DESCRIPTION

• Transgender and gender-diverse individuals have gender identities that differ from the gender assigned at birth. Gender identity may be binary (male, female) or nonbinary (genderqueer).
• Transgender and gender-diverse individuals can experience barriers to health care access. By providing gender-sensitive and gender-affirming care, pediatric and adolescent providers can improve health care outcomes for transgender and gender-diverse youth.

EPIDEMIOLOGY

The prevalence of transgender people in the general population is not well known. The 2017 Youth Risk Behavior Survey reported 1.8% of U.S. high school students pooled from 10 states and 9 urban school districts identified as transgender.

ETIOLOGY

The development of gender identity is not well understood but is thought to be influenced by both biologic and environmental factors.

COMMONLY ASSOCIATED CONDITIONS

Transgender and gender-diverse youth are at higher risk than cisgender peers (those with gender identity that is the same as birth sex assignment) for the following:

• Mental health disorders including depression, anxiety, substance abuse, disordered eating (abnormal eating behavior), suicidal ideation, and suicidal attempts
• Violence: physical, emotional, and sexual
• Sexually transmitted infections (STIs) (including HIV)
• Housing instability and food insecurity
• Transgender and gender-diverse youth are less likely to engage with preventive care practices and may present later for care.