katz-Wise SL, Rosario M, Calzo JP, Scherer EA, Sarda V, Austin SB. Endorsement and timing of sexual orientation developmental milestones among sexual minority young adults in the growing up today study. J Sex Res. 2017;54:172–85.

    PubMed  Google Scholar 

  117. Lopez X, Marinkovic M, Eimicke T, Rosenthal SM, Olshan JS. Statement on gender-affirmative approach to care from the pediatric endocrine society special interest group on transgender health. Curr Opin Pediatr. 2017;29:475–80.

    PubMed  Google Scholar 

  118. Levine DA, Braverman PK, Adelman WP, Breuner CC, Levine DA, Marcell AV, et al. Office-based care for lesbian, gay, bisexual, transgender, and questioning youth. Pediatrics. 2013. https://doi.org/10.1542/peds.2013-1283.

    PubMed  Google Scholar 

  119. Hembree WC, Cohen-Kettenis PT, Gooren L, Hannema SE, Meyer WJ, Murad MH, et al. Endocrine treatment of gender-dysphoric/gender-incongruent persons: an endocrine society* clinical practice guideline. J Clin Endocrinol Metab. 2017;102:3869–903.

    Google Scholar 

  120. Tishelman AC, Kaufman R, Edwards-Leeper L, Mandel FH, Shumer DE, Spack NP. Serving transgender youth: challenges, dilemmas, and clinical examples. Prof Psychol Res Pract. 2015. https://doi.org/10.1037/a0037490.

    Google Scholar 

  121. Vance SR, Ehrensaft D, Rosenthal SM. Psychological and medical care of gender nonconforming youth. Pediatrics. 2014;134:1184–92.

    PubMed  Google Scholar 

  122. Chen D, Hidalgo MA, Leibowitz S, Leininger J, Simons L, Finlayson C, et al. Multidisciplinary care for gender-diverse youth: a narrative review and unique model of gender-affirming care. Transgender Heal. 2016;1:117–23.

    PubMed  PubMed Central  Google Scholar 

  123. Edwards-Leeper L, Spack NP. Psychological evaluation and medical treatment of transgender youth in an interdisciplinary “gender management service” (GeMS) in a major pediatric center. J Homosex. 2012;59:321–36.

    PubMed  Google Scholar 

  124. Salehi P, Divall SA, Crouch JM, Hopkinson RA, Kroon L, Lawrence J, et al. Review of current care models for transgender youth and application to the development of a multidisciplinary clinic - the seattle children’s hospital experience. Pediatr Endocrinol Rev. 2018;15:280–90.

  125. Olson-Kennedy J, Chan Y-M, Garofalo R, Spack N, Chen D, Clark L, et al. Impact of early medical treatment for transgender youth: protocol for the longitudinal, observational trans youth care study. JMIR Res Protoc. 2019;8:e14434.

    PubMed  PubMed Central  Google Scholar 

  126. • Olson-Kennedy J, Rosenthal SM, Hastings J, Wesp L (2016) Health considerations for gender non-conforming children and transgender adolescents | Transgender Care. In: UCSF Transgender Care Treat. Guidel. https://transcare.ucsf.edu/guidelines/youth. Provides comprehensive guidance on the treatment of trangsgender and nonbinary adolescents as part of a larger document provding comprehensive guidance for the provision of care across the lifespan.

  127. de Vries ALC, McGuire JK, Steensma TD, Wagenaar ECF, Doreleijers TAH, Cohen-Kettenis PT. Young adult psychological outcome after puberty suppression and gender reassignment. Pediatrics. 2014. https://doi.org/10.1542/peds.2013-2958.

    PubMed  Google Scholar 

  128. Connolly MD, Zervos MJ, Barone CJ, et al. The mental health of transgender youth: advances in understanding. J Adolesc Health. 2016;59:489–95.

    PubMed  Google Scholar 

  129. Olson KR, Durwood L, DeMeules M, McLaughlin KA. Mental health of transgender children who are supported in their identities. Pediatrics. 2016;137:1–8.

    Google Scholar 

  130. Gridley SJ, Crouch JM, Evans Y, Eng W, Antoon E, Lyapustina M, et al. Youth and caregiver perspectives on barriers to gender-affirming health care for transgender youth. J Adolesc Health. 2016;59:254–61.

