Skip to main content
SpringerLink
Log in

Care of Sexual and Gender Minority Adolescents

  • Chapter
  • First Online:
Book cover Sexually Transmitted Infections in Adolescence and Young Adulthood

  • 553 Accesses

Abstract

With approximately 11% of adolescents in the United States identifying as sexual or gender minority (SGM, i.e., lesbian, gay, bisexual, transgender, questioning/queer), pediatricians, internists, and family practitioners are likely to care for SGM patients during their career and have the opportunity to support their healthy development. It is important to take steps to let SGM young people know they are welcome and respected in a clinical setting, where providers should emphasize confidentiality, nonjudgment, and honesty. Services such as pre-exposure and post-exposure prophylaxis for human immunodeficiency virus (HIV), extragenital testing for sexually transmitted infections (STIs), inclusive reproductive health services, and transition services or referral information for transgender youth are all ways to create an affirming clinical environment and to improve both individual and public health outcomes for SGM adolescents.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Kann L, Olsen EO, McManus T, Harris WA, Shanklin SL, Flint KH, et al. Sexual identity, sex of sexual contacts, and health-related behaviors among students in grades 9–12 – United States and selected sites, 2015. MMWR Surveill Summ. 2016;65:1–202.

    PubMed  Google Scholar 

  2. Dowshen NL, Hawkins LA, Arrington-Sanders R, Reirden DH, Garofalo R. Sexual and gender minority youth. In: Ginsburg KR Kinsman SB, editors. Reaching teens strength-based communication strategies to build resilience and support healthy adolescent development. Am Acad Pediatrics; 2014. p. 531–8.

    Google Scholar 

  3. Connolly MD, Zervos MJ, Barone CJ, Johnson CC, Joseph CLM. The mental health of transgender youth: advances in understanding. J Adolesc Health. 2016;59:489–95.

    Article  Google Scholar 

  4. Vance SR, Ehrensaft D, Rosenthal SM. Psychological and medical care of gender nonconforming youth. Pediatrics. 2014;134:1184–92.

    Article  Google Scholar 

  5. Conron KJ, Landers SJ, Reisner SL, Sell RL. Sex and gender in the US health surveillance system: a call to action. Am J Public Health. 2014;104:970–6.

    Article  Google Scholar 

  6. Shields JP, Cohen R, Glassman JR, Whitaker K, Franks H, Bertolini I. Estimating population size and demographic characteristics of lesbian, gay, bisexual, and transgender youth in middle school. J Adolesc Health. 2013;52:248–50.

    Article  Google Scholar 

  7. Clark TC, Lucassen MFG, Bullen P, Denny SJ, Fleming TM, Robinson EM, et al. The health and well-being of transgender high school students: results from the New Zealand adolescent health survey (Youth’12). J Adolesc Health. 2014;55:93–9.

    Article  Google Scholar 

  8. Macapagal K, Bhatia R, Greene GJ. Differences in healthcare access, use, and experiences within a community sample of racially diverse lesbian, gay, bisexual, transgender, and questioning emerging adults. LGBT Health. 2016;3:434–42.

    Article  Google Scholar 

  9. Alencar Albuquerque G, de Lima Garcia C, da Silva Quirino G, Alves MJH, Belém JM, dos Santos Figueiredo FW, et al. Access to health services by lesbian, gay, bisexual, and transgender persons: systematic literature review. BMC Int Health Hum Rights. 2016;16:2.

    Article  Google Scholar 

  10. Ten things: creating inclusive health care environments for LGBT people [Internet]. National LGBT Health Education Center; 2015 [cited 2016 Nov 17]. Available from: http://www.lgbthealtheducation.org/wp-content/uploads/Ten-Things-Brief-Final-WEB.pdf.

  11. Grant JM, Mottet LA, Tanis J, Herman JL, Harrison J, Keisling M, et al. National transgender discrimination survey report on health and health care. Washington, DC: National Center for Transgender Equality, National Gay Lesbian Task Force [Internet]; 2010 [cited 2016 Nov 17]. Available from: http://www.kwncbxw.thetaskforce.org/downloads/resources_and_tools/ntds_report_on_health.pdf.

