Lessons from Grassroots Efforts to Increase Gender-Affirming Medical Care for Transgender and Gender Diverse Youth in the Community Health Care Setting.

Increasingly, transgender and gender diverse (TGD) youth are seeking gender-affirming medical care. Most multidisciplinary gender-affirming pediatric clinics are located in academic facilities in urban areas. To improve access to care and advance the field, grassroots establishment-without targeted funding or explicitly trained gender health providers-of multidisciplinary gender health clinics in rural and community health care settings can increase care access and lay the foundation for dedicated funding, staff, and clinic space. In this perspective piece, we share our grassroots process of establishing a multidisciplinary gender health clinic in the community setting, highlighting critical turning points that facilitated our clinic's rapid growth. Our experience can provide important lessons learned for community health care systems seeking to establish programs that will serve TGD youth.