As public awareness of and openness to transgenderism increases, the demand for trans-specific medical care is surging, even among young pediatric patients, according to STAT.
Physicians at the 30-plus clinics for transgender youth across the U.S. can barely accommodate the thousands of young patients vying for counseling, hormone treatments and genital surgery.
Here are five things to know about rising demand for transgender health services and the challenges that persist for those who seek it.
1. Established transgender clinics are already inundated with patients. For example, Chicago's Lurie Children's Hospital opened its trans clinic four years ago and already has 500 patients and a four-month waiting list. The largest transgender clinic, the Center for Transyouth Health and Development at Children's Hospital Los Angeles, treats 725 trans youth from across the western U.S.
2. STAT's report focused on the practice of Johannah Olson-Kennedy, MD, who treats 500 of the 725 trans patients at the Center for Transyouth Health and Development at Children's Hospital Los Angeles. Dr. Olson-Kennedy said her youngest patients, including toddlers, receive only counseling. She begins medical interventions for patients whose gender dysphoria persists into adolescents, as the development of secondary sex characteristics can be a serious trigger for trans patients.
"I've had mothers call me who say their child tries to kill themselves every time they have their period," Dr. Olson-Kennedy told STAT. "Parents come in saying, 'My kid tried to cut off his penis with dental floss.'"
3. Not all physicians agree with Dr. Olson-Kennedy and her colleagues' approach. Some believe young patients will grow out of their gender discomfort, or that children should wait until they are 18 to make gender altering decisions. Many others would like to see data on whether delaying puberty and transitioning genders at a younger age is safe in the long run, according to the report.
4. In 2015, Dr. Olson-Kennedy and three other leading trans youth physicians received the first grant from the National Institutes of Health to study transgender youth. The $5.7 million, five-year study will evaluate 300 transgender youth, some of whom received puberty-blocking hormones and others who took masculinizing or feminizing hormones after puberty, according to the report. Researchers will evaluate the effect of treatment on mental health and determine the safety of the treatments.
5. Physicians who provide treatment and counseling to transgender patients face many roadblocks, including those created by insurance companies, as some deny coverage or only partially cover care for patients with gender dysphoria. But the most top-of-mind worry for providers treating trans patients now is that the gains achieved in the transgender community will be eroded under President-elect Donald Trump. "It's my number one concern right now," Dr. Olson-Kennedy said, according to the report. "I'm very worried."