{"id":211,"date":"2024-12-19T03:17:54","date_gmt":"2024-12-19T03:17:54","guid":{"rendered":"https:\/\/ubc.tapestry-tool.com\/library-of-lived-experience\/?p=211"},"modified":"2025-06-24T08:30:16","modified_gmt":"2025-06-24T08:30:16","slug":"accessing-gender-affirming-care","status":"publish","type":"post","link":"https:\/\/ubc.tapestry-tool.com\/library-of-lived-experience\/accessing-gender-affirming-care\/","title":{"rendered":"Accessing Gender Affirming Care"},"content":{"rendered":"\n<p>Accessing gender-affirming care can be challenging for families with children who have neurodevelopmental conditions. Academic articles on this topic highlight the importance of creating inclusive healthcare spaces that understand both gender identity and unique developmental needs. These studies show that families often face barriers like a lack of knowledgeable providers, long wait times, and social stigma. Systemic issues, such as racism and cultural biases, can further limit access to care for families from diverse backgrounds. They also emphasize the need for collaboration between healthcare professionals and families to ensure children receive the support they need to thrive. By addressing these challenges, gender-affirming care can become more accessible and supportive for all. Click on the articles below to read further.<\/p>\n\n\n\n<p><\/p>\n\n\n\n<div class=\"wp-block-buttons is-layout-flex wp-block-buttons-is-layout-flex\">\n<div class=\"wp-block-button\"><a class=\"wp-block-button__link wp-element-button\" href=\"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S2589537024004280\" target=\"_blank\" rel=\"noreferrer noopener\">The missing clinical guidance: a scoping review of care for autistic transgender and gender-diverse people<\/a><\/div>\n<\/div>\n\n\n\n<p><strong>Article Summary<\/strong>:<\/p>\n\n\n\n<p>By Lorna Bo, Anna I.R. van der Misen, Sascha E. Klomp, Zachary J. Williams, Peter Szatmari, and Men-Chuan Lai\u00a0<\/p>\n\n\n\n<p><strong>What is the authors' purpose?<\/strong>\u00a0<\/p>\n\n\n\n<p>The authors searched current academic research to understand current clinical guidance for the care of transgender and gender-diverse individuals diagnosed with autism.\u00a0<\/p>\n\n\n\n<p><strong>Relevant background information\u2026<\/strong>\u00a0<\/p>\n\n\n\n<p>Autistic people show higher-than-expected levels of gender diversity compared to non-autistic people. There is also a high rate of autism\/autistic traits in transgender and gender diverse people (TGD). It is estimated that around 11% of TGD people have an autism diagnosis.\u00a0\u00a0<\/p>\n\n\n\n<p>Despite the link between autism and gender diversity, there is little clinical guidance for autistic TGD people.\u00a0\u00a0<\/p>\n\n\n\n<p><strong>What did they find?<\/strong>\u00a0<\/p>\n\n\n\n<p>They examined current clinical guidance documents but found a superficial overview on the intersections between autism and gender diversity. There is growing research in this area, but it has not been incorporated into current guidelines.\u00a0\u00a0<\/p>\n\n\n\n<p>They highlighted a specific document called the World Professional Association for Transgender Health's Standards of Care (WPATH SOC8). They believed that it provided the most detailed guidelines compared to the other documents and also cited the highest number of academic papers. Additionally, it incorporated lived experience in its development.\u00a0\u00a0<\/p>\n\n\n\n<p>They also noticed that when autism and gender diversity were mentioned, it was usually in the context of adolescence, despite the intersection being present across the lifespan.\u00a0\u00a0<\/p>\n\n\n\n<p><strong>What did they recommend?<\/strong>\u00a0<\/p>\n\n\n\n<p>The authors believe that caring for autistic TGD individuals needs to be integrated into general clinical care for TGD, instead of just specialists. They also recommended that more long-term follow-up studies should be done to understand autism and gender diversity across the lifespan, instead of just during adolescence. The authors strongly believe that guidelines should incorporate emerging research, especially from those with lived experiences.