    PubMed  Google Scholar 

  131. Vance SR, Halpern-Felsher BL, Rosenthal SM. Health care providers’ comfort with and barriers to care of transgender youth. J Adolesc Health. 2015. https://doi.org/10.1016/j.jadohealth.2014.11.002.

    PubMed  Google Scholar 

  132. Turban JL, Winer J, Boulware S, VanDeusen T, Encandela J. Knowledge and attitudes toward transgender health. Clin Teach. 2018;15:203–7.

    PubMed  Google Scholar 

  133. Rider GN, Mcmorris BJ, Gower AL, Coleman E, Eisenberg ME. Health and care utilization of transgender and gender nonconforming youth: a population-based study. Pediatrics. 2018;141:e20171683.

    PubMed  PubMed Central  Google Scholar 

  134. • Dowshen N, Meadows R, Byrnes M, Hawkins L, Eder J, Noonan K. Policy perspective: ensuring comprehensive care and support for gender nonconforming children and adolescents. Transgender Heal. 2016;1:75–85 Highlights a number of policy-level advances and challenges that impact the health of TGY using case studies and proposes changes at the local (e.g., organization, community), state, and national levels to further support and improve the health and healthcare experiences of TGY.

    Google Scholar 

  135. Byron P, Rasmussen S, Wright Toussaint D, Lobo R, Robinson KH, Paradise B. ‘You learn from each other’: LGBTIQ young people’s mental health help-seeking and the RAD Australia Online Directory. 2017. https://doi.org/10.4225/35/58AE2DEA65D12.

  136. Knight RE, Shoveller JA, Carson AM, Contreras-Whitney JG. Examining clinicians’ experiences providing sexual health services for LGBTQ youth: considering social and structural determinants of health in clinical practice. Health Educ Res. 2014;29:662–70.

    CAS  PubMed  PubMed Central  Google Scholar 

  137. Grant R, Nash M. Young bisexual women’s sexual health care experiences in Australian rural general practice. Aust J Rural Health. 2019;27:ajr.12505.

    Google Scholar 

  138. Taliaferro LA, Harder BM, Lampe NM, Carter SK, Rider GN, Eisenberg ME. Social connectedness factors that facilitate use of healthcare services: comparison of transgender and gender nonconforming and cisgender adolescents. J Pediatr. 2019;211:172–8.

    PubMed  Google Scholar 

  139. Behler RL, Cornwell BT, Schneider JA. Patterns of social affiliations and healthcare engagement among young, Black, men who have sex with men. AIDS Behav. 2018;22:806–18.

    PubMed  PubMed Central  Google Scholar 

  140. Bauer GR, Zong X, Scheim AI, Hammond R, Thind A. Factors impacting transgender patients’ discomfort with their family physicians: a respondent-driven sampling survey. PLoS One. 2015. https://doi.org/10.1371/journal.pone.0145046.

    PubMed  PubMed Central  Google Scholar 

  141. Solazzo AL, Tabaac AR, Agénor M, Austin SB, Charlton BM. Sexual orientation inequalities during provider-patient interactions in provider encouragement of sexual and reproductive health care. Prev Med (Baltim). 2019;126:105787.

    Google Scholar 

  142. Charlton BM, Reisner SL, Agé M, Gordon AR, Sarda V, Austin SB. Sexual orientation disparities in human papillomavirus vaccination in a longitudinal cohort of U.S. males and females. https://doi.org/10.1089/lgbt.2016.0103.

    PubMed  PubMed Central  Google Scholar 

  143. Doull M, Wolowic J, Saewyc E, Rosario M, Prescott T, Ybarra ML. Why girls choose not to use barriers to prevent sexually transmitted infection during female-to-female sex. J Adolesc Health. 2018;62:411–6.

    PubMed  Google Scholar 

  144. Luk JW, Gilman SE, Haynie DL, Simons-Morton BG. Sexual orientation differences in adolescent health care access and health-promoting physician advice. J Adolesc Health. 2017;61:555–61.

    PubMed  PubMed Central  Google Scholar 

  145. Agénor M, Jahn JL, Kay E, Bishop RA, Peitzmeier SM, Potter J, et al. Human papillomavirus risk perceptions among young adult sexual minority cisgender women and nonbinary individuals assigned female at birth. Perspect Sex Reprod Health. 2019;51:27–34.

    PubMed  Google Scholar 

  146. Rose I, Friedman D. Schools: a missed opportunity to inform African American sexual and gender minority youth about sexual health education and services. J Sch Nurs. 2017;33:109–15.

    PubMed  Google Scholar 

  147. Hall WJ, Jones BLH, Witkemper KD, Collins TL, Rodgers GK. State policy on school-based sex education: a content analysis focused on sexual behaviors, relationships, and identities. Am J Health Behav. 2019;43:506–19.

    PubMed  Google Scholar 

  148. Youatt EJ, Harris LH, Harper GW, Janz NK, Bauermeister JA. Sexual health care services among young adult sexual minority women. Sex Res Soc Policy. 2017;14:345–57.

    Google Scholar 

  149. Peitzmeier SM, Khullar K, Reisner SL, Potter J. Pap test use is lower among female-to-male patients than non-transgender women. Am J Prev Med. 2014;47:808–12.

    PubMed  Google Scholar 

  150. Arrington-Sanders R, Morgan A, Oidtman J, Qian I, Celentano D, Beyrer C. A medical care missed opportunity: preexposure prophylaxis and young Black men who have sex with men. J Adolesc Health. 2016;59:725–8.

    PubMed  Google Scholar 

  151. Wood SM, Lee S, Barg FK, Castillo M, Dowshen N. Young transgender women’s attitudes toward HIV pre-exposure prophylaxis. J Adolesc Health. 2017;60:549–55.

    PubMed  PubMed Central  Google Scholar 

  152. Steever J, Francis J, Gordon LP, Lee J. Sexual minority youth. Prim Care. 2014;41:651–69.

    PubMed  Google Scholar 

  153. Centers for Disease Control and Prevention HPV | Who Should Get Vaccine | Human Papillomavirus | CDC. https://www.cdc.gov/hpv/parents/vaccine.html. Accessed 23 Sep 2019

  154. Eunice Kennedy Shriver National Institute of Child Health and Human Development (2018) Item of interest: FDA approves PrEP therapy for adolescents at risk of HIV | NICHD - Eunice Kennedy Shriver National Institute of Child Health and Human Development. https://www.nichd.nih.gov/newsroom/news/051618-PrEP. Accessed 29 Sep 2019

  155. Arrington-Sanders R, Wilson CM, Perumean-Chaney SE, Patki A, Hosek S. Brief report. JAIDS J Acquir Immune Defic Syndr. 2019;80:160–5.

    PubMed  Google Scholar 

  156. Liu AY, Vittinghoff E, von Felten P, et al. Randomized controlled trial of a mobile health intervention to promote retention and adherence to preexposure prophylaxis among young people at risk for human immunodeficiency virus: the EPIC study. Clin Infect Dis. 2019;68:2010–7.

    PubMed  Google Scholar 

  157. Lindley LL, Walsemann KM. Sexual orientation and risk of pregnancy among New York city high-school students. Am J Public Health. 2015;105:1379–86.

    PubMed  PubMed Central  Google Scholar 

  158. Charlton BM, Corliss HL, Missmer SA, Rosario M, Spiegelman D, Austin SB. Sexual orientation differences in teen pregnancy and hormonal contraceptive use: an examination across 2 generations. Am J Obstet Gynecol. 2013;209:204.e1–8.

    Google Scholar 

  159. Austin SB, Gordon AR, Ziyadeh NJ, Charlton BM, Katz-Wise SL, Samnaliev M. Stigma and health-related quality of life in sexual minorities. Am J Prev Med. 2017. https://doi.org/10.1016/j.amepre.2017.05.007.

    PubMed  PubMed Central  Google Scholar 

  160. Veale J, Watson RJ, Adjei J, Saewyc E. Prevalence of pregnancy involvement among Canadian transgender youth and its relation to mental health, sexual health, and gender identity. Int J Transgenderism. 2016;17:107–13.

