OVERVIEW

Emergency Care for Transgender and Gender-Diverse Children and Adolescents (Ethics CME) is organized by EB Medicine.

Publication Date: September 2, 2020
CME Expiration Date: October 3, 2023

About This Issue
In one survey, approximately 50% of transgender patients reported that they have had a negative experience in the emergency department. Enhanced knowledge about gender identity and gender-affirming care will help emergency clinicians provide better care to transgender and gender-diverse (TGD) patients in a safe, supportive environment. This issue discusses the current evidence surrounding best practices for caring for TGD children and adolescents in the ED, including approaches to the history and physical examination; benefits and complications of social, medical, and surgical affirmation; and disposition concerns. You will learn:
• Terminology regarding gender identity, expression, and affirmation (terms to use and those to avoid)
• Recommendations for general interactions, history taking, and the physical examination
• Common forms of gender-affirming care (medical and surgical), as well as common complications
• Mental health concerns for TGD youth (including an increased propensity for psychological comorbidities such as anxiety, depression, and suicidal ideation)
• Issues and complications that can arise from unsupervised medical care (including the use of nonprescribed hormones, self-performed surgeries, and silicone injection)
• Recommendations for addressing concerns regarding privacy and disclosing the patient's gender identity

Goals:
Upon completion of this activity, you should be able to:
• Demonstrate medical decision-making based on the strongest clinical evidence;
• Cost-effectively diagnose and treat the most critical ED presentations; and
• Describe the most common medicolegal pitfalls for each topic covered.

CME Objectives
Upon completion of this article, you should be able to:
• Discuss the terminology and health concerns surrounding transgender and gender-diverse (TGD) youth
• Describe barriers to effective healthcare that are experienced by TGD youth
• Describe an effective approach to emergency care for TGD youth
• Discuss the benefits and complications of gender-affirming therapies.