How To Find an LGBTQIA-Friendly Pediatrician for Your Child

Raising children can be a high-stakes adventure. As parents and caregivers, we want the best for our children and want to help them lead healthy, happy lives full of enriched experiences.

But when it comes to the deeply personal parts of our children’s individuality, like sexual orientation and gender identity, parents don’t always have all the answers. It can be confusing and difficult to know just how you can best help support them if you don’t know where to look for resources or if you’re new to these experiences.

“Parents and guardians are coming from a place where they want to know more information about how they can best care for their child who they love,” explains transgender health specialist Henry Ng, MD, MPH (he/they).

“They read a lot of information from all kinds of sources, and there can be very extreme views in any direction. Not all of it is necessarily covered by science and sometimes it’s hard to tell what information is based in science and what isn’t.”

And that’s where the importance of welcoming and affirming pediatricians, family physicians and other healthcare providers comes into play. With their help, you can make sure you’re knowledgeable, informed and up-to-date on the best practices for keeping your child safe, protected and supported throughout their journey of self-discovery.

Recent data shows that 14.3% of adolescents in 2017 identified as “lesbian, gay, bisexual, other or questioning,” — up from 7.3% in 2009. And while that increase suggests an improvement in societal openness toward coming out safely and being proud of our identities, LGBTQIA youth are still at higher risk for bullying, abuse and mental health issues

When young folks aren’t fully supported physically, mentally and emotionally at home, at school and elsewhere in their lives for being their authentic selves, their health and well-being are at risk — and that is perhaps every parent’s worst nightmare.

“The care that’s needed for LGBTQIA youth is not anything different than cisgender heterosexual youth,” says Dr. Ng. “There are just more factors at play with the additional facets of sexual orientation and gender identity intersecting with every other facet of their identity.”

If you’re wondering how you can best look for an affirming LGBTQIA-friendly pediatrician who can provide care for your child and your family’s needs, Dr. Ng provides several options and tips.

And if you live in an area where gender-affirming care isn’t available or even safe to access, Dr. Ng provides resources and advice to help you and your loved ones as well.

Do your research

Academic institutions and local LGBT centers can provide a wellspring of resources for parents looking for providers who are well-versed in caring for children and their families. If you’re a first-time patient interested in joining a new clinic, searching through their website for inclusive language and the types of gender-affirming care they offer can be helpful. Other resources, like the GLMA directory from the Tegan and Sara Foundation can also help locate local and regional LGBTQIA+ family physicians, pediatricians and health specialists if you’re unsure of where to look in your area.

“People can see in their area who’s available and who has skilled training and experience in providing LGBTQ IA healthcare in any discipline, including surgeons, behavioral health, medical doctors, primary care and health specialists,” says Dr. Ng.

“If an organization has placed care for LGBTQIA youth on their website, they’re generally more likely to have caregivers with the intention and interest in providing this type of care. Those folks have sought out additional training and have developed skills to some degree to be helpful in these areas.”

Look for signs your family is welcome in the office

From pride flags to pamphlets that use gender-inclusive language, your healthcare provider’s office will likely have several visual cues that signal their office is a safe space for everyone who comes there for care. But some of these visual signs may also be discrete and less noticeable to protect the providers and the ones they care for, too, so you may want to keep an eye out for some of the more subtle signs.

“Clinical practices may place some signs of allyship and support discretely, but visibly. They may not necessarily have pride flags everywhere, but maybe there’s a badge they wear that has a rainbow or a nametag that says ‘Ally’ on it, or it has the provider’s pronouns listed beside their name,” explains Dr. Ng.

“Some practices will put in their mission that they don’t discriminate based on gender identity or sexual orientation and they provide specific care to a specific community. Even having private, single-use restrooms for people to use so that anyone of any gender is comfortable can be reassuring to those who are coming in for an appointment, too.”

Ask your pediatrician how they can provide care related to sexual orientation or gender identity

Sometimes, the best sure-fire way of knowing your healthcare provider’s stance and approach to care is to ask them directly about their specialty, the kinds of care they offer and to share any questions or concerns you have about the kind of care you and your child need from them.

“Affirming pediatricians, family doctors and others who care for children will be able to do a couple of different things,” explains Dr. Ng. “They will have developed a set of interpersonal skills that’s respectful to the emerging identity of the pediatric or adolescent patient and at the same time, they’ll try to help the family members by providing information from solid science-based recommendations for care for that person.”

The American Academy of Pediatrics has a list of recommendations and clinical guidelines for providing care to LGBTQIA+ youth and their families — and an affirming pediatrician or family physician should be familiar and well-versed with these guidelines, particularly if they’re providing puberty blockers and other gender-affirming care.

“We listen for consistence, persistence and insistence in the patient’s and family’s stories,” shares Dr. Ng. “A young person’s sense of self and identity is emerging and developing during adolescence. Many will tell their families and caregivers who they are, as they have strong feelings about their identities and who they are as people. Others may have feelings that they may not fully understand or have words to describe. Each of these patients will need support and some will demonstrate persistence as they grow and develop their language to share their identity with their friends, families and care teams.”

