Browsing by Subject "Gender-diverse youth"

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    A retrospective review of psychosocial correlates of chronic pain in cisgender, transgender, and gender-diverse youth receiving evaluation in interdisciplinary pediatric pain clinics
    (Taylor & Francis, 2025-04-15) Tracy, Crystal; Lynch Milder, Mary; Vater, Lindsey; Lagges, Ann; Lemanek, Kathleen; Wrona, Sharon; Gilbert, Elaine; Hirsh, Adam T.; Miller, Megan M.; Donahue, Kelly; Streicher, Morgan; Williams, Amy E.; Psychiatry, School of Medicine
    Background: Individuals who experience social marginalization, such as transgender and gender-diverse (TGD) youth, have increased risk for poor health outcomes, including chronic pain. A better understanding of the impact of chronic pain in these populations would improve treatment and aid in reducing health care disparities. Our retrospective review of clinical data examined psychosocial correlates of pain in TGD and cisgender youth with chronic pain. Aims: The study aim was to explore differences in psychosocial variables between TGD and cisgender youth with chronic pain. In alignment with the minority stress model, we hypothesized worse pain and pain-related disability, poorer quality of life, and more internalizing symptoms in TGD patients. The secondary aim was to explore associations among psychosocial variables in TGD and cisgender youth. Methods: Data were collected from 140 youth (48 TGD, 92 cisgender) evaluated in pediatric pain clinics. Independent samples t-tests examined group differences in pain intensity, functional disability, quality of life, pain catastrophizing, and internalizing symptoms. Bivariate correlations were conducted for each group, and differences in the strength of correlations were evaluated using Fisher r-to-z. Institutional review board (IRB) approval was obtained for all study procedures at each participating institution prior to extraction of retrospective clinical data (Indiana 240 University IRB Protocol No. 12506, The Ohio State University College of Medicine IRB Protocol No. 16-00937). Informed consent was not required or obtained due to the retrospective nature of the study. Results: Cisgender patients reported worse pain intensity, whereas TGD patients reported lower quality of life and more internalizing symptoms. In the combined sample, pain intensity was correlated with worse functional disability, poorer quality of life, and more catastrophic thinking. No group differences in the strength of correlations were found. Conclusions: Results suggest that for TGD youth with chronic pain, internalizing symptoms and quality of life are important targets for treatment and improvement.
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    Gender-Diverse Youth's Experiences and Satisfaction with Telemedicine for Gender-Affirming Care During the COVID-19 Pandemic
    (Mary Ann Liebert, 2022-04-11) Sequeira, Gina M.; Kidd, Kacie M.; Rankine, Jacquelin; Miller, Elizabeth; Ray, Kristin N.; Fortenberry, J. Dennis; Richardson, Laura P.; Pediatrics, School of Medicine
    Purpose: Telemedicine holds potential to improve access to gender-affirming care for gender-diverse youth (GDY), but little is known about youth's perspectives regarding its use. The purpose of this study was to explore GDY's experiences and satisfaction with telemedicine for gender-affirming care during the COVID-19 pandemic. Methods: An online, cross-sectional survey was completed by 12-17-year-old GDY after a telemedicine gender clinic visit. Demographic characteristics, responses to a 12-item telemedicine satisfaction scale, and items assessing interest in future telemedicine use were analyzed using descriptive statistics. Open-ended items exploring GDY's experiences were coded qualitatively to identify key themes. Results: Participants' (n=57) mean age was 15.6 years. A majority were satisfied with telemedicine (85%) and willing to use it in the future (88%). Most GDY preferred in-person visits for their first gender care visit (79%), with fewer preferring in-person for follow-up visits (47%). Three key themes emerged from the open-ended comments: (1) benefits of telemedicine including saving time and feeling safe; (2) usability of telemedicine such as privacy concerns and technological difficulties; and (3) telemedicine acceptability, which included comfort, impact on anxiety, camera use, and patient preference. Conclusions: Despite their preference for in-person visits, a majority of GDY were satisfied and comfortable with telemedicine, and expressed their interest in continuing to have telemedicine as an option for care. Pediatric gender care providers should continue services through telemedicine while implementing protocols related to privacy and hesitation regarding camera use. While adolescents may find telemedicine acceptable, it remains unclear whether telemedicine can improve access to gender-affirming care.
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    SUN-079 Baseline Body Satisfaction in Gender-Diverse Youth
    (Endocrine Society, 2020-05-08) Gohil, Anisha; Donahue, Kelly; Eugster, Erica A.; Medicine, School of Medicine
    Background: Body dissatisfaction often contributes to the distress experienced by transgender and nonbinary individuals. However, limited data exist regarding body image in the pediatric age range. Objective: To establish baseline ratings of body satisfaction among gender-diverse youth prior to puberty blocking medication. Methods: Subjects were recruited from the gender health clinic at Riley Hospital for Children beginning in January 2018. Eligible subjects met clinical criteria for a puberty blocker, were treatment naïve, and were anticipated to be on a blocker alone for ≥ 1 year. We assessed self-reported body satisfaction at baseline using the Body Image Scale-Gender Spectrum. Subjects rated various body parts on a scale of 1 (very satisfied) to 5 (very dissatisfied). For analysis, body parts were grouped into gendered features (primary sex, secondary sex, & neutral characteristics) and also body areas (appearance/hair/voice, head & neck, musculoskeletal, hips, chest, & genitals/gonads).1 Results: Twenty subjects (mean age 12.0, range 8.4-14.0) were enrolled of whom 13 were transmasculine (TM) and 7 were transfeminine (TF). TM subjects had a mean BMI percentile of 73.7% and height z-score of 0.50, with breast Tanner stage (TS) of II (n=2), III (n= 3), IV (n=3) and V (n=4). Estradiol levels ranged from <20-120 pg/mL and testosterone levels ranged from <10-38 ng/dL. TF subjects had a mean BMI percentile of 65.3% and height Z-score of 0.58, with testicular volumes of 5 cc (n=1), 6 cc (n=2), 9 cc (n=1), 10 cc (n=1) and 15 cc (n=1). Testosterone levels ranged from <10-215 ng/dL and estradiol levels ranged from <5-31 pg/mL. Among all subjects, mean satisfaction ratings for gendered features were 4.45 (primary sex characteristics), 3.21 (secondary sex characteristics), and 2.61 (neutral characteristics). Mean satisfaction ratings for body areas were 4.45 (genitals/gonads), 3.85 (chest), 3.23 (appearance/hair/voice), 3.03 (hips), 2.83 (musculoskeletal), and 2.55 (head & neck). The only significant between-group difference in satisfaction was for the chest region, with TM subjects reporting higher dissatisfaction (4.35 vs 2.93, p <0.004). Conclusion: The gender-diverse youth in our study reported high degrees of dissatisfaction with their genitals/gonads and, for TM subjects, their chest. In contrast, they reported generally neutral feelings toward many of their other body parts. To the best of our knowledge this is the youngest cohort of gender-diverse youth in whom body satisfaction has been explored. Further studies of the effects of endocrine treatment on body image in gender-diverse youth are warranted, specifically as they relate to other measures of well-being.