\u00a0<\/p>\n\n\n\n<p><strong>Anything else?<\/strong>\u00a0<\/p>\n\n\n\n<p>The authors did not examine guidelines for other neurodevelopmental conditions. They also did not review guidelines for autistic individuals in relation to gender identity (they reviewed guidelines for gender diverse individuals in relation to autism). They also excluded documents not written in English.\u00a0\u00a0<\/p>\n\n\n\n<p><\/p>\n\n\n\n<div class=\"wp-block-buttons is-layout-flex wp-block-buttons-is-layout-flex\">\n<div class=\"wp-block-button\"><a class=\"wp-block-button__link wp-element-button\" href=\"https:\/\/dx.plos.org\/10.1371\/journal.pone.0257194\" target=\"_blank\" rel=\"noreferrer noopener\">Experiences of transgender and non-binary youth accessing gender-affirming care: A systematic review and meta-ethnography<\/a><\/div>\n<\/div>\n\n\n\n<p><\/p>\n\n\n\n<p><strong>Article Summery:<\/strong><\/p>\n\n\n\n<p>By S\u00e9an Kearns, Thilo Kroll, Donal O'Shea, and Karl Neff\u00a0<\/p>\n\n\n\n<p><strong>What is the authors' objective?<\/strong>\u00a0<\/p>\n\n\n\n<p>The authors wanted to identify and collect data on the experiences of youth accessing gender-affirming healthcare and develop a new line of argument based on their findings.\u00a0<\/p>\n\n\n\n<p><strong>Relevant background information\u2026<\/strong>\u00a0<\/p>\n\n\n\n<p>Researchers have struggled to provide accurate statistics on how many transgender people there are. Collecting accurate data is complicated for several reasons. Non-binary individuals are underrepresented due to the gender binary often found in health surveys. If data is collected during healthcare encounters, transgender individuals who are not seeking medical assistance may not be counted.\u00a0\u00a0<\/p>\n\n\n\n<p>Many transgender people find the healthcare system to be arduous due to stigma and discrimination. Some have reported being refused care due to their gender identity. Other barriers to care include reluctance to disclose identity, financial constraints, insurance coverage denials, concerns over quality of care, and geographical location. As a result of the difficulty of accessing quality care, some trans individuals go to unregistered sources for gender-affirming care, like hormones.\u00a0\u00a0<\/p>\n\n\n\n<p><strong>What did they find?<\/strong>\u00a0<\/p>\n\n\n\n<p>There were five major themes that emerged during their review.\u00a0\u00a0<\/p>\n\n\n\n<p><em>Disclosure of Gender Identity: <\/em>For most young people, disclosing their gender identity was a major barrier for accessing care, especially if they needed parental\/guardian consent. Some expressed fear of not being accepted, fear of being a burden, or a general lack of comfort about discussing their gender identity. Some individuals were also worried about their gender identity being documented by providers and it could negatively impact their insurance.\u00a0\u00a0<\/p>\n\n\n\n<p><em>Pursuit of Care<\/em>: Finding a competent provider was a struggle for many trans individuals. It was hard to find someone who was accepting new patients, trans-friendly, worked with adolescents, and accepted their insurance. Some trans individuals had to select providers far from home, which could be very inconvenient, expensive, and inaccessible. Lastly, long waiting times could contribute to dysphoria and anxiety and multiple appointments were needed before starting gender-affirming care (eg. hormones).\u00a0\u00a0<\/p>\n\n\n\n<p><em>Cost of Care: <\/em>Many youth felt guilty that their parents would be burdened with the cost of their care. Those who weren't in school or working struggled to find insurance. People often select their doctors based on expertise and\/or being trans-friendly, before finding out they may not be covered by their insurance. Many participants noted that they had to battle for their hormones and surgery to be covered.