Doctor's Rec: Statement from American Academy of Pediatrics

The official American Academy of Pediatrics published (link to summary article) 9 clear recommendations for caring for youth and adolescents who identify as transgender or gender-diverse.

I highlight the portions that specify providing health care according to what the youth wants, especially to match the youth’s gender expression. Not parent, guardian, teacher, staff member, administrator, guidance counselor, etc.

[Aside: You may have heard a FoxNews Glenn Beck headline about an anti-gay-marriage hate group calling itself “American Pediatricians” creating a hoax claiming supporting a transgender youth is abuse. Read more about how Snopes debunked this, as well as the American Academy of Pediatrics’ internal presentation recommending affirming a child’s gender expression (pdf). —RXS]

1. that youth who identify as TGD have access to comprehensive, gender-affirming, and developmentally appropriate health care that is provided in a safe and inclusive clinical space;

2. that family-based therapy and support be available to recognize and respond to the emotional and mental health needs of parents, caregivers, and siblings of youth who identify as TGD;

3. that electronic health records, billing systems, patient-centered notification systems, and clinical research be designed to respect the asserted gender identity of each patient while maintaining confidentiality and avoiding duplicate charts;

4. that insurance plans offer coverage for health care that is specific to the needs of youth who identify as TGD, including coverage for medical, psychological, and, when indicated, surgical gender-affirming interventions;

5. that provider education, including medical school, residency, and continuing education, integrate core competencies on the emotional and physical health needs and best practices for the care of youth who identify as TGD and their families;

6. that pediatricians have a role in advocating for, educating, and developing liaison relationships with school districts and other community organizations to promote acceptance and inclusion of all children without fear of harassment, exclusion, or bullying because of gender expression;

7. that pediatricians have a role in advocating for policies and laws that protect youth who identify as TGD from discrimination and violence;

8. that the health care workforce protects diversity by offering equal employment opportunities and workplace protections, regardless of gender identity or expression; and

9. that the medical field and federal government prioritize research that is dedicated to improving the quality of evidence-based care for youth who identify as TGD.

Citation:

Jason Rafferty (2018) Ensuring Comprehensive Care and Support for Transgender and Gender-Diverse Children and Adolescents. Pediatrics Sep 2018, e20182162; DOI: 10.1542/peds.2018-2162 (direct pdf)

NSTA Position Statement on Gender Equity in Science Education

In November 2019, The National Science Teaching Association adopted a revised position statement on gender equity in science education. The statement broadens the scope of gender equity from girls vs. boys, to supporting students of any sex, gender identity, gender expression, and sexual orientation.

Family Acceptance of LGBT Youth Protects Against Suicide, Depression & Substance Abuse and Predicts Better Health & Self-Esteem (Journal of School Health)

Lesbian, gay, bisexual, and transgender-related school victimization is strongly linked to young adult mental health and risk for STDs and HIV; there is no strong association with substance use or abuse.

Elevated levels of depression and suicidal ideation among males can be explained by their high rates of LGBT school victimization.

Citation: Russell ST, Ryan C, Toomey RB, Diaz RM, Sanchez J. Lesbian, gay, bisexual, and transgender adolescent school victimization: implications for young adult health and adjustment. J Sch Health. 2011; 81: 223-230. (pdf)

Using a Transgender Person's Name Can Decrease Their Risk of Depression and Suicide (Teen Vogue)

A new study from The University of Texas at Austin has shed light on the importance of name usage for transgender youth. The study, which was published in the Journal of Adolescent Health in preparation for the annual Transgender Day of Visibility, concluded that when young transgender people are able to use their names in areas of everyday life, their risk of suicide and depression decreases.

They found that young people who could use their names in all four scenarios experienced 71% fewer symptoms of depression, 34% fewer symptoms of suicidal ideation, and a 65% decrease in attempted suicide than those who were not able to use their names.

