Overshadowed by the cloud of lousy news is a ray of hope for transgender kids and the people who love them.
The American Academy of Pediatrics announced its first-ever policy statement for parents and clinicians caring for transgender and gender-diverse children and adolescents. The statement, which is now available online, will be published in the October issue of Pediatrics.
"In its dedication to the health of all children, the American Academy of Pediatrics strives to improve health care access and eliminate disparities for children and teenagers who identify as lesbian, gay, bisexual, transgender or questioning (LGBTQ) of their sexual or gender identity," the statement reads.
"Despite some advances in public awareness and legal protections, youth who identify as LGBTQ continue to face disparities that stem from multiple sources, including inequitable laws and policies, societal discrimination, and a lack of access to quality health care, including mental health care. Such challenges are often more intense for youth who do not conform to social expectations and norms regarding gender."
The AAP recommends a "gender-affirming" approach that calls for the following:
Access to family-based therapy and support for parents, caregivers and siblings of youth who identify as transgender.
Electronic health records, billing systems and other notifications that respect the asserted gender identity of each patient.
Insurance plans that offer coverage specific to the needs of youth who identify as transgender, including coverage for medical, psychological and, when appropriate, surgical interventions.
Advocacy by pediatricians for policies and laws that promote acceptance of all children without fear of harassment, exclusion or bullying because of gender expression.
"As a parent, even when you struggle to understand and may not see eye-to-eye, your most important role is to offer understanding, respect and unconditional love for your child," Jason Rafferty, lead author of the policy statement told me. "This builds trust and puts you in a better position to help them through difficult times. Research has shown that if a transgender teen has even just one supportive person in their life they can go to, it greatly reduces their risk of suicide."
Population-based surveys estimate that 0.7 percent of teens ages 13 to 17 identify as transgender, according to the AAP. Studies indicate roughly 50 percent of teens who identify as transgender have attempted suicide.
I talked to Rafferty, a Rhode Island-based pediatrician and child psychologist, about the policy statement, which strikes me as much-needed guidance for parents, and a sign of real progress toward a more inclusive world for all of our children to inherit.
"There is increasing recognition that gender and sexual development is a normal process for all children starting at an early age, and that some children will exhibit variations, similar to all areas of human health and behavior," Rafferty said. "Having a vocabulary around gender and sexual diversity facilitates conversations with parents, families and providers, allowing children to label some of their complicated feelings that otherwise may have been suppressed or hidden."
I asked if he expects pushback from pediatricians about the policy statement.
"No," he replied. "The messages of this policy statement are very much in line with the core principles of pediatrics, including the importance of using a nonjudgmental, family-based, developmentally appropriate approach. It emphasizes that transgender and gender-diverse children — like all children — need support, love and care from family, school and society. When supported and loved as they grow and develop, kids mature into happy and healthy adults."
Some parents will have an easier time accepting gender differences than others, of course.
"Some transgender youth expect immediate acceptance, but often family members proceed through a process of becoming more comfortable and understanding of the youth's gender," Rafferty said. "The process often resembles the stages of grieving as it may require letting go of strongly held expectations for their child."
Pediatricians can help, Rafferty said, by promoting open dialogue and perspective-taking between young people and their parents.
"Gender affirmative care," he said, "is based on the belief that all children benefit from love and support — a principle that is almost always a place where providers can meet parents to start a discussion."
Heidi Stevens (email@example.com) is a columnist for the Chicago Tribune.