October 22, 2013
SickKids supports transgender teens with opening of new clinic
Beginning in October 2013, transgender teens in the Greater Toronto Area will have better access to healthcare services with the opening of the Transgender Youth Clinic at The Hospital for Sick Children (SickKids).
“Transgender teens in the GTA are lacking the timely medical support required to manage their gender dysphoria. The Transgender Youth Clinic at SickKids will fill this important gap by providing medical care, and aims to minimize negative medical and psychosocial outcomes and maximize the potential for a healthy and happy future,” says Dr. Joey Bonifacio, Physician in Adolescent Medicine and lead of the Transgender Youth Clinic at SickKids.
Transgender individuals are those whose gender identity (self-identified as male, female, both, or neither) do not match their anatomical sex. Gender dysphoria is the extreme discomfort experienced by such individuals. If left unmanaged, it could lead to negative consequences such as mental health concerns and behavioural risks.
While the prevalence of gender dysphoria is uncommon, increased openness and acceptance of sexual and gender identity minorities has resulted in more adolescents and young adults identifying as transgender (or trans) at a younger age. The medical support offered through the Transgender Youth Clinic at SickKids includes consultations with an interdisciplinary team who provide ongoing assessments to ensure patients are receiving appropriate counselling, and in some cases hormone therapy to prevent pubertal changes.
“Not all transgender adolescents will choose to transition to the opposite gender when they are adults. However, for adolescents who are unsure about their gender and experience serious mental health concerns due to pubertal changes, hormone therapy can reduce depression and anxiety caused by these changes in the body,” says Bonifacio.
A study of lesbian, gay, bisexual and transgender youth found that 15 per cent met the criteria for major depression. Another recent study found that close to 50 per cent of Ontarian transgender youth aged 16 to 24 had seriously considered suicide and 19 per cent had attempted suicide. “This is likely a reflection of the multiple psychosocial problems faced by transgender adolescents such as family and peer rejection, harassment, trauma, abuse, inadequate housing, and lack of financial support,” says Bonifacio.
He adds that some transgender youth may try to inappropriately access cross-sex hormones and engage in behaviours like self-mutilation, putting their physical health directly at risk. “These mental health and medical problems are likely compounded by a delay in care, so our hope is that the establishment of the Transgender Youth Clinic will allow for timely access to this much-needed care,” says Bonifacio.
There are two mental health clinics providing the diagnosis of gender dysphoria in Toronto but there are currently no clinics devoted towards meeting the medical care needs of transgender adolescents. While there are established transgender adolescent clinics in, and affiliated with tertiary paediatric hospitals in Vancouver, Winnipeg, Montreal, Ottawa, and Halifax, there are none in Toronto.
The current team at SickKids includes staff physicians in Adolescent Medicine and Endocrinology, a nurse practitioner, a nurse, and social worker and liaise with numerous children’s mental health organizations.
The Transgender Youth Clinic will include both educational and research roles and will offer valuable training to other medical health care professionals. The link between research, learning and care is aligned with SickKids values in providing compassionate care, advancing scientific and clinical knowledge and preparing the next generation of leaders in child health.