Medical Care for Nonbinary Youth: Individualized Gender Care Beyond a Binary Framework

Area of Science:

• Gender-affirming care
• Adolescent medicine
• Psychology

Background:

• Nonbinary and genderqueer youth constitute a significant portion of the transgender youth population.
• Traditional transgender healthcare models, based on a gender binary, often lead nonbinary individuals to avoid or withhold needs during care.
• This results in a critical gap in healthcare access and affirmation for gender-expansive youth.

Purpose of the Study:

• To present a paradigm shift in gender care for nonbinary and gender-expansive youth.
• To outline components of supportive and affirming care, addressing discrimination and stigma.
• To guide providers in offering individualized and effective medical and social support.

Main Methods:

• Review of current gender-affirming care models for transgender youth.
• Analysis of the specific needs and challenges faced by nonbinary and gender-expansive youth.
• Development of recommendations for provider language, focus on embodiment goals, and medical interventions.

Main Results:

• Gender-affirming language and a focus on individual embodiment goals are crucial for serving nonbinary youth.
• Medical interventions (pubertal suppression, hormones, surgeries) should be discussed based on individual physical effects, not binary terms.
• Estrogen, testosterone, or a combination can support individualized goals.

Conclusions:

• A paradigm shift towards individualized, gender-affirming care is essential for nonbinary and gender-expansive youth.
• Providers must engage in supportive conversations, assist with decision-making, and balance priorities with patients and families.
• Affirming care models improve health outcomes and reduce barriers for this underserved population.