Gender Affirming Care

Primary care teams and school personnel serve crucial roles in supporting the overall health and development of children and adolescents. An increasingly important part of this role is understanding and supporting gender diverse youth. We understand that gender identity development starts in childhood, which is why this toolkit is designed for pediatric providers and educators. The current understanding of gender is on a spectrum or continuum. This toolkit will explain the gender spectrum, provide overview of key terms, and provide recommendations for primary care teams and school personnel to help support gender diverse youth.  


"It is difficult to accurately estimate the number of transgender people, mostly because there are no population studies that accurately and completely account for the range of gender identity and gender expression" (American Psychological Association, 2014)  

Recent statistics indicate that approximately 1.2 million individuals in the US identify as non-binary (Wilson % Meyer, 2021).  

Studies indicate two trends:  

  • Growth in self-identifying individuals 
  • Higher proportion of TGNB identities in younger generations 

Purportedly due to increased visibility and acceptance as well as improved survey methods (Nolan et al., 2019) 


Research suggests that supporting gender diverse youth has significant physical and emotional health benefits. Lack of support increases stress, isolation, and some risky health behaviors (I.e., access to hormones without the guidance of a medical provider). Experts recommend providing comprehensive care for gender diverse youth which includes increased health care access, improved awareness from individuals working with youth (I.e., school personnel), and gender affirming laws and policies (Dowshen et al., 2016).  

graph outlining comprehensive care

Chapter List:

Gender Affirming Care Series Coordinators: Roberts, H., Franta, E., Zivny, S., Albin, A., & Clarke, B.

Wilson, B. D. M., & Meyer, I. H. (2021). Nonbinary LGBTQ Adults in the United States. Williams Institute. 

Dowshen, N., Meadows, R., Byrnes, M., Hawkins, L., Eder, J., & Noonan, K. (2016). Policy perspective: Ensuring comprehensive care and support for gender nonconforming children and adolescents. Transgender health, 1(1), 75-85. 

Nolan, I. T., Kuhner, C. J., & Dy, G. W. (2019). Demographic and temporal trends in transgender identities and gender confirming surgery. Translational andrology and urology, 8(3), 184–190. 

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