Many trans youth lack access to trans affirming care, which may put them at risk for HIV. This is according to a study that explored trans youth’s perceptions regarding encounters with primary care providers (PCPs) related to gender and sexual minority (GSM) identity and sexual health.
In “Perceived Barriers to HIV Prevention Services for Transgender Youth”, which appeared in LGBT Health, C.B. Fisher, A.L. Fried, M. Desmond, K. Macapagal and B. Mustanski engaged youth aged 14-21 (N = 228; 45% trans masculine, 41% trans feminine, 14% gender nonbinary) and asked them to complete a survey 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.
For the researchers, “trans youth may not discuss their GSM identity or sexual health with PCPs because they anticipate GSM stigma and fear being ‘outed’ to parents.” And so “PCPs should receive transgender-inclusive training to adequately address youths’ sexual health needs and privacy concerns.”