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Transgender and gender diverse youth (TGDY) require access to equitable health care services that address their needs. However, TGDY experience different forms of discrimination, stigma and inequitable access when dealing with healthcare providers. Therefore, creating sexual and reproductive health (SRH) services with the purpose of providing more inclusive and equitable health services is an urgent public health need. We aim to explore among TGDY the facilitators and barriers to providing inclusive and discrimination-free SRH services within health care settings, and importantly generate solutions specific to SRH inequities experienced by TGDY from their own perspectives to generate ideas for future programmatic and policy change.
This qualitative research study consists of single participant interviews among participants are TGDY youth ages 16-24 from an academic medical center An audio-recorded semi-structured interview was conducted with each participant. We used a modified grounded theory approach to identify themes regarding the perceived barriers and facilitators for TGDY in receiving inclusive SRH care from primary care providers (PCPs). All protocols were approved by the CHOP Institutional Review Board.
Participants (n=12) are a mean age of 18. This study is ongoing with emergent themes including the desire for TGDY to have their PCPs discuss socio-emotional topics related to SRH including healthy relationships, the need for elaboration beyond asking about sexual activity when talking to youth, and discussing queer sexual and reproductive health and natal anatomy. Study participants highlighted the effect familial norms have on youth communication with PCPs in discussing SRH and the important role PCPs have in bridging the gaps in parent and youth communication about SRH.
PCPs remain a desired source of SRH information for TGDY. Preliminary data suggests discussions with PCPs not only include information regarding sexual activity but also discuss the socio-emotional aspects of SRH including consent and healthy relationships. Familial practices pertaining to discussing SRH with youth can potentially affect the way in which youth talk to providers about SRH. PCPs should be equipped to talk about SRH and sexual practices in a lens that pushes past heteronormative standard and addresses topics that are specific to queer youth. The study suggests PCPs have a vital role in leading robust and inclusive SRH discussions with TGDY and facilitating these discussions among TGDY and their guardians. The data gathered in this study will help to inform policy and best practice guidelines for SRH that is equitable for all youth
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