  12. Coleman E, Bockting W, Botzer M, Cohen-Kettenis P, DeCuypere G, Feldman J, et al. Standards of care for the health of transsexual, transgender, and gender-nonconforming people, version 7. Int J Transgenderism. 2012;13:165–232.

    Article  Google Scholar 

  13. Deutsch MB, editor. Guidelines for the primary and gender-affirming care of transgender and gender nonbinary people [Internet]. Center of Excellence for Transgender Health, Department of Family and Community Medicine, University of California San Francisco; 2016 [cited 2016 Nov 20]. Available from: www.transhealth.ucsf.edu.

  14. National LGBT Health Eduation Center – Fenway Health [Internet]. National LGBT Health Education Center [cited 2016 Nov 22]. Available from: http://www.lgbthealtheducation.org/.

  15. Hembree WC, Cohen-Kettenis P, Delemarre-van de Waal HA, Gooren LJ, Meyer WJ, Spack NP, et al. Endocrine treatment of transsexual persons: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2009;94:3132–54.

    Article  CAS  Google Scholar 

  16. State Policies on Teens [Internet]. Guttmacher Institute [cited 2016 Nov 22]. Available from: https://www.guttmacher.org/united-states/teens/state-policies-teens.

  17. A guide to taking a sexual history [Internet]. US Department of Health and Human Services, Centers for Disease Control and Prevention [cited 2016 Nov 11]. Available from: www.cdc.goc/std/treatment/sexualhistory.pdf.

  18. Friedman MS, Marshal MP, Guadamuz TE, Wei C, Wong CF, Saewyc EM, et al. A meta-analysis of disparities in childhood sexual abuse, parental physical abuse, and peer victimization among sexual minority and sexual nonminority individuals. Am J Public Health. 2011;101:1481–94.

    Article  Google Scholar 

  19. Wood SM, Salas-Humara C, Dowshen NL. Human immunodeficiency virus, other sexually transmitted infections, and sexual and reproductive health in lesbian, gay, bisexual, transgender youth. Pediatr Clin N Am. 2016;63:1027–55.

    Article  Google Scholar 

  20. HIV among gay and bisexual men [Internet]. Centers for Disease Control and Prevention. 2016 [cited 2016 Nov 18]. Available from: https://www.cdc.gov/hiv/group/msm/index.html.

  21. HIV surveillance report, 2014 [Internet]. Centers for Disease Control and Prevention; 2015 Nov. Report no.: 26. Available from: http://www.cdc.gov/hiv/library/reports/surveillance/.

  22. Baral SD, Poteat T, Strömdahl S, Wirtz AL, Guadamuz TE, Beyrer C. Worldwide burden of HIV in transgender women: a systematic review and meta-analysis. Lancet Infect Dis. 2013;13:214–22.

    Article  Google Scholar 

  23. CROI press release: HIV Risk/2016/Newsroom/NCHHSTP/CDC [Internet]. [cited 2016 Apr 15]. Available from: http://www.cdc.gov/nchhstp/newsroom/2016/croi-press-release-risk.html.

  24. Millett GA, Flores SA, Peterson JL, Bakeman R. Explaining disparities in HIV infection among black and white men who have sex with men: a meta-analysis of HIV risk behaviors. AIDS. 2007;21:2083–91.

    Article  Google Scholar 

  25. HIV and the black community: do #black(gay) lives matter? [Internet]. Washington, DC: The Foundation for AIDS Research; 2015 February. Available from: http://www.amfar.org/uploadedFiles/_amfarorg/Articles/On_The_Hill/2016/Black-Gay-Men-and-HIV.pdf.

  26. Clerkin EM, Newcomb ME, Mustanski B. Unpacking the racial disparity in HIV rates: the effect of race on risky sexual behavior among black young men who have sex with men (YMSM). J Behav Med. 2011;34:237–43.

    Article  Google Scholar 

  27. Updated guidelines for antiretroviral postexposure prophylaxis after sexual, injection-drug use, or other nonoccupational exposure to HIV – United States, 2016 [Internet]. Centers for Disease Control and Prevention; 2016 May. Available from: http://www.cdc.gov/hiv/pdf/programresources/cdc-hiv-npep-guidelines.pdf.

