Michelle Forcier - Pediatric Gender Identity: Gender-affirming Care for Transgender & Gender Diverse Youth

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We welcome our readers medical and mental healthcare professionals, health and human service experts, as well as parents and patients who wish to learn more to our multidisciplinary, collaborative textbookPediatric Gender Identity. This text offers a broad overview of the latest research, clinical recommendations, and conceptual frameworks in the field. We hope that it will help readers develop a practical understanding regarding affirmative care for transgender and gender diverse (TGD) youth. Inherent in this approach is an understanding that gender identity development is just that a developmental process, not a disease or a pathology. Our approach is grounded in the importance of thoughtfully listening to and respecting TGD youth who are undergoing the process of gender identity development during a time of ever-evolving understanding for the adults who seek to care for them.

We recognize that pediatric gender identity research and clinical care are constantly advancing. We are continuously learning from new research, language, concepts, and clinical options as they relate to our understanding of gender identity. We are excited by the growing body of evidence that supports affirmative care and resources for a population that has long suffered from health disparities and social injustice often at the hands of health and human services providers. We hope this text will highlight for you new opportunities we have to provide patient-centered, consent-based care to TGD youth, working to fight against the historical maltreatment of these young people and striving to listen to and affirm the variety of authentic gendered selves these patients share with us.

We appreciate the time and efforts contributed by our authors, national and international leaders from a variety of health and human services disciplines, including our TGD-identified authors who contributed a combined lens of experts and members of the community. Our goal is that the readers have access to thoughtful, respectful, evidence-based options both for direct clinical services and for new ways to advocate for positive sociocultural changes in our communities.

Readers are invited to hear more about language and paradigms that acknowledge and support diversity and encourage resiliency. We then move into the epidemiology of pediatric gender identity, followed by overviews of relevant developmental psychology and neurobiology. Discussions of the impact of social stigma, discrimination, and harassment are framed within the minority stress model, offering opportunities and points of intervention to impact future generations of TGD youth and adults. Both primary care and specialty care medical topics are reviewed with a design to improve not just knowledge but practical, on-the-ground, clinical services and program developments. Specific attention to the neurodevelopmental and psychosocial needs of TGD youth has been geared for a wide variety of providers, considering issues of specific developmental periods, neurodiversity, and areas of importance in the realm of mental healthcare for TGD youth. Recognized hormonal and surgical recommendations are reviewed in detail so as to support better communication and education among the varied disciplines in the community of gender care providers. Authors provide practical information and potential applications for advocacy in improving schools, communities, and clinical settings. Authors explicitly overview several legal and cultural considerations that may improve clinical services and frame professional responsibilities as social change agents for these young and resilient youth.

Most of all, we appreciate the trust our patients have placed in us. We will continue to carefully listen and make deliberate efforts to learn more from our gender diverse children, colleagues, and members of the community. Transgender and gender diverse youth are increasingly visible and articulate, refusing to accept the status quo, expanding our understanding of gender and self-identity, and willing to engage with providers to create a culture that creates support and resources for the diverse ways we might grow up healthy and safe in each of our own unique gender identities.