The estimated 1.3 million transgender adolescents in the United States (defined as those whose gender identity does not match the gender they were assigned at birth) experience higher rates of anxiety, depression, and suicide—as well as discrimination within the nation’s healthcare system.
The Transgender Youth Health Program, part of Hassenfeld Children’s Hospital at NYU Langone, is one of the few programs of its kind to offer both medical care and emotional support for transgender and gender-diverse young people. And Hassenfeld Children’s Hospital is the first and only children’s hospital in New York City designated an LGBTQ+ Healthcare Equality Leader by the Human Rights Campaign Foundation, the nation’s largest LGBTQ+ advocacy group.
Meeting Families Where They Are
The program’s team uses a holistic approach that addresses the needs of not just LGBTQ+ children, but their families as well. “We support both our young people and their parents,” says Samantha Busa, PsyD, clinical director of the Gender and Sexuality Service at NYU Langone’s Child Study Center and part of the Transgender Youth Health Program team.
“There’s a misconception that we only see parents who are supportive, that parents will be shamed if they’re not accepting of their child’s gender identity,” Dr. Busa says. “But we meet families where they are. Our job is to help parents see the importance of gender-affirming care.”
Affirming Gender Identities
“This population has historically not been met with a lot of TLC at their doctor’s offices,” says Jason A. Klein, MD, medical director of the Transgender Youth Health Program and a pediatric endocrinologist at Hassenfeld Children’s Hospital. “They’re being forced not to live as their true selves.”
The Transgender Youth Health Program’s pediatric endocrinologists, adolescent medicine specialists, psychologists, social workers, nurses, and support staff offer LGBTQ+ young people mental health and gender-affirming care, including supporting a child’s gender identity and social transition, often through clothing choices or a name change.
“Simply affirming somebody in their gender identity—using their name, using their chosen pronouns, giving them respect—dramatically improves quality of life,” says Dr. Klein.
“For many kids, this is a lifesaving intervention,” adds Dr. Busa.
Offering Medical Treatments and More
Every transgender adolescent is different. “We see kids as young as 4 and 5 who have gender-diverse identities,” says Dr. Busa. “But there’s no need for medical intervention until kids are approaching puberty. That’s another misconception.”
When a child is emotionally and developmentally ready, the program’s doctors might help them with puberty blockers, hormone therapy, and other options, following accepted guidelines from the World Professional Association for Transgender Health (WPATH) and the Endocrine Society.
“Medical treatment is a path for many but may not be the full picture. Some might want to work on vocal therapy to change the quality of their voice,” says Dr. Klein. “Some patients are interested in fertility preservation techniques and might want to conserve sperm or eggs to use for a future pregnancy.”
The program’s team supports adolescents at every step. “These kids need that extra lift sometimes,” says Dr. Klein. “But they’re awesome, I’ll tell you that much.”
Providing Validation and a Safe Space
Marlo, a 17-year-old from Manhattan, credits the program with his comfort with himself. At 12, Marlo came out to his mother, Amy, as transgender, and he began working with the Transgender Youth Health Program at 15. Marlo’s physician is Melissa Dundas, MD, who specializes in adolescent medicine and sees patients as part of the program.
“I finally felt validated and recognized,” says Marlo, who along with his mother is a part of Hassenfeld Children’s Hospital’s Sala Family Advisory Council and Sala Youth Advisory Council. “Hassenfeld Children’s Hospital has been a safe space where I have been seen and heard and treated with respect as a whole person.”
Marlo’s mother concurs. “The team at NYU Langone has worked with us to provide Marlo with the tools he needs to be a happy and healthy teenage boy,” Amy says. “And we know that if harder times come, we have our team there to support us.”