Gender-based care is medically necessary, evidence-based care that uses a multidisciplinary approach to help a person move from their gender – the one they were assigned to at birth – to their gender. the gender one wants to be famous for.
It is estimated that more than 58,000 transgender people aged 13 and over in the United States face limited access or offers and may soon lose access to gender-based care.
In Texas, Gov. Greg Abbott ordered the Department of Family and Protection Services to investigate all cases of certain procedures used in such care, on the grounds that it is now considered child abuse, according to an opinion issued by Attorney General Ken Paxton. A Texas judge granted the ACLU’s request for a temporary restraining order, not allowing the state to enforce the order. Despite legislative pressure to discontinue this type of treatment, sex care is a recommended practice for people who identify as transsexual, meaning they identify with a gender that is different from that determined at birth or different from gender, with an expression of gender, which does not strictly correspond to the traditional notions of society about gender.
The gold standard of care
The World Professional Association for Transsexual Health, which is considered the gold standard and focuses on gender mainstreaming around the world, says it should be a way for people to create “effective ways to achieve lasting personal comfort with their selves.” gender mainstreaming in order to maximize their overall health, psychological well-being and self-fulfillment. In 2015, 1 in 4 adults who identify as transsexual avoid the need to see a doctor because they fear being abused, according to a study of transgender people in the United States by the National Center for Transsexual Equality. Gender can solve some of these problems and significantly improve mentality o human health and well-being.
Social care for children
For children, gender-based care is defined by the American Academy of Pediatrics as appropriate for development, non-judgmental treatment that is provided in a safe clinical space. The care is individualized and is based on peer-reviewed research that shows its effectiveness.
This type of care requires a multidisciplinary approach. Providers work with the person’s counselors and family, as well as the individual. They can also work with the school and the child’s community.
When someone needs this care really depends on the person. Some children have a sense of their true gender as early as age 3, experts say, others when they enter puberty, and still others much later.
An increasing number of clinics across the country have been set up to provide gender-specific care, including for children. Many use a similar approach that involves a multidisciplinary team of experts who can tailor the program to the patient and his or her needs.
In the Gender Identity Program at Columbia University Medical Center, director Melina Wald says the process usually begins with a phone call. The family talks to a reception coordinator and completes a short screening to give an initial assessment of where the child is developing. Depending on the age of the child, they may also be involved.
The clinic then scheduled the family for several visits with the team’s mental health professionals. At the first meeting, the team assesses the needs of the family and the child.
“It’s really about getting a better sense of what leads them to the clinic,” Wald said. “We are also looking to understand the child’s understanding of their own gender, gender expression and related history.
The team also determines if there are any additional mental health needs. A 2018 study of transgender young people found that the prevalence of mental health problems was seven times higher than among their gender peers. A 2019 study of transgender adults found that they had higher levels of anxiety and depression. A 2019 survey found that 54% of transgender and non-binary youth in the United States reported considering suicide that year, and 29% attempted suicide. Mental health problems do not stem from their very identity, but often due to social discrimination, and what is known as minority stress is shown by a growing number of studies. Stigma, marginalization, discrimination, harassment, harassment and even violence can lead to feelings of isolation and rejection.
At the Wald Clinic, after initial screening and appointments, staff offer feedback and their clinical impressions to the child and family. They then offer a specific treatment plan tailored to that child, based on who they are, how they identify, and where they develop.
“This treatment plan may include individual therapy. It may include parental support. We have a group of adolescents for trance and non-binary teenagers, and we also have a parental support group led by one of the psychologists on our team,” Wald said. .
This part of the care will help the social transition, said Dr. Madeleine Deutsch, medical director of the UCSF Gender Confirmation Program.
At this point, the child can begin to use a chosen name and pronoun. They can wear different clothes. This practice helps young people have the confidence to present in a way that seems more real to them, Deutsche said.
“It’s very individualized and usually involves a mix of decision-making by parents and guardians, and then maybe other stakeholders, for example if parents have access to mental health care or if the school gets involved to help discuss things, “Deutsch said. “It’s usually something like an uninjured thing. So part of it depends on the level of comfort of the parents and the community they live in.”
The physical aspect of care
Deutsche said that when children reach a certain stage of puberty – diagnosed by a provider – and still have a constant, well-documented feeling that their gender does not match the definition at birth, depending on the child’s age, they may be move forward with reversible suppression of puberty, commonly referred to as puberty blockers. Initially, these gonadotropin-releasing hormones were used to delay puberty in people with what is known as premature puberty, when a child’s body changes to that of an adult too early.
“It just pauses everything and the kids can be on it for a few years without any harm and it’s completely reversible,” Deutsch said. “If it’s stopped, then everything just keeps going where you left off.”
Puberty blockers can reduce the suffering that can occur when a child develops secondary sexual characteristics such as breast growth, a bulge in the Adam’s apple, or a change in voice. Studies show that transgender adolescents who have used puberty blockers are less likely to have suicidal thoughts than those who have sought treatment but have not received it.
This part of the process may include hormone therapy, which can lead to gender-enhancing physical change, but again, the care plan is flexible, Deutsche said.
“I think one of the big myths is that there is a feeling that children are in a hurry with medical care decisions, such as hormone therapy or surgery. That’s just not the case, “Wald said.
Deutsche agreed: “Kids don’t make things up about it, wanting to be a trance because it’s fashionable or something,” she said. “Trans-youth and trans people generally don’t have access to a hormone vending machine.”
With gender-responsive care, the team of experts will work with the young person and family throughout the process to decide what treatment is appropriate.
The process could take several years or move faster if the child is in “puberty” and struggles for a long time, Deutsch said. There is still an assessment of what is needed.
Other options include voice and communication therapy. There are also gynecological and reproductive options, but most people receive these treatments when they are older, if they decide to have surgery at all. Gender validation surgery may involve feminization of the face or what is known as facial gender surgery. Some may choose what is commonly called upper surgery, which for transgender men and non-binary people removes breast or chest tissue, or genital reconstructive procedures, also known as lower surgery. In general, these are not procedures that adolescents would need, Wald said.
Legal part of the care
Legal interventions may include a change of name or gender in a person’s legal documents.
How easy this is or whether it is possible depends on where the person lives. The rules vary from country to country.
Changes to documents may include a birth certificate, social security card, passport or driver’s license.
Why care is needed
“For transgender and non-binary children and adolescents, early gender mainstreaming is critical to overall health and well-being,” said the U.S. Department of Health and Human Services. Delaying care can exacerbate stressors and children’s health problems.
Some critics of the process have suggested that children have to wait until adulthood to pass, but the American Academy of Pediatrics says it’s an outdated approach. Gender identity is thought to be fixed at a certain age, but research shows that it is healthier to judge a child for what he or she is than for what will happen.
The association says the approach helps children feel secure “in a society that all too often marginalizes or stigmatizes those who see themselves as different” and strengthens family resilience.
Wald says waiting to transition can create additional psychological stress for the child and can increase the child’s risk of depression, suicide, self-harm or substance abuse.
“Detention of interference …
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