Beth A Clark, Jaimie F Veale, Devon Greyson, Elizabeth Saewyc. Primary care access and foregone care: a survey of transgender adolescents and young adults. Family Practice (2017)

Transgender adolescents and young adults are at increased risk for many negative health outcomes, including depression, anxiety and suicide. Research has documented that transgender adults and cisgender (non-transgender) adolescents may experience barriers to health care, and that foregone care is associated with poorer physical and mental health outcomes. Barriers to medical care experienced by transgender adults range from negative past experiences with doctors to outright denial of care by clinicians. Existing studies with general adolescent populations indicate that young people may forego health care for stigmatized needs (e.g. mental health) or if they are members of stigmatized populations (e.g. gay, lesbian, bisexual).

North American youth are disclosing transgender identities in greater numbers and at earlier ages, leading to growing recognition of the need for gender-affirming care in childhood and adolescence. Transgender youth may experience barriers to accessing necessary primary, endocrine and mental health care. However, issues of primary care access and foregone care among transgender young people have remained unexamined, even as general practitioners are increasingly called upon to provide non-specialist transgender care for adolescents and adults, often without sufficient training.

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