Monday, July 1, 2013

Pediatricians' Pride:Upgrading Care of LGBTQ Youth


  
If a pediatrician sees somewhere around fifty patients a day in a busy practice, there is a good chance that she will see a youth who identifies as LGBTQ, short for lesbian, gay, bisexual, transgender or questioning.   A "questioning" youth, according to the AAP is "anyone struggling with sexual attractions and identity formation,"  according to a summary of the new policy published in AAP News.


The AAP's Committee on Adolescence has just come out with recommendations for providers on how to best approach and care for these youth.  According to the lead author of the study, the approach is that "these children...are normal; they are just different." The emphasis in the article and its recommedations is on the good general physical and mental health of LGBTQ youth.  An updated guideline helps provide compassionate care in a few special areas based on the epidemiology and social  behaviours of LGBTQ youth.  We know a lot more about them than we did even in 2004 when the last official statement on caring for this subset of the population came out.

"Sexual Minority" youth is a term used in the report to describe LGBTQ youth.  Some may quibble with this term but the spirit of the report is an admirable one.  Sexual minority youth may be at higher risk for early sexual activity, multiple partners, and unprotected sexual encounters and therefore higher risk for STI's.  The report also points out that "Many adolescents who self-report as lesbian or gay may have sex with members of the opposite sex, and thus behaviors do not equal identity" Recognizing this is important for practitioners since they should not assume that a lesbian teen is free from the risk of pregnancy.  Providers need to ask questions using gender neutral language (e.g. "Tell me about your partner?")and do a complete assessment.

Caring for youth means really caring and when providers stop to evaluate their own biases and knowledge and the lacunae that sometimes make them appear insensitive, they will be able to engage their patients in a refreshing and interesting way that not only spices up everyday routines in practice but will endear them to some of their most needy and interesting patients.

image from allunderoneroof.org via Google images

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