\u00a0\u00a0<\/p>\n\n\n\n<p><em>Complex family dynamics: <\/em>Families can be enablers to accessing healthcare, when they are supportive and willing to listen. However, they can also be major barriers. Some parents\/caregivers were unwilling to support their child's gender-affirming care due to factors like wanting to protect their fertility and wanting to have biological grandchildren. Some did support their child's gender identity but were reluctant to support medical intervention. One parent interviewed in a study thought that time would change their child's mind.\u00a0\u00a0<\/p>\n\n\n\n<p><em>Patient-provider relationships<\/em>: Reports of healthcare providers being ill-equipped to help autistic gender-diverse patients were common across the studies. Some participants spoke about their experience being referred to different therapists due to lack of expertise or having their prescriptions put on hold until therapeutic guidelines were found. Due to a general lack of training in this area, participants reported avoiding their healthcare providers and experienced dread. They also felt like they had to prove their gender to be cleared for gender-affirming treatments. Some even said that they had been refused care because of their gender identity and\/or had their pronouns invalidated. Positive experiences were noted, though specialists received more praise than general physicians.\u00a0\u00a0<\/p>\n\n\n\n<p><strong>What did they recommend?<\/strong>\u00a0<\/p>\n\n\n\n<p>They recommended that staff (doctors, receptionists, nurses, etc) be trained on pronoun and name etiquette. Additionally, healthcare providers should partner with gender affirming services to youth, like speech language therapists, peer support groups, counselling, etc.\u00a0\u00a0<\/p>\n\n\n\n<p><strong>Anything else?<\/strong>\u00a0<\/p>\n\n\n\n<p>The authors noticed a lack of research on this issue that included the perspectives of healthcare providers, as well as a lack of research on the non-binary experience. The sample size of this study was small.\u00a0\u00a0<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Accessing gender-affirming care can be challenging for families with children who have neurodevelopmental conditions. Academic articles on this topic highlight the importance of creating inclusive healthcare spaces that understand both gender identity and unique developmental needs. These studies show that families often face barriers like a lack of knowledgeable providers, long wait times, and social &hellip; <\/p>\n<p class=\"link-more\"><a href=\"https:\/\/ubc.tapestry-tool.com\/library-of-lived-experience\/accessing-gender-affirming-care\/\" class=\"more-link\">Continue reading<span class=\"screen-reader-text\"> &#8220;Accessing Gender Affirming Care&#8221;<\/span><\/a><\/p>\n","protected":false},"author":969,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"_links":{"self":[{"href":"https:\/\/ubc.tapestry-tool.com\/library-of-lived-experience\/wp-json\/wp\/v2\/posts\/211"}],"collection":[{"href":"https:\/\/ubc.tapestry-tool.com\/library-of-lived-experience\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/ubc.tapestry-tool.com\/library-of-lived-experience\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/ubc.tapestry-tool.com\/library-of-lived-experience\/wp-json\/wp\/v2\/users\/969"}],"replies":[{"embeddable":true,"href":"https:\/\/ubc.tapestry-tool.com\/library-of-lived-experience\/wp-json\/wp\/v2\/comments?post=211"}],"version-history":[{"count":7,"href":"https:\/\/ubc.tapestry-tool.com\/library-of-lived-experience\/wp-json\/wp\/v2\/posts\/211\/revisions"}],"predecessor-version":[{"id":1202,"href":"https:\/\/ubc.tapestry-tool.com\/library-of-lived-experience\/wp-json\/wp\/v2\/posts\/211\/revisions\/1202"}],"wp:attachment":[{"href":"https:\/\/ubc.tapestry-tool.com\/library-of-lived-experience\/wp-json\/wp\/v2\/media?parent=211"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/ubc.tapestry-tool.com\/library-of-lived-experience\/wp-json\/wp\/v2\/categories?post=211"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/ubc.tapestry-tool.com\/library-of-lived-experience\/wp-json\/wp\/v2\/tags?post=211"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}