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      Improving transgender health by building safe clinical environments that promote existing resilience: Results from a qualitative analysis of providers

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          Abstract

          Background

          Transgender (TG) individuals experience discordance between their sex at birth and their gender identity. To better understand the health care needs and characteristics of TG youth that contribute to resilience, we conducted a qualitative study with clinical and non-clinical providers.

          Methods

          In-depth interviews were conducted of providers ( n = 11) of TG youth (ages 13–21). Convenience and purposive sampling were used to recruit participants in the Boston area. All interviews were audio-recorded and transcribed verbatim. An interview guide of 14 open-ended questions was used to guide the discussion. A grounded theory approach was utilized to code and analyze the data, including double-coding to address issues of inter-rater reliability.

          Results

          Five primary themes emerged: 1) resilience of TG youth 2) lack of access to services that influence health, 3) the critical role of social support, 4) challenges in navigating the health care system, and 5) the need for trans-affirming competency training for providers and frontline staff.

          Conclusion

          The findings of this study show that providers recognize multiple barriers and challenges in the care of TG youth. However, they also identify the resilience exhibited by many youth. We propose that providers can further enhance the resilience of TG youth and help them flourish by offering them necessary resources via the creation of safe and welcoming clinical environments.

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          Most cited references23

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          Standards of Care for the Health of Transsexual, Transgender, and Gender-Nonconforming People, Version 7

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            Family acceptance in adolescence and the health of LGBT young adults.

            the role of family acceptance as a protective factor for lesbian, gay, bisexual, and transgender (LGBT) adolescents and young adults has not been established. a quantitative measure with items derived from prior qualitative work retrospectively assessed family accepting behaviors in response to LGBT adolescents' sexual orientation and gender expression and their relationship to mental health, substance abuse, and sexual risk in young adults (N= 245). family acceptance predicts greater self-esteem, social support, and general health status; it also protects against depression, substance abuse, and suicidal ideation and behaviors. family acceptance of LGBT adolescents is associated with positive young adult mental and physical health. Interventions that promote parental and caregiver acceptance of LGBT adolescents are needed to reduce health disparities.
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              The coding manual for qualitative researchers

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                Author and article information

                Contributors
                617-643-6187 , lopezlenny77@gmail.com
                Journal
                BMC Pediatr
                BMC Pediatr
                BMC Pediatrics
                BioMed Central (London )
                1471-2431
                18 November 2015
                18 November 2015
                2015
                : 15
                Affiliations
                [ ]Harvard Medical School, Boston, Massachusetts USA
                [ ]Partners HealthCare, Boston, Massachusetts USA
                [ ]Massachusetts General Hospital, Boston, Massachusetts USA
                [ ]Disparities Solutions Center, Massachusetts General Hospital, Boston, Massachusetts USA
                [ ]Mongan Institute for Health Policy, Massachusetts General Hospital, 50 Staniford St, Suite 901, Boston, Massachusetts 02114 USA
                Article
                505
                10.1186/s12887-015-0505-6
                4650954
                26577820
                aee1f87e-dba7-4ebf-88de-41f286e478b5
                © Torres et al. 2015

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                Categories
                Research Article
                Custom metadata
                © The Author(s) 2015

                Pediatrics
                transgender health,lgbt health,lgbt youth,transgender youth,health disparities,resilience
                Pediatrics
                transgender health, lgbt health, lgbt youth, transgender youth, health disparities, resilience

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