  28. Preexposure prophylaxis for the prevention of HIV infection in the United States – 2014: a clinical practice guideline [Internet]. Centers for Disease Control and Prevention [cited 2016 Nov 20]. Available from: http://www.cdc.gov/hiv/pdf/prepguidelines2014.pdf.

  29. Truvada: full prescribing information [Internet]. Gilead Sciences, Inc.; 2016 [cited 2016 Nov 20]. Available from: http://www.gilead.com/~/media/Files/pdfs/medicines/hiv/truvada/truvada_pi.pdf.

  30. Hosek S, Landovitz R, Rudy B, Kapogiannis B, Siberry G, Rutledge B, et al. An HIV pre-exposure prophylaxis (PrEP) demonstration project and safety study for adolescent MSM ages 15–17 in the United States (ATN 113). 21st International AIDS conference, Durban, South Africa; 2016.

    Google Scholar 

  31. Hosek S, Rudy B, Landovitz R, Kapogiannis B, Siberry G, Liu N, et al. An HIV pre-exposure prophylaxis (PrEP) demonstration project and safety study for young men who have sex with men in the United States (ATN 110). 8th IAS conference on HIV pathogenesis, treatment and prevention, Vancouver; 2015.

    Google Scholar 

  32. Havens PL, Stephensen CB, Van Loan MD, Schuster GU, Woodhouse LR, Flynn PM, et al. Decline in bone mass with tenofovir disoproxil fumarate/emtricitabine is associated with hormonal changes in the absence of renal impairment when used by HIV-uninfected adolescent boys and young men for HIV preexposure prophylaxis. Clin Infect Dis. 2016;64:317–25;ciw765.

    Article  Google Scholar 

  33. Culp L, Caucci L. State adolescent consent laws and implications for HIV pre-exposure prophylaxis. Am J Prev Med. 2013;44:S119–24.

    Article  Google Scholar 

  34. Singh D, Fine DN, Marrazzo JM. Chlamydia trachomatis infection among women reporting sexual activity with women screened in Family Planning Clinics in the Pacific Northwest, 1997 to 2005. Am J Public Health. 2011;101:1284–90.

    Article  Google Scholar 

  35. Patton ME, Kidd S, Llata E, Stenger M, Braxton J, Asbel L, et al. Extragenital gonorrhea and chlamydia testing and infection among men who have sex with men – STD surveillance network, United States, 2010–2012. Clin Infect Dis. 2014;58:1564–70.

    Article  Google Scholar 

  36. 2015 sexually transmitted diseases treatment guidelines [Internet]. Centers for Disease Control and Prevention. Available from: http://www.cdc.gov/std/tg2015/.

  37. Law CL, Qassim M, Cunningham AL, Mulhall B, Grierson JM. Nonspecific proctitis: association with human immunodeficiency virus infection in homosexual men. J Infect Dis. 1992;165:150–4.

    Article  CAS  Google Scholar 

  38. 2015 sexually transmitted diseases surveillance [Internet]. Centers for Disease Control and Prevention. Available from: https://www.cdc.gov/std/stats15/std-surveillance-2015-print.pdf.

  39. Garland SM, Steben M, Sings HL, James M, Lu S, Railkar R, et al. Natural history of genital warts: analysis of the placebo arm of 2 randomized phase III trials of a quadrivalent human papillomavirus (types 6, 11, 16, and 18) vaccine. J Infect Dis. 2009;199:805–14.

    Article  Google Scholar 

  40. Clifford GM, Smith JS, Plummer M, Muñoz N, Franceschi S. Human papillomavirus types in invasive cervical cancer worldwide: a meta-analysis. Br J Cancer. 2003;88:63–73.

    Article  CAS  Google Scholar 

  41. Recommended adult immunization schedule United States – 2016 [Internet]. Centers for Disease Control and Prevention [cited 2016 Nov 20]. Available from: https://www.cdc.gov/vaccines/schedules/downloads/adult/adult-combined-schedule.pdf.

  42. Marrazzo JM, Stine K, Koutsky LA. Genital human papillomavirus infection in women who have sex with women: a review. Am J Obstet Gynecol. 2000;183:770–4.