    Google Scholar 

  161. Tornello SL, Riskind RG, Patterson CJ. Sexual orientation and sexual and reproductive health among adolescent young women in the United States. J Adolesc Health. 2014;54:160–8.

    PubMed  Google Scholar 

  162. Saewyc EM, Poon CS, Homma Y, Skay CL. Stigma management? The links between enacted stigma and teen pregnancy trends among gay, lesbian, and bisexual students in British Columbia. Can J Hum Sex. 2008;17:123–39.

    PubMed  PubMed Central  Google Scholar 

  163. Ela EJ, Budnick J. Non-heterosexuality, relationships, and young women’s contraceptive behavior. Demography. 2017;54:887–909.

    PubMed  PubMed Central  Google Scholar 

  164. Light AD, Obedin-Maliver J, Sevelius JM, Kerns JL. Transgender men who experienced pregnancy after female-to-male gender transitioning. Obstet Gynecol. 2014;124:1120–7.

    CAS  PubMed  Google Scholar 

  165. Chen D, Kolbuck VD, Sutter ME, Tishelman AC, Quinn GP, Nahata L. Knowledge, practice behaviors, and perceived barriers to fertility care among providers of transgender healthcare. J Adolesc Health. 2019;64:226–34.

    PubMed  Google Scholar 

  166. Chen D, Matson M, Macapagal K, Johnson EK, Rosoklija I, Finlayson C, et al. Attitudes toward fertility and reproductive health among transgender and gender-nonconforming adolescents. J Adolesc Health. 2018;63:62–8.

    PubMed  Google Scholar 

  167. Nahata L, Tishelman AC, Caltabellotta NM, Quinn GP. Low fertility preservation utilization among transgender youth. J Adolesc Health. 2017;61:40–4.

    PubMed  Google Scholar 

  168. Clark B, Jarin J, Strang J, Call D, Solages M, Gomez-Lobo V. Transgender adolescent attitudes towards their future fertility. J Pediatr Adolesc Gynecol. 2017;30:326.

    Google Scholar 

  169. Chen D, Kyweluk MA, Sajwani A, Gordon EJ, Johnson EK, Finlayson CA, et al. Factors affecting fertility decision-making among transgender adolescents and young adults. LGBT Heal. 2019;6:107–15.

    PubMed  PubMed Central  Google Scholar 

  170. • Hoffkling A, Obedin-Maliver J, Sevelius J. From erasure to opportunity: a qualitative study of the experiences of transgender men around pregnancy and recommendations for providers. BMC Pregnancy Childbirth. 2017;17:332 Highlights varying experiences of transgender men who have been pregnant and provides a comprehensive list of reproductive health topics to include in conversations regarding preventing or supporting pregnancy (Table 2), and environmental/general clinic recommendations to be addressed (Table 5).

    PubMed  PubMed Central  Google Scholar 

  171. Knudson G, De Sutter P. Fertility options in transgender and gender diverse adolescents. Acta Obstet Gynecol Scand. 2017;96:1269–72.

    PubMed  Google Scholar 

  172. Wesp L (2016) Transgender patients and the physical examination | Transgender Care. In: UCSF Transgender Care Treat. Guidel. https://transcare.ucsf.edu/guidelines/physical-examination. Accessed 28 Sep 2019

  173. Bosse JD, Nesteby JA, Randall CE. Integrating sexual minority health issues into a health assessment class. J Prof Nurs. 2015;31:498–507.

    PubMed  Google Scholar 

  174. Peitzmeier S, Gardner I, Weinand J, Corbet A, Acevedo K. Health impact of chest binding among transgender adults: a community-engage...: Find books, articles, DVDs & more. Cult Health Sex. 2017;19:64–75.

    PubMed  Google Scholar 

  175. Healthline tucking: how-to, safety, supplies, tips, and more. https://www.healthline.com/health/transgender/tucking#how-to-tuck. Accessed 28 Sep 2019

  176. Marsh C, McCracken M, Gray M, Nangia A, Gay J, Roby KF. Low total motile sperm in transgender women seeking hormone therapy. J Assist Reprod Genet. 2019;36:1639–48.

