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Transgender youth should have access to comprehensive gender-affirming healthcare, said the American Academy of Pediatrics (AAP) in a new policy statement.

Children and adolescents who identify as transgender and gender-diverse often face health-related disparities, such as barriers to quality care and mental health resources, which can put their overall health at risk, explained Jason Richard Rafferty, MD, MPH, EdM, and co-authors on the AAP Committee on Psychosocial Aspects of Child and Family Health, Adolescence, and Lesbian, Gay, Bisexual and Transgender Health and Wellness.

The document, the AAP's first policy statement on the topic and published online in , recommends that pediatricians provide a "safe and inclusive clinical space" for these individuals.

In order to provide this care, though, the authors write, it must start with proper medical education throughout medical school, residency, and continuing medical education in order to train healthcare professionals to provide competent care specifically to transgender and gender-diverse youth.

At the center of this care is social support for the child -- pediatricians not only "have a role in advocating for, educating, and developing liaison relationships with school districts and other community organizations to promote acceptance and inclusion of all children without fear of harassment, exclusion, or bullying because of gender expression," but also have a role in advocating for policies to protect transgender youth from discrimination.

From a healthcare perspective, this includes ensuring that insurance plans offer specific coverage for transgender persons, encompassing coverage of hormones and other transition-related medical needs, gender-affirming surgery, and psychological resources. Although there is no evidence of a direct link between a transgender identity and mental illness, the policy authors highlighted how a number of factors including stigma, discrimination, social rejection, and internal conflict can put these individuals at a higher risk for mental health-related issues such as depression, anxiety, eating disorders, and .

The authors also pointed to the as a valuable resource for mental healthcare providers.

The AAP statement also recommended that electronic health records and billing systems be specifically designed to "respect the asserted gender identify of each patient" by making updates to the individual's record without creating duplicate charts -- all while maintaining confidentiality.

Family inclusion and support is vital to the overall well-being of transgender and gender-diverse youth, and family-based therapy is an ideal resource for not only the transgender adolescent, but also parents, caregivers, and the siblings of these youth, the statement continues.

"We know that family and community support are essential for any child's healthy development, and children who are gender-diverse are no different," explained Rafferty in a statement. "What is most important is for a parent to listen, respect, and support their child's self-expressed identity. This encourages open conversations that may be difficult but are key to the child's mental health and the family's resilience and wellbeing."

Said Cora Breuner, MD, chairperson of the AAP Committee on Adolescence, in a statement: "We encourage families, schools, and communities to value every child for who they are in the present, even at a young age. As pediatricians and parents, we also appreciate how challenging, and at times confusing, it can be for family members to realize their child's experience and feelings."

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