    Article  CAS  Google Scholar 

  43. Machalek DA, Poynten M, Jin F, Fairley CK, Farnsworth A, Garland SM, et al. Anal human papillomavirus infection and associated neoplastic lesions in men who have sex with men: a systematic review and meta-analysis. Lancet Oncol. 2012;13:487–500.

    Article  Google Scholar 

  44. Koumans EH, Kendrick JS, CDC Bacterial Vaginosis Working Group. Preventing adverse sequelae of bacterial vaginosis: a public health program and research agenda. Sex Transm Dis. 2001;28:292–7.

    Article  CAS  Google Scholar 

  45. Evans AL, Scally AJ, Wellard SJ, Wilson JD. Prevalence of bacterial vaginosis in lesbians and heterosexual women in a community setting. Sex Transm Infect. 2007;83:470–5.

    Article  Google Scholar 

  46. Berger BJ, Kolton S, Zenilman JM, Cummings MC, Feldman J, McCormack WM. Bacterial vaginosis in lesbians: a sexually transmitted disease. Clin Infect Dis. 1995;21:1402–5.

    Article  CAS  Google Scholar 

  47. McCaffrey M, Varney P, Evans B, Taylor-Robinson D. Bacterial vaginosis in lesbians: evidence for lack of sexual transmission. Int J STD AIDS. 1999;10:305–8.

    Article  CAS  Google Scholar 

  48. Forcey DS, Vodstrcil LA, Hocking JS, Fairley CK, Law M, McNair RP, et al. Factors associated with bacterial vaginosis among women who have sex with women: a systematic review. Graham SM, editor. PLoS One. 2015;10:e0141905.

    Article  Google Scholar 

  49. Marrazzo JM, Thomas KK, Fiedler TL, Ringwood K, Fredricks DN. Risks for acquisition of bacterial vaginosis among women who report sex with women: a cohort study. Myer L, editor. PLoS One. 2010;5:e11139.

    Article  Google Scholar 

  50. Vodstrcil LA, Walker SM, Hocking JS, Law M, Forcey DS, Fehler G, et al. Incident Bacterial Vaginosis (BV) in women who have sex with women is associated with behaviors that suggest sexual transmission of BV. Clin Infect Dis [Internet]. 2014 [cited 2016 Nov 21]. Available from: http://cid.oxfordjournals.org/lookup/doi/10.1093/cid/ciu1130.

  51. Marrazzo JM, Thomas KK, Ringwood K. A behavioural intervention to reduce persistence of bacterial vaginosis among women who report sex with women: results of a randomised trial. Sex Transm Infect. 2011;87:399–405.

    Article  Google Scholar 

  52. Reisner SL, Mimiaga MJ, Skeer M, Mayer KH. Beyond anal sex: sexual practices associated with HIV risk reduction among men who have sex with men in Boston, Massachusetts. AIDS Patient Care STDs. 2009;23:545–50.

    Article  Google Scholar 

  53. Marturana A. Can an STD live on a sex toy?/YouBeauty [Internet]. [cited 2016 Nov 22]. Available from: http://www.youbeauty.com/love/can-an-std-live-on-a-sex-toy/.

Download references

Author information

Authors and Affiliations

  1. Department of Pediatrics, Henry Ford Health System, Detroit, MI, USA

    Maureen D. Connolly

  2. Craig-Dalsimer Division of Adolescent Medicine, Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Nadia Dowshen

  3. Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA

    Nadia Dowshen

Authors
  1. Maureen D. Connolly
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Nadia Dowshen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Maureen D. Connolly .

Editor information

Editors and Affiliations

  1. Hubert Department of Global Health, Rollins School of Public Health Emory University, Atlanta, GA, USA

    Sophia A. Hussen

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Connolly, M.D., Dowshen, N. (2020). Care of Sexual and Gender Minority Adolescents. In: Hussen, S. (eds) Sexually Transmitted Infections in Adolescence and Young Adulthood. Springer, Cham. https://doi.org/10.1007/978-3-030-20491-4_2

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-20491-4_2

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-20490-7

  • Online ISBN: 978-3-030-20491-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation