Challenge norms & build interruption skills

Headline: Male Adolescents’ Gender Attitudes and Violence: Implications for Youth Violence Prevention

[What they measured:] This study analyzed the associations among male adolescents’ gender attitudes, intentions to intervene, witnessing peers’ abusive behaviors, and multiple forms of adolescent violence perpetration.

[Who they studied:] Data were from a cross-sectional survey conducted at baseline with 866 male adolescents in community settings (i.e., youth-serving organizations, churches, after school programs, and libraries) across 20 lower-resource neighborhoods in Pittsburgh, PA from August 2015 to June 2017, as part of a cluster RCT.28 Eligible youth were aged 13—19 years, identified as male, and recruited to participate in a gender-specific violence prevention program.

[Goals] This community-based evaluation aims to inform future youth violence prevention efforts through the identification of potential predictors of interpersonal violence perpetration.

[Conclusions] Findings support violence prevention strategies that challenge harmful gender and social norms while simultaneously increasing youths’ skills in interrupting peers’ disrespectful and harmful behaviors.

Citation

Miller E, Culyba AJ, Paglisotti T, Massof M, Gao Q, Ports KA, Kato-Wallace J, Pulerwitz J, Espelage DL, Abebe KZ, Jones KA. Male Adolescents' Gender Attitudes and Violence: Implications for Youth Violence Prevention. Am J Prev Med. 2020 Mar;58(3):396-406. doi: 10.1016/j.amepre.2019.10.009. Epub 2019 Dec 27. PMID: 31889621; PMCID: PMC7039734.

Pathways STEM Outreach Program

This is a unique STEM outreach program for LGBTQ+ high schoolers. Please share with students who may be interested! Sam Long will lead a workshop about diversity in biology in the July session.

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Calling all LGBTQ+ high schoolers! Wanna learn about LGBTQ+ scientists, build STEM skills, and meet other students this summer? Check out the new Pathways in STEM summer outreach program at CU Boulder! All events are online over summer 2020.

Info and registration at http://bit.ly/pathwaysstem

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Doctor's Rec: Puberty blockers can be life-saving for transgender teenagers. (Pediatrics)

Summary: Pubertal suppression therapy could significantly diminish their chances of suicide and mental health problems.

Title: Trends in the use of puberty blockers among transgender children in the United States.

Authors: Lopez CMSolomon DBoulware SDChristison-Lagay ER

Journal: Journal of Pediatric Endocrinology and Metabolism

Publication date: 2018 Jun 27;31(6):665-670. doi: 10.1515/jpem-2018-0048.

Pub Med ID: 29715194 DOI: 10.1515/jpem-2018-0048. Available at https://www.ncbi.nlm.nih.gov/pubmed/29715194 .

BACKGROUND:

The objective of the study was to identify national trends in the utilization of histrelin acetate implants among transgender children in the United States.

METHODS:

We analyzed demographic, diagnostic and treatment data from 2004 to 2016 on the use of histrelin acetate reported to the Pediatric Health Information System (PHIS) to determine the temporal trends in its use for transgender-related billing diagnoses, e.g. "gender identity disorder". Demographic and payer status data on this patient population were also collected.

RESULTS:

Between 2004 and 2016, the annual number of implants placed for a transgender-related diagnosis increased from 0 to 63. The average age for placement was 14 years. Compared to natal females, natal males were more likely to receive implants (57 vs. 46) and more likely to have implants placed at an older age (62% of natal males vs. 50% of natal females were ≥;13 years; p<0.04). The majority of children were White non-Hispanic (White: 60, minority: 21). When compared to the distribution of patients treated for precocious puberty (White: 1428, minority: 1421), White non-Hispanic patients were more likely to be treated with a histrelin acetate implant for a transgender-related diagnosis than minority patients (p<0.001). This disparity was present even among minority patients with commercial insurance (p<0.001).

CONCLUSIONS:

Utilization of histrelin acetate implants among transgender children has increased dramatically. Compared to natal females, natal males are more likely to receive implants and also more likely to receive implants at an older age. Treated transgender patients are more likely to be White when compared to the larger cohort of patients being treated with histrelin acetate for central precocious puberty (CPP), thus identifying a potential racial disparity in access to medically appropriate transgender care.

Doctor's Rec: Statement from American Academy of Pediatrics

The official American Academy of Pediatrics published (link to summary article) 9 clear recommendations for caring for youth and adolescents who identify as transgender or gender-diverse.

I highlight the portions that specify providing health care according to what the youth wants, especially to match the youth’s gender expression. Not parent, guardian, teacher, staff member, administrator, guidance counselor, etc.

[Aside: You may have heard a FoxNews Glenn Beck headline about an anti-gay-marriage hate group calling itself “American Pediatricians” creating a hoax claiming supporting a transgender youth is abuse. Read more about how Snopes debunked this, as well as the American Academy of Pediatrics’ internal presentation recommending affirming a child’s gender expression (pdf). —RXS]

1. that youth who identify as TGD have access to comprehensive, gender-affirming, and developmentally appropriate health care that is provided in a safe and inclusive clinical space;

2. that family-based therapy and support be available to recognize and respond to the emotional and mental health needs of parents, caregivers, and siblings of youth who identify as TGD;

3. that electronic health records, billing systems, patient-centered notification systems, and clinical research be designed to respect the asserted gender identity of each patient while maintaining confidentiality and avoiding duplicate charts;

4. that insurance plans offer coverage for health care that is specific to the needs of youth who identify as TGD, including coverage for medical, psychological, and, when indicated, surgical gender-affirming interventions;

5. that provider education, including medical school, residency, and continuing education, integrate core competencies on the emotional and physical health needs and best practices for the care of youth who identify as TGD and their families;

6. that pediatricians have a role in advocating for, educating, and developing liaison relationships with school districts and other community organizations to promote acceptance and inclusion of all children without fear of harassment, exclusion, or bullying because of gender expression;

7. that pediatricians have a role in advocating for policies and laws that protect youth who identify as TGD from discrimination and violence;

8. that the health care workforce protects diversity by offering equal employment opportunities and workplace protections, regardless of gender identity or expression; and

9. that the medical field and federal government prioritize research that is dedicated to improving the quality of evidence-based care for youth who identify as TGD.

Citation:

Jason Rafferty (2018) Ensuring Comprehensive Care and Support for Transgender and Gender-Diverse Children and Adolescents. Pediatrics Sep 2018, e20182162; DOI: 10.1542/peds.2018-2162 (direct pdf)