    PubMed  Google Scholar 

  177. Zevin B (2016) Testicular and scrotal pain and related complaints | Transgender Care. In: UCSF Transgender Care Treat. Guidel. https://transcare.ucsf.edu/guidelines/testicular-pain. Accessed 28 Sep 2019

  178. Torres CG, Renfrew M, Kenst K, Tan-McGrory A, Betancourt JR, López L. Improving transgender health by building safe clinical environments that promote existing resilience: results from a qualitative analysis of providers. BMC Pediatr. 2015;15:1–10. https://doi.org/10.1186/s12887-015-0505-6.

    Article  Google Scholar 

  179. Kull RM, Kosciw JG, Greytak EA. Preparing school counselors to support LGBT youth: the roles of graduate education and professional development. Prof Sch Couns. 2017;20:1096–2409–20.1a.

    Google Scholar 

  180. Dickey Lore M, Singh AA. Finding a trans-affirmative provider: challenges faced by trans and gender ...: Find books, articles, DVDs & more. J Clin Psychol. 2017;73:938–44.

    CAS  PubMed  Google Scholar 

  181. Dy GW, Osbun NC, Morrison SD, Grant DW, Merguerian PA. Exposure to and attitudes regarding transgender education among urology residents. J Sex Med. 2016;13:1466–72.

    PubMed  Google Scholar 

  182. Greene MZ, France K, Kreider EF, Wolfe-Roubatis E, Chen KD, Wu A, et al. Comparing medical, dental, and nursing students’ preparedness to address lesbian, gay, bisexual, transgender, and queer health. PLoS One. 2018;13:e0204104.

    PubMed  PubMed Central  Google Scholar 

  183. Carabez RM, Eliason MJ, Martinson M. Nurses’ knowledge about transgender patient care. Adv Nurs Sci. 2016;39:257–71.

    Google Scholar 

  184. McCann E, Brown M. The inclusion of LGBT+ health issues within undergraduate healthcare education and professional training programmes: a systematic review. Nurse Educ Today. 2018;64:204–14.

    PubMed  Google Scholar 

  185. Lim F, Johnson M, Eliason M. A national survey of faculty knowledge, experience, and readiness for teaching lesbian, gay, bisexual, and transgender health in baccalaureate nursing programs. Nurs Educ Perspect. 2015;36:144–52.

    Google Scholar 

  186. Fraser L, Knudson G. Education needs of providers of transgender population. Endocrinol Metab Clin N Am. 2019;48:465–77.

    Google Scholar 

  187. Rider GN, McMorris BJ, Gower AL, Coleman E, Brown C, Eisenberg ME. Perspectives from nurses and physicians on training needs and comfort working with transgender and gender-diverse youth. J Pediatr Health Care. 2019;33:379–85.

    PubMed  Google Scholar 

  188. Turban JL. Transgender youth: the building evidence base for early social transition. 2017. https://doi.org/10.1016/j.jaac.2016.11.008.

    Google Scholar 

  189. Sekoni AO, Gale NK, Manga-Atangana B, Bhadhuri A, Jolly K. The effects of educational curricula and training on LGBT-specific health issues for healthcare students and professionals: a mixed-method systematic review. J Int AIDS Soc. 2017;20:21624.

    PubMed  PubMed Central  Google Scholar 

  190. Bristol S, Kostelec T, MacDonald R. Improving emergency health care workers’ knowledge, competency, and attitudes toward lesbian, gay, bisexual, and transgender patients through interdisciplinary cultural competency training. J Emerg Nurs. 2018;44:632–9. https://doi.org/10.1016/j.jen.2018.03.013

    PubMed  Google Scholar 

  191. Mayfield J, May H De, Tillery K, Winer J, Ball E, Rogers J, Fancovic E, Crandall C (2016) Lesbian, Gay, Bisexual, Transgender, and Queer (LGBTQ) Healthcare in undergraduate medical education: assessment and focused intervention for medical students transitioning to the wards. Undergrad. Med. Student Res.

  192. Morris M, Cooper RL, Ramesh A, Tabatabai M, Arcury TA, Shinn M, et al. Training to reduce LGBTQ-related bias among medical, nursing, and dental students and providers: a systematic review. BMC Med Educ. 2019;19:325.

