Adolescents and young adults of all identities open to discussing sexual identity and gender identity with doctors

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Lisa Black, 630-626-6084, lblack@aap.org

Tom McPheron, 630-626-6315, tmcpheron@aap.org

Adam Alexander, 630-626-6765, aalexander@aap.org

Washington, D.C.— Teenagers and young adults are fairly open to the idea of talking with their doctors and nurses about their sexual orientation and gender identity and are okay being asked through various methods, whether on paper, electronically, or in person, according to research presented during the 2023 AAP National Conference & Exhibition at the Walter E. Washington Convention Center. 

This is one of the first studies to establish how adolescents would prefer to broach this sensitive subject while visiting their health care provider. Gender-diverse and lesbian, gay, and bisexual youth are far more open to having these personal conversations with health care providers than their straight and cisgender peers, according to the research abstract.

Researchers who wrote the abstract, “Asking Adolescents and Young Adults about their Sexual Orientation and Gender Identity: Lessons for Clinic Staff and EHR Documentation,” surveyed 260 youth, ages 10 to 26, and found that nearly 70% were comfortable with being asked about their sexual orientation and gender identity during medical visits.  

“Our study showed that teenagers are remarkably open to discussing their sexual orientation and gender identity through various methods when visiting their doctor’s office. This finding emphasizes the importance of creating diverse avenues for communication, whether in-person or through virtual or paper registration forms,” said Jessica Pourian, MD, who conducted her research as a pediatric resident at Hasbro Children’s Hospital in Providence, Rhode Island and is now a clinical informatics fellow at the University of California, San Francisco. “By facilitating these discussions, we can foster an inclusive healthcare environment that ultimately leads to more effective and tailored care for our young patients.”  

While 64% of all youth agreed that it is important for health care providers to ask about their gender identity, chosen name, and pronouns, gender diverse youth were far more comfortable with that conversation (83%) compared with their cisgender peers (45%). Lesbian, gay, and bisexual youth were also more open to conversations about sexual orientation—56% compared to 38% of heterosexual youth. Over 96% of gender-diverse youth expressed a desire to have their chosen name and pronouns displayed in electronic health records, available to all medical staff. 

“When health care providers make assumptions about patients’ sexual orientation or gender identity, they miss opportunities for screening, risk causing distress, and can damage patient-provider relationships,” Dr. Pourian said. “This research shows that clinics should focus on integrating conversations about sexual orientation or gender identity into their practice to provide better and more comprehensive care to teenagers and young adults.” 

Dr. Pourian is scheduled to present her research, which is below, from 12 to 12:45 PM Monday, Oct. 23, during session H4051. To request an interview with the authors, contact Dr. Pourian at jessica.pourian@gmail.com. 

In addition, Dr. Pourian is among highlighted abstract authors who will give a brief presentation and be available for interviews during a press conference on Sunday, Oct. 22, from 8-9 a.m. ET in the National Conference Press Room 102 AB. During the meeting, you may reach AAP media relations staff in the press room. 

Please note: only the abstract is being presented at the meeting. In some cases, the researcher may have more data available to share with media, or may be preparing a longer article for submission to a journal. 

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The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. For more information, visit www.aap.org. Reporters can access the meeting program and other relevant meeting information through the AAP meeting website at http://www.aapexperience.org/

ABSTRACT

Submission Type: Section on LGBT Health and Wellness

Abstract Title: Asking Adolescents and Young Adults about their Sexual Orientation and Gender Identity: Lessons for Clinic Staff and EHR Documentation

Jhanavi Kapadia

North Attleboro, MA, United States

When healthcare providers make assumptions about patients’ sexual orientation or gender identity (SOGI), they miss opportunities for screening, risk causing distress, and can damage patient-provider relationships. Previous studies of gender diverse (GD) and lesbian, gay, and bisexual (LGB) adults have reported high levels of acceptance with their SOGI data being assessed and documented in the electronic health record (EHR), but less is known about adolescent and young adult (AYA) perspectives. Our study aimed to identify preferred approaches to collecting and documenting SOGI data from AYA.

This study was conducted at an academic adolescent medicine clinic in the northeastern United States between November 2022 to February 2023. Patients presenting to the clinic, which included four programs (primary care, gender, eating disorder, gynecology/menstrual health), were recruited. Participation was anonymous and voluntary. Paper questionnaires were administered by a medical assistant upon check-in during in-person visits. Demographics included SOGI and age. Likert scales were used to assess perceived importance of provider or staff assessing their SOGI and preferred method of assessment (via tablet, physician, etc.). Responses were entered into a REDCap database. All comparisons were performed using Pearson’s chi-squared or Fisher’s exact test where appropriate. All tests were two-sided; p-values < 0.05 were considered statistically significant. Patients were classified as GD and/or LGB based on responses.

Two hundred and sixty patients completed the survey, ages 10 to 26 (most common age category 18-20, 32%). Fifteen percent of respondents were from the eating disorder program, 43% from gender, 34% from primary care, and 7% from gynecology/menstrual health. Overall, 129 (50%) were GD and 136 (52%) were LGB. Ninety-nine patients (38%) identified as both GD and LGB. Sixty four percent agreed it was important for providers to ask about gender identity, chosen name, and pronouns. More GD youth compared to cisgender youth agreed that asking about this data was important (83% v 45%, p< 0.001). Asking about sexual orientation was perceived as less important compared to gender identity. More LGB youth agreed with the importance of asking about sexual orientation compared to heterosexual youth (56% v 38%, p< 0.02). Seventy percent of AYA were comfortable being asked about their SOGI, and no single method was preferred over another. Over 96% of GD youth wanted their chosen name and pronouns displayed in EHRs.

Most AYA are comfortable being asked for their SOGI data in a healthcare setting. GD and LGB youth expressed higher rates of comfort than their cisgender and heterosexual peers for SOGI questions respectively. AYA did not have a preference on the SOGI collection method. Clinics should focus on integrating SOGI collection into their practice to provide more comprehensive care to AYA.

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