The role of an affirming pediatrician and family physician is to support the entire family unit with education, resources and science-based practices so everyone feels safe, supported and healthy. That includes a young person who is questioning their identity for the first time or parents who have questions on how they can best support their child at home, school and other areas of life.

“Our goal is to try and help the family unit as much as we can. That’s why it’s important to know the data and literature around why family acceptance is helpful to a young person’s health,” encourages Dr. Ng.

“When young people are accepted for who they are, and they’re supported and loved, they actually do have good things happen to them, and not just the absence of bad things, but they graduate high school, they do better academically, they avoid HIV, depression and suicide and a number of other health issues.”

Look to your pediatrician on how to support your child

Sometimes, children will speak openly about their feelings and realizations as they explore their gender identity, gender expression and sexual orientation. But this isn’t always the case, as these realizations can sometimes feel overpowering or overwhelming and maybe even a little confusing or scary.

“Our experiences of gender identity and our attraction toward others is a very complex process and it creates all types of feelings that many of us will internalize,” recognizes Dr. Ng. “Often, young people will internalize these complex feelings and they can manifest in a number of different ways.”

Some key changes in behavior to be concerned about or aware of may include:

• Lashing out or acting out of aggression.
• Losing interest in activities or hobbies they once loved.
• Extreme fatigue or tiredness.
• Trouble focusing or struggling with academics.
• Difficulty being bullied at school.
• Anxiety.
• Depression.
• Self-harm.
• Eating disorders.

If your child is dealing with any of these issues, an affirming pediatrician, therapist or other affirming family physician may be a useful member to have as part of your family healthcare team. They’ll not only provide guidance on the care that’s needed for your child, but they can also help guide you on how you can best support them through those experiences.

Of course, these signs and symptoms don’t always mean your child identifies one way or another. But when we center our children’s personal health and well-being, and we make space for their needs, it often creates an opportunity for them to share what’s causing these other behavioral changes and impacting their daily lives.

“When we meet parents, we don’t know where they’re coming from, so we’re meeting parents where they are as well, and that’s common in healthcare and health literacy,” explains Dr. Ng.

“At any moment, we’re listening to a person and hearing their concerns, and we’re presenting the information, the data and the science that’s available. Parents just want the best for their young people. They want their child to be safe and to be OK. And we’re here to help them — physically, mentally and emotionally — through every step of that process.”

What if you live where gender-affirming services are banned or not available?

Gender-affirming care isn’t available everywhere. In some parts of the world, including areas in the United States, certain aspects of gender care are being shut down by governing bodies.

“In those cases when gender-affirming care is not available, I would try to connect with reliable, clinical health centers that typically provide gender care for young people because they’re going to be most up-to-date with the legal and social ramifications of the communities they live in, and that’s assuming that they exist and haven’t been closed,” advises Dr. Ng.

“Otherwise, turning to academic health centers that provide gender care, community LGBTQ organizations, LGBTQ health advocacy groups, counseling groups, youth centers and community centers may also have more useful information on what’s available and what’s possible in your area.”

The Movement Advancement Project (MAP) is a helpful resource that tracks local, state and federal laws and policies that impact the LGBTQIA+ community, including the area of healthcare, for all 50 states and U.S. territories. Other helpful resources that stay current on legislation that impacts your access to healthcare and the state of the LGBTQIA+ community, include:

• The American Civil Liberties Union.
• The Human Rights Campaign (HRC).
• GLMA: Health Professionals Advancing LGBTQ+ Equality.
• PFLAG (formerly Parents, Families and Friends of Lesbians and Gays).

Closer to home, you also have to continue to find ways to support your child’s mental and emotional health as gender-affirming care possibly becomes unavailable or inaccessible.

“Even in states that limit the initiation of gender care, mental health care is still available, which is really important,” notes Dr. Ng. “As parents and family members, if you’re noticing behavioral changes in your children, talk to them about how they’re feeling and what they’re experiencing and appropriately connect them with a behavioral health specialist for care and support.”

Look into other various support services within your community and at your kids’ schools, too. LGBT centers often have extracurricular activities and groups that help kids connect with other kids in a safe setting. Gay-straight student alliances may also be helpful for your young person to establish friendships and receive social and cultural support if your school offers such programs.

“In terms of healthcare, many pediatricians are comfortable talking about sexual orientation and gender identity in terms of their skillset and as permitted by law,” notes Dr. Ng.

“They may not be able to start hormones or puberty blockers, but they’re definitely willing to have these conversations. And as you’re interviewing offices about what type of care they offer and what experiences they have working with and caring for transgender, nonbinary or LGBTQIA youth, you can look at websites of various clinical programs where you live and in nearby states, you can look at state advocacy sites and really focus on what you can do to support your young person’s physical, mental and emotional health.”