Tit estimates that 1.3 million transgender adolescents in the United States (defined as those whose gender identity does not match the gender they were assigned at birth) experience higher rates of anxiety, depression, and suicide, as well as discrimination within of the nation’s health care system.
The Transgender Youth Health Program, part of NYU Langone Hassenfeld Children’s Hospital, is one of the few programs of its kind that offers both medical care and emotional support to transgender and gender nonconforming youth. Hassenfeld Children’s Hospital is the first and only children’s hospital in New York City to be designated an LGBTQ+ Health Equality Leader by the Human Rights Campaign Foundation, the nation’s largest LGBTQ+ advocacy group.
Meeting families where they are
The program team uses a holistic approach that meets the needs of not only LGBTQ+ children, but also their families. “We support both our young people and their parents,” says Samantha Bussa, PsyD, clinical director of the Office of Gender and Sexuality at NYU Langone’s Child Study Center and part of the Transgender Youth Health Program team.
“There’s a misconception that we only see supportive parents, that parents will be shamed if they don’t accept their child’s gender identity,” says Dr Bussa. “But we meet families where they are. Our job is to help parents understand the importance of gender-affirming care.”
Affirmation of gender identity
“This population historically hasn’t seen much TLC in their doctor’s offices,” says Jason A. Klein, MD, medical director of the Transgender Youth Health Program and pediatric endocrinologist at Hassenfeld Children’s Hospital. “They are forced not to live as their true selves.”
The Transgender Youth Health Program’s pediatric endocrinologists, adolescent medicine specialists, psychologists, social workers, nurses and support staff offer LGBTQ+ youth mental health care and gender affirmation, including support for a child’s gender identity and social transition , often through clothing choices or name changes.
“Simply affirming someone’s gender identity — using their name, using their chosen pronouns, giving them respect — dramatically improves quality of life,” says Dr. Klein.
“For many children, this is a life-saving intervention,” adds Dr. Bussa.
Offers medical procedures and much more
Every transgender adolescent is different. “We’re seeing 4- and 5-year-olds who have a different gender identity,” says Dr. Bussa. “But there is no need for medical intervention until children approach puberty. This is another misconception.
When a child is emotionally and developmentally ready, program doctors can help them with puberty blockers, hormone therapy and other options, following guidelines accepted by the World Professional Association for Transgender Health (WPATH) and the Endocrine Society.
“Medical treatment is an avenue for many, but it may not be the full picture. Some may want to work on vocal therapy to change the quality of their voice,” says Dr. Klein. “Some patients are interested in fertility preservation techniques and may want to save sperm or eggs to use for a future pregnancy.”
The program team supports adolescents every step of the way. “These kids sometimes need that extra lift,” says Dr. Klein. “But they’re great, I’ll tell you that.”
Providing validation and a safe space
Marlo, a 17-year-old from Manhattan, credits the program with being comfortable with herself. At 12, Marlo came out to her mother Amy as transgender and began working with the Transgender Youth Health Program at 15. Marlo’s doctor is Melissa Dundas, MD, who specializes in adolescent medicine and accepts patients as part of the program.
“I finally felt validated and recognized,” says Marlo, who, along with his mother, is part of Hassenfeld Children’s Hospital’s Sala Family Advisory Board and Sala Youth Advisory Board. “Hassenfeld Children’s Hospital was a safe place where I was seen and heard and treated with respect as a whole person.”
Marlo’s mother agrees. “The team at NYU Langone worked with us to give Marlo the tools she needs to be a happy and healthy teenager,” says Amy. “And we know that if tougher times come, our team will support us.”