Health

Trans Youth Struggle to Find Competent Health Services

SMYAL, Youth Pride Clinic Service Wants, Needs

Camilla Barillas, a college student who calls herself queer, helps other queer youth access the resources and services they need in the District region, but can sometimes be hard to find.

She’s a Peer Health Fellow for SMYAL (Supporting and Mentoring Youth Advocates and Leaders), which supports and empowers lesbian, gay, bisexual, transgender and questioning (LGBTQ) youth.

From workshops to one-on-one conversations, Barillas’s passion centers around connecting those who need help with those who dispense it. That includes assistance with housing, transportation, or health care.

“Being a queer person, I know plenty of other queer people who could benefit from help,” Barillas said. “When you’re a young person, you don’t know all that’s available to you.”

Barillas said she enjoys imparting knowledge on peers who don’t have access to the information that could change the trajectory of their lives.

“People can make dangerous choices when they are in dire circumstances,” Barillas said. “It’s just nice to know I’m not giving someone empty words. Instead, I’m giving them tangible options to address their challenges.”

One challenge LGBTQ youth face is accessing competent health care, according to Adalphie Johnson, SMYAL’s director of youth development and community engagement.

Competent health care means providers understand that the bodies of transgender or nonbinary youth are different from those of their cisgender peers, Johnson said.

“It’s hard for them to find health care providers who are competent and willing to lean into those conversations with clients,” Johnson said.

Sexual health education is also often geared toward cisgender individuals, Johnson said. The inclusivity is missing, she said.

“It’s not just about men who have sex with women,” Johnson said. “It’s about bodies who engage in sexual activities with each other. That could be male, female, non-binary, transgender, or any other genders that exist.”

When youth don’t receive the proper sexual health education, they miss out on prominent information, which affects the choices they make.

“SMYAL does all we can to educate the community,” Johnson said.

PRIDE CLINIC FILLS HEALTH NEEDS

One place where transgender youth can access the services they need is the Youth Pride Clinic at the National Children’s Hospital. The clinic, which opened in 2015, offers primary care services and specialty services.

Dr. Lawrence D’Angelo, director of the Pride Clinic, said on the first day the clinic opened five transgender patients showed up. Now, 95 percent of the clinic’s patients are transgender youth.

“We’ve been identified as a place that wants very much to provide services for youth who haven’t otherwise felt comfortable accessing services elsewhere,” D’Angelo said. “The need is so great and there are so few places they can get this care.”

The clinic provides three key services to transgender youth: mental health care, hormone blockers, and gender-affirming hormones.

“You can imagine that growing up with the feeling that you are someone different than the rest of the world thinks you are is an extraordinarily stressful experience,” D’Angelo said. “The mental health aspect has to be addressed.”

Hormone blockers slow down the onset of puberty, which is vital for transgender youth. “Going through puberty is so troublesome and disconcerting for them and can cause gender dysphoria.”

The final medical step is gender affirmation hormones, which means giving feminizing hormones to those who are transitioning to a female and masculinizing hormones to those who are transitioning to males. These services aren’t offered at most pediatric clinics, D’Angelo said.

The lack of easy access to these services is evidence of the disparities that exist in the health care system, he adds.

The physical and mental harm of not getting the services they need is well documented, D’Angelo said. The rate of suicide is three to five times higher among transgender youth than their cisgender peers. The risk of substance abuse is also three times higher among transgender youth.

“We are doing all we can to be a part of the solution for the youth,” D’Angelo said. “We might have been a little late to the game, but we are here now.”

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