Read the article here: https://www.teenvogue.com/story/using-transgender-persons-name-decrease-risk-of-depression-suicide

School Victimization of Gender-Nonconforming LGBT Youth Linked with Depression and Quality Of Life In Adulthood (Developmental Psychology)

From the American Psychological Association (which historically pathologized LGBT+ behavior), researchers found that bullying over LGBT status alone is completely responsible for how well that 13 to 19 year-old associates with gender as an adult.

We also found that school victimization due to LGBT status between the ages of 13 and 19 fully accounts for the associations between gender nonconformity and young adult adjustment, measured as depression and life satisfaction.

The researchers also analyzed their data to make sure other kinds of bullying weren’t responsible for depression and happiness.

However, school victimization for other reasons does not mediate this association.

This effect of bullying on the gender development of queer youth affects youth of all genders equally.

On the other hand, we did not find support for our hypothesis that the strength between gender nonconformity and school LGBT victimization would be stronger for boys. The process through which early gender nonconformity affects later psychosocial adjustment is similar for boys and girls.

Homophobic bullying in particular continues on into the young adult years and negatively impacts quality of life.

We found that the negative impact of specifically homophobic school victimization continues into the young adult years and affects quality of life and capacity to enjoy life.

The researchers do recommend that school policies specifically prohibiting queer-targeted bullying will reduce these negative outcomes.

Enactment of school policies that specifically prohibit victimization due to LGBT status, gender nonconformity, and other types of bias-related harassment can help reduce negative psychosocial outcomes in LGBT and gender-nonconforming young people. Thus, although it is clear that all victimization should be prohibited in schools, these findings specifically indicate the need for antibullying policies that enumerate categories often targeted by bullies.

The authors also seem thoughtful about how they are considering their transgender participants:

We also tested the model without transgender participants. The findings (available upon request) were similar to the results based on the full sample (i.e., the indirect pathway was significant and all pathways were of similar strength and the same direction). On the basis of these results, and because our measure of LGBT school victimization was inclusive of transgender experiences, we present finding based on the full sample.

Citation: Russell B. Toomey, Caitlyn Ryan, Rafael M. Diaz, Noel A. Card, & Stephen T. Russell. (2010) Gender-Nonconforming Lesbian, Gay, Bisexual, and Transgender Youth: School Victimization and Young Adult Psychosocial Adjustment. Developmental Psychology 2010, Vol. 46, No. 6, 1580-1589. (pdf)

pdf

Groundbreaking Research on Family Rejection of Lesbian, Gay and Bisexual Adolescents Establishes Predictive Link to Negative Health Outcomes (Pediatrics)

On the basis of odds ratios, lesbian, gay, and bisexual young adults who reported higher levels of family rejection during adolescence were 8.4 times more likely to report having attempted suicide, 5.9 times more likely to report high levels of depression, 3.4 times more likely to use illegal drugs, and 3.4 times more likely to report having engaged in unprotected sexual intercourse compared with peers from families that reported no or low levels of family rejection.

Latino men reported the highest number of negative family reactions to their sexual orientation in adolescence.

Researchers have established a link between rejecting behaviors of families towards lesbian, gay and bisexual adolescents and negative health problems in early adulthood.

Published in the January 2009 issue of Pediatrics, journal of the American Academy of Pediatrics.

Citation: Caitlin Ryan, David Huebner, Rafael M. Diaz, Jorge Sanchez. Family Rejection as a Predictor of Negative Health Outcomes in White and Latino Lesbian, Gay, and Bisexual Young Adults. Pediatrics Jan 2009, 123 (1) 346-352; DOI: 10.1542/peds.2007-3524 (link to abstract)

The Evolutionary Puzzle of Homosexuality

In BBC News, William Kremer discusses how homosexuality in humans and animal species may fit in with the theory of evolution.

The Evolutionary Mystery of Homosexuality

In The Chronicle of Higher Education, evolutionary biologist David P. Barash reviews six leading hypotheses for the evolution of homosexuality as a behavior.

Creating an Inclusive Classroom in December

This article by Ariel Serkin in Chem Ed Xchange describes the author's choice not to do any Christmas-themed chemistry celebrations that are popular on social media. The author cautions educators that these common school traditions may unintentionally create an environment where students and teachers may feel excluded.

