ADOLESCENT GENDER IDENTITY SCREENING IN PRIMARY CARE VISITS: FEASIBILITY AND ACCEPTABILITY

Purpose: To examine the feasibility and acceptability of systematic gender identity screening among adolescents in pediatric primary care in a large integrated health care delivery system. Methods: Systematic gender identity screening was implemented in 2 adolescent medicine clinics in the Kaiser Pe...

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Bibliographic Details
Published in:Journal of adolescent health 2020-02, Vol.66 (2S), p.S31
Main Authors: Lau, Josephine S, Sterling, Stacy, Hojilla, J Carlo, Kline-Simon, Andrea, Grijalva, Christina, Negusse, Rahel, Hartman, Lauren
Format: Article
Language:English
Subjects:
Adolescents
Anonymity
Feasibility
Gender differences
Gender identity
Gender nonconforming
Gender-affirming care
Guardians
Health care
Health care delivery
Integrated care
Medical screening
Non-binary gender
Parents & parenting
Physicians
Polls & surveys
Primary care
Questionnaires
Teenagers
Timing
Transgender persons
Visits
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Summary:Purpose: To examine the feasibility and acceptability of systematic gender identity screening among adolescents in pediatric primary care in a large integrated health care delivery system. Methods: Systematic gender identity screening was implemented in 2 adolescent medicine clinics in the Kaiser Permanente Northern California (KPNC) health system between July 1, 2018 and June 30, 2019. Adolescents between the ages of 12.5-18 who presented for well visits at the two clinic pilot sites completed a gender identity screening question. The gender identity screening question asked: "What is your gender?" with possible responses that included transgender female/male, non-binary/genderqueer, and other. To assess the opinions of parents/guardians and adolescents toward gender identity screening, separate, anonymous questionnaires were administered to patients and parents/guardians, at the time of screening between January 7, 2019 and June 30, 2019. To assess pediatric providers' perspectives on potential barriers to and facilitators of gender identity screening, an online survey was administered to all KPNC pediatric providers during a 3-week period in December 2018. Descriptive methods were used to summarize the data. Results: Of the 344 adolescents who attended well visits and completed a well check questionnaire, 311 (90%) adolescents completed the anonymous questionnaires. Almost all (98.7%) adolescents felt that it was worthwhile to ask them about their gender. Two-third (66.6%) felt that doctors should ask all patients about their gender. A small percentage of adolescents reported that they found the question offensive (0.3%,) or made them feel uncomfortable (0.6%). Two hundred and forty-nine (72%) parents/guardians completed the anonymous questionnaires. Of whom, the majority (75.5%) reported that it was worthwhile to ask adolescents, and 63.1% thought screening and discussions about gender would be beneficial for teens and families. A small percentage of parents/ guardians reported that asking the question could interfere with the timing of their child's doctor visit (3.6%), was offensive (2.8%) or made them feel uncomfortable (4.4%). Among the 800 KPNC pediatric providers, 228 (28.5%) completed the online survey. Most (92.5%) reported that it was somewhat important/important/critically important to screen for gender identity during well checks; and 85.6% felt that systematic gender identity screening would help direct more teens to receive gender-affirmin
ISSN:1054-139X
1879-1972