P0625 - Health Care Transition of Transgender Youth

Background/Purpose: No studies have yet examined health care transition (HCT) among transgender youth, although they are known to experience difficulty accessing culturally competent healthcare. The goal of this study was to identify gaps in education and support for transgender youth transitioning gender-affirming care to an adult healthcare setting.

Methods: Transgender youth 14-21 years old and their parents were recruited at clinic visits for gender-affirming care at a pediatric medical center. For patients ≥18 years old attending visits without a parent, youth permission was obtained to prior to contacting their parent. Pediatric healthcare providers caring for transgender youth were recruited by email. Participants completed a sociodemographic survey and readiness assessment of themselves, their child, or their patients. The Center for Health Care Transition Improvement readiness assessment was modified for this study. Youth were divided by age (14-17 versus 18-21 years old) and parents by their child’s age. Mean ratings of importance and readiness by groups on a zero to ten scale were compared using independent t-tests in SPSS. Participants rated youth readiness skills competence by choosing among options of knowing it, needing to learn to do it themselves, or needing help with it; responses of different groups were compared using chi-square tests.

Results: Total of 27 youth, 29 parents, and 5 providers were recruited. Transgender youth 18-21 years old and parents of that age group were congruent on degree and importance of readiness. Parents of youth 14-17 years old rated their child’s readiness lower than parents of youth 18-21 years old (p<0.01). Overall youth 14-21 years old reported knowing several skills at higher rates than parents reported: hormone therapy side effects, how to reduce risk of side effects, and thinking of questions before visits (p<0.05). Pediatric providers viewed their patients’ ability to complete multiple skills lower than youth did. All participant categories frequently identified making appointments, getting referrals to other providers, keeping records of medical information, and knowing information monitored by bloodwork as skills needing to be learned.

Conclusion: Parents of transgender youth 14-17 years old did not rate their adolescents’ readiness for HCT highly compared to parents of older transgender youth. This suggests parents of youth 14-17 years old need additional support in preparing their youth to transition to adult care. In addition, all youth may benefit from resources tailored to the skills identified as needing to learn for successful HCT.