During the month of June, the LGBTQIA community celebrates across the world with various events, to recognize the many positive ways LGBTQIA people have contributed significantly to every country and every community. June is chosen as Pride month in memory of the Stonewall Riots which happened in 1969. Patrons and supporters of the Stonewall Inn in New York City staged an uprising to resist the police harassment and persecution to which LGBTQ Americans were commonly subjected. This uprising marked the beginning of a movement to outlaw discriminatory laws and practices against LGBTQ Americans.

 

The Children’s Hospital at Montefiore has a long history of delivering cutting-edge care for LGBTQIA youth. For 30 years, Montefiore has been at the forefront in providing care for children and young adults living with HIV. Over recent years, our program has expanded services to include comprehensive, gender-affirming care for pediatric, adolescent, and young adults, seeking this medically necessary care.

 

Transgender and gender nonconforming youth need the affirmation, and support from family, peers, and their healthcare providers. Their emotional, physical, and mental health depends on their ability to access gender-affirming care in a healthcare setting that “affirms their” gender identity. Multiple studies have shown that access to gender-affirming healthcare decreases the incidence of depression and suicidality among transgender children and teenagers. To better meet the needs of our increasingly younger, gender-diverse community in The Bronx, our program has expanded access to gender-affirming healthcare to include counseling and evaluation of prepubertal children for pubertal suppression.

 

The Montefiore Youth and Adolescent Sexual-health (MAYS) Clinic is housed under the divisions of infectious diseases and adolescent medicine, and led by me, a former member of the presidential advisory council on HIV/AIDS, under the Obama administration. Our expert team provides comprehensive gender-affirming care for transgender adolescents living with HIV/AIDS, pre-exposure prophylaxis (PrEP) for HIV, post-exposure prophylaxis (PEP) for HIV, as well as diagnosis and treatment of sexually transmitted infections.

 

Our gender-affirming program for transgender youth is composed of a multidisciplinary network of infectious disease and adolescent medicine physicians, a licensed clinical social worker with special training in transgender counseling, PrEP and PEP navigators, as well as partnerships with community LGBTQ centers.

 

MAYS has recently expanded services to provide care for prepubertal children, requiring gender-affirming counseling, medical care, and referrals for supportive services. An increasing amount of published data shows that pediatric people with gender dysphoria experience severe depression when forced to experience pubertal changes consistent with the sex assigned at birth. The clinic has expanded its focus with strategies for families with transgender children requesting pubertal blockers.

 

Studies show that children who identify as transgender or non-binary have a dramatic decrease in suicides, suicide attempts, and depression when they have the opportunity to receive pubertal blockers or hormones. Under the status neutral approach, we provide comprehensive care for children, adolescents, and young adults living with HIV in need of gender-affirming hormone therapy as well.

 

The goals of the newly structured MAYS Clinic are to meet youth and families where they are, and to:

 

• destigmatize sexual health and gender-affirming care;
• expand access to pediatric and adolescent people at risk for sexually transmitted infections (STIs) including HIV;
• expand access to gender-affirming care for pediatric and adolescent people;
• provide options to care for people living with HIV so they can access the same healthcare services as their HIV negative cohorts;
• collaborate and network across divisions within the Montefiore Healthcare System to provide comprehensive care for MAYS clinic patients;
• identify champions within our community whose participation is essential in providing comprehensive medical care; and
• offer youth access to medical care in a non-judgmental, gender-affirming, welcoming environment.

 

As we observe what is inarguably the worst year in recent history for legislative attacks against transgender and gender non-conforming kids in several states across this country, let’s remember that these children need holistic wraparound care, which focuses on their mental health, it being equally as important as their physical well-being.

 

Dr. Michelle Collins-Ogle is a pediatric infectious disease specialist at the Children’s Hospital at Montefiore.