    PubMed  PubMed Central  Google Scholar 

  193. Pepping CA, Lyons A, Morris EMJ. Affirmative LGBT psychotherapy: outcomes of a therapist training protocol. Psychotherapy. 2018;55:52–62.

    PubMed  Google Scholar 

  194. Hickerson K, Hawkins LA, Hoyt-Brennan AM. Sexual orientation/gender identity cultural competence: a simulation pilot study. Clin Simul Nurs. 2018;16:2–5. https://doi.org/10.1016/j.ecns.2017.10.011.

    Google Scholar 

  195. Rafferty J. Ensuring comprehensive care and support for transgender and gender-diverse children and adolescents. Pediatrics. 2018;142.

    PubMed  Google Scholar 

  196. Sabin JA, Riskind RG, Nosek BA. Health care providers’ implicit and explicit attitudes toward lesbian women and gay men. Am J Public Health. 2015;105:1831–41.

    PubMed  PubMed Central  Google Scholar 

  197. Adelson SL, Stroeh OM, Kee Y, Ng W. or Transgender youth in pediatric practice. Dev Ment Heal Lesbian. https://doi.org/10.1016/j.pcl.2016.07.002.

    PubMed  Google Scholar 

  198. Hidalgo MA, Ehrensaft D, Tishelman AC, Clark LF, Garofalo R, Rosenthal SM, et al. The gender affirmative model: what we know and what we aim to learn. Hum Dev. 2013. https://doi.org/10.1159/000355235.

    Google Scholar 

  199. Lawlis SM, Donkin HR, Bates JR, Britto MT, Conard LAE. Health concerns of transgender and gender nonconforming youth and their parents upon presentation to a transgender clinic. J Adolesc Health. 2017;61:642–8.

    PubMed  Google Scholar 

  200. Potter J, Peitzmeier SM, Bernstein I, Reisner SL, Alizaga NM, Agénor M, et al. Cervical cancer screening for patients on the female-to-male spectrum: a narrative review and guide for clinicians. J Gen Intern Med. 2015;30:1857–64.

    PubMed  PubMed Central  Google Scholar 

  201. Baams L. Disparities for LGBTQ and gender nonconforming adolescents. Pediatrics. 2018. https://doi.org/10.1542/peds.2017-3004.

    PubMed  Google Scholar 

  202. Veale JF, Watson RJ, Peter T, Saewyc EM. Mental health disparities among canadian transgender youth. J Adolesc Health. 2017;60:44–9.

    PubMed  PubMed Central  Google Scholar 

  203. Mateu-Gelabert P, Harris S, Berbesi D, Segura Cardona ÁM, Montoya Vélez LP, Mejía Motta IE, et al. Heroin use and injection risk behaviors in Colombia: implications for HIV/AIDS prevention. Subst Use Misuse. 2016;51:230–40.

    Google Scholar 

  204. Potter J, Peitzmeier SMS, Bernstein I, Reisner SSL, Alizaga NNM, Agenor M, et al. Cervical cancer screening for patients on the female-to-male spectrum: a narrative review and guide for clinicians. J Gen Intern Med. 2015;30:1857–64.

    PubMed  PubMed Central  Google Scholar 

  205. Strang JF, Jarin J, Call D, Clark B, Wallace GL, Anthony LG, et al. Transgender youth fertility attitudes questionnaire. 2018. https://doi.org/10.1037/t70339-000.

  206. Torres CG, Renfrew M, Kenst K, Tan-McGrory A, Betancourt JR, López L. Improving transgender health by building safe clinical environments that promote existing resilience: results from a qualitative analysis of providers. BMC Pediatr. 2015;15:187. https://doi.org/10.1186/s12887-015-0505-6.

  207. Hanneman T (2014) HEI 2014: Promoting equitable and inclusive care for lesbian, gay, bisexual, and transgender patients and their families. Washington, D.C.

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Bosse, J.D. Sexual and Gender Identity Development in Young Adults and Implications for Healthcare. Curr Sex Health Rep 11, 274–286 (2019). https://doi.org/10.1007/s11930-019-00215-w

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