Clinicians Report Less Comfort in Provision of Medical Care to Nonbinary Transgender Youth.

PURPOSE

The purpose of this study was to determine whether clinician comfort differs in the provision of gender-affirming medical care to transgender and gender diverse (TGD) youth with binary versus nonbinary gender identities.

METHODS

A cross-sectional survey was distributed to three international health professional electronic mailing lists. Comfort providing gonadotropin-releasing hormone agonist (GnRHa) and gender-affirming hormone therapy (GAHT) to nonbinary and binary TGD youth was assessed using 5-point Likert scales and analyzed with Wilcoxon signed-rank tests. Logistic regression modeling comfort providing GnRHa and GAHT to nonbinary compared to binary TGD youth was performed to identify relevant predictors.

RESULTS

Fifty-five respondents completed the survey. Respondents reported more comfort providing both GnRHa therapy and GAHT to binary compared to nonbinary TGD youth. In univariate analyses, being in a pediatric endocrinology specialty and work within a multidisciplinary clinic setting were associated with less comfort providing GAHT to nonbinary compared to binary TGD youth. Non-straight/non-heterosexual sexual orientation, being in a general pediatrics specialty, and higher estimated percentage of nonbinary TGD youth cared for in clinical practice were associated with more comfort. Only nonstraight/nonheterosexual sexual orientation maintained significance after adjusting for potential confounders in multivariate analyses.

CONCLUSIONS

Clinicians are less comfortable providing gender-affirming medical care to nonbinary versus binary TGD youth. Efforts to decrease barriers and to inform development of clinical practice guidelines inclusive of nonbinary TGD youth are needed.