Health care professionals are integral in our development from childhood to adulthood. For transgender and gender-diverse (TGD) youth, health care professionals’ care and support is vital for their mental, social, and physical health. Despite this necessity, barriers exist in doctors discussing gender with their young patients.

First, according to the American Academy of Pediatrics (AAP), a pediatrician’s average length of a visit is 16.4 minutes. Considering most people only see their pediatrician once a year for a physical, this is a strikingly limited amount of time–certainly not enough time to discuss such a complex topic.

Secondly, after knowing their patients since birth, pediatricians may feel uncomfortable asking questions about sexuality and gender. In conservative regions of this country, AAP notes how discussing sexuality and gender identity may be viewed as taboo and dismiss it as a phase.

Perhaps the most alarming barrier is that some pediatricians are not comprehensively educated on caring for TGD youth. In a 2017 study conducted by the Children’s Hospital of Philadelphia and the Philadelphia Department of Public Health, researchers found that 86 percent of the pediatricians surveyed believed that they needed more training in the topic of gender nonconformity.

However, change is happening in many places. Medical schools—such as Harvard, Tufts, and Northwestern—are integrating TGD physical and mental care in their curriculums.

In addition, the AAP has partnered with organizations like the Human Rights Campaign to promote TGD health and wellness. One of their policies, Ensuring Comprehensive Care and Support for Transgender and Gender-Diverse Children and Adolescent, focuses on addressing the needs, obstacles and resilience of transgender children and their families. It encourages the doctor to withhold from predicting or preventing who a child may become.

The policy also promotes a collaborative approach to working with the child. According to the AAP, since TGD youths have high rates of depression and suicide, health care professionals are advised to work with mental and social health services to support the individual and family. Social adaptations are also implemented, such as change of name and pronouns, as well as hormone therapy or pubertal suppression.

Substantial strides are being taken, and hopefully, in the near future, the topic of gender will receive more attention and education in the health fields.

“Having a space to express whatever that might be is key to the growth and personal evolution,” said therapist Leora Perlman, LCSW. “Just listening and validating [TGD youth’s] experience is often helpful, since what they really want is to be seen and heard.”