Learning Pediatric Patients’ Preferences about Sexual Orientation and Gender Identity Questions during a Regular Pediatric Clinic Visit
Creators: name: Lee, Amalia
Publisher: name: The University of North Carolina at Chapel Hill University Libraries
Year: 2018

description: Introduction: Early identification of children/adolescent with gender dysphoria results in early referral to mental health professionals, referrals to endocrinology, and the formation of a multidisciplinary team to support the child and their family. This cascade of events leads to improvement in health outcomes. At present, no guidelines recommend when physicians should begin asking their patients about sexual orientation and gender identity (SOGI) questions. In addition, no guidelines exist on how to approach asking these questions and the method of delivery of these questions. Aim: This study aims to give guidance to physicians about when to start asking SOGI questions, which method to use, how to frame and approach these questions, and how to introduce them in the most patient-centered way. Methods: This study used an anonymous paper and pencil questionnaire to survey a sample of pediatric patients in the UNC Endocrine's Pediatric and Adolescent Gender Clinic and in the UNC Children’s Primary Care Clinic. This study had three primary outcomes: how to approach asking SOGI questions, participants’ preferences about SOGI questioning, and the best wording to use when asking such questions.  Results: Twenty-two pediatric patients consented to participating in the survey during the study period.  The average age of participants was 14.53 (+/-1.63). The study participants were mostly assigned the sex at birth of female (68%) and white (43%). A majority of participants identified their current gender as either female (41%) or male (41%) and their sexual identity as straight (59%) based on the multiple choice question. In total, 36% of participants identified as a gender minority and 55% identified as a sexual orientation minority based on the multiple choice question. Participants’ preferences about SOGI questions included wanting to be asked about gender identity (71%) and sexual orientation (67%) in the 13-16 years old time frame. Participants wanted their physician to be the one to ask SOGI questions (88%). Participants preferred the multiple choice method for both gender identity (71%) and sexual orientation (59%) questions. None of the preference variables were statistically significantly associated with how participants identified their gender or sexual orientation. “On paper without parent present” was the approach for delivering SOGI questions that received the most top ranks (56%). Conclusion: This study shows that pediatric patients would like their doctor to begin asking SOGI questions between the ages of 13 and 16 years without their parent/guardian present in the room. These questions should be delivered on paper or electronically. The best method to ask these questions whether it is multiple choice, using the Trevor Spectrum, or adopting another method, requires further research.  Although we have preliminary data about pediatric patients’ preferences for SOGI questions, the results emphasize the need for future larger scale studies. This would allow us to gain a more robust sample size that could be used to develop more concrete conclusions.