Only 25% of transgender youth feel that their primary care providers (PCPs) are helpful about the sexual health issues of gender and sexual minorities (GSMs). This is according to a study that explored trans youth’s perceptions regarding encounters with PCPs related to GSM identity and sexual health.
In “Perceived Barriers to HIV Prevention Services for Transgender Youth” – written by Celia B. Fisher, Adam L. Fried, Margaret Desmond, Kathryn Macapagal and Brian Mustanski for LGBT Health – it was posited that many trans youth lack access to trans affirming care, which may put them at risk for HIV.
So researchers surveyed youth ages 14–21 (N = 228; 45% trans masculine, 41% trans feminine, 14% gender nonbinary) on GSM identity disclosure and acceptance, gender-affirming services, sexual health attitudes and behaviors, and interactions with PCPs involving GSM identity and concerns about stigma and confidentiality.
A factor analysis yielded three scales: GSM Stigma, Confidentiality Concerns, and GSM-Sexual Health Information. Items from the GSM Stigma scale showed that nearly half of respondents had not disclosed their GSM identity to their PCP due to concern about an unaccepting PCP. One-quarter of youth were less inclined to discuss GSM identity and sexual health with their PCP due to concern that their provider would disclose this information to parents; these concerns were greater among adolescents <18 and those not out to parents about their gender identity.
Only 25% felt their PCP was helpful about GSM-specific sexual health issues. Youth who were out to parents about their gender identity and had received gender-affirming hormone therapy were more likely to report receiving GSM-specific sexual health information.
Transgender youth may not discuss their GSM identity or sexual health with PCPs because they anticipate GSM stigma and fear being “outed” to parents. As such, “PCPs should receive transgender-inclusive training to adequately address youths’ sexual health needs and privacy concerns.”
