Department of Population Health Sciences, University of Central Florida, Orlando, FL.
Department of History, Sociology, Geography, and Legal Studies, University of Tampa, Tampa, FL.
J Pediatr. 2019 Aug;211:172-178. doi: 10.1016/j.jpeds.2019.04.024. Epub 2019 May 10.
To compare social connectedness factors that facilitate use of primary, dental, and mental healthcare services among transgender and gender nonconforming (TGNC) and cisgender adolescents.
Data from the cross-sectional 2016 Minnesota Student Survey were used to examine protective social connectedness factors associated with use of different healthcare services among matched samples of 1916 TGNC and 1916 cisgender youth. Stratified, logistic regression analyses were used to examine background characteristics and social connectedness factors (parent connectedness, connections to other nonparental adults, teacher-student relationships, and friend connections) associated with use of each healthcare service within the last year.
For TGNC youth, but not for cisgender youth, higher levels of parent connectedness were associated with receipt of primary (OR, 2.26; 95% CI, 1.40-3.66) and dental (OR, 3.01; 95% CI, 1.78-5.08) care services, and lower levels of connectedness to nonparental adults was associated with receipt of mental healthcare (OR, 0.55; 95% CI, 0.33-0.93). Among cisgender youth, no protective factors were significantly associated with receipt of primary care services, higher levels of friend connections were associated with receipt of dental services (OR, 1.85; 95% CI, 1.10-3.09), and lower levels of parent connectedness were associated with receipt of mental healthcare (OR, 0.20; 95% CI, 0.10-0.40).
To promote the health of TGNC youth, clinicians should understand the distinct factors associated with obtaining healthcare among this population such as the need for tailored efforts focused on strengthening connectedness between TGNC youth and their parents to facilitate receipt of needed care.
比较促进跨性别和性别不一致（TGNC）青少年与顺性别青少年使用初级、牙科和心理健康保健服务的社会联系因素。
使用 2016 年明尼苏达州学生调查的横断面数据，在匹配的 1916 名 TGNC 和 1916 名顺性别青年样本中，检查与使用不同医疗保健服务相关的保护社会联系因素。使用分层逻辑回归分析，检查与去年内使用每种医疗保健服务相关的背景特征和社会联系因素（与父母的联系、与其他非父母成年人的联系、师生关系和朋友联系）。
对于 TGNC 青少年，但对于顺性别青少年，与父母的联系程度较高与接受初级保健（OR，2.26；95%CI，1.40-3.66）和牙科保健（OR，3.01；95%CI，1.78-5.08）服务相关，与非父母成年人的联系程度较低与接受心理健康保健相关（OR，0.55；95%CI，0.33-0.93）。在顺性别青少年中，没有保护因素与接受初级保健服务显著相关，与朋友的联系程度较高与接受牙科保健服务相关（OR，1.85；95%CI，1.10-3.09），与父母的联系程度较低与接受心理健康保健服务相关（OR，0.20；95%CI，0.10-0.40）。
为促进 TGNC 青少年的健康，临床医生应了解与该人群获得医疗保健相关的不同因素，例如需要有针对性的努力，重点加强 TGNC 青少年与其父母之间的联系，以促进获得所需的护理。