2018 HRC LGBTQ Youth Report

This is a survey of over 12,000 LGBTQ teenagers in the United States. Although it lacks any specific data about science curriculum, it contains the important finding that only 10% of youth are out to all of their teachers. This informs teachers’ work because we must not assume that there are no LGBTQ students in our classrooms, just because they are not out.

Teaching the Biology of Gender, Sex, and Sexuality Leads to a Marked Increase in Acceptance of the Theory of Evolution by Natural Selection

This research by Nathan H. Lents finds that undergraduate students are more likely to accept evolutionary concepts after learning about the biological basis of reproduction and sexuality. The authors suggest that the topics of reproduction and sexuality may be opening students’ minds to accepting the ideas of evolution, or that these topics are high-interest and they make tangible and striking examples of evolution.

Queering High School Biology Textbooks

This article by Vicky L. Snyder and Francis S. Broadway uses queer theory to question assumptions embedded in high school biology textbooks. The authors identify "deafening silences" on some topics and "socially sanitized concepts". The authors suggest ways to science educators to broaden their perspectives.

Article uploaded with permission from Francis S. Broadway.

Video: Secrets of the X chromosome

This TED-Ed video by Robin Ball comes with a small set of questions to be used in a lesson. The gendered language and visuals used in the video are more nuanced than most.

Irresponsible scientific research and media portrayals are hurting trans people. Do better.

In this article in Massive Science, neuroscientist Elysa Carr calls for authors to avoid essentialist biases and treat all identities, non-binary, gender nonconforming, trans, or cis, as equally valid. Carr advises scientists to consider how research on the genetics of human behavior can impact marginalized communities when the research is misinterpreted or abused.

Are the Brains of Transgender People Different from Those of Cisgender People?

In this article in The Scientist, Shawna Williams reviews current research on how brain structures may be linked to gender identity.

LGBT high school seniors were more likely to be interested in studying STEM [...] in college if their relevant high school classes had included positive LGBT content." (GLSEN, 2013)

The 2013 GLSEN National School Climate Survey is the most recent GLSEN survey to report a correlation between LGBT-inclusive science teaching and students' interest in studying STEM.

“LGBT high school seniors were more likely to be interested in studying STEM (Science, Technology, Engineering, or Math) or Social Science in college if their relevant high school classes had included positive LGBT content (35.8% vs. 18.5% for STEM majors; 29.0 vs. 19.7% for Social Science majors).”

— GLSEN, 2013 (page xx)

The Effects of Gender Neuroessentialism on Transprejudice: An Experimental Study

This research by Boby Ho-Hong Ching and Jason Teng Xu suggests that biology teaching may have the power to reduce transphobic attitudes in students. In the experiment, students read one of two articles - one claimed that sex differences in personality and social behavior are caused by neurological factors, and the other claimed that brain and environment interact to shape personality and behavior. Students who read the first article were less likely to support equal rights and anti-discrimination protections for transgender people.

Article uploaded with permission from Boby Ho-Hong Ching.

LGBTQ inclusion in Educator preparation: getting ready for gender and sexual diversity in secondary school settings

In this Ph.D. dissertation, M. H. Hoelscher, discusses findings on possibilities for LGBTQ inclusion in life science educator preparation programs. Hoelscher suggests ways to integrate LGBTQ topics in many areas of biology curriculum, and reports on a multiple-case study of how science teacher candidates adopt LGBTQ inclusion.

The Egg and the Sperm: How Science Has Constructed a Romance Based on Stereotypical Male-Female Roles

The false romance of egg and sperm

In this article, anthropologist Emily Martin analyzes the metaphors that are used to teach reproduction and makes the claim that these metaphors reflect the socially constructed definitions of male and female.

Martin highlights modern research that dispels stereotypes of the sperm as being more aggressive, remarkable, and valuable than the egg. She advises scientists and educators to be aware of biases in the metaphors we use to describe human sex cells.

read the article (pdf)