AAP issues new statement on sexual minority youth

The American Academy of Pediatrics (AAP) Committee on Adolescence has issued a new policy statement regarding office-based care for lesbian, gay, bisexual, transgender, and questioning youth.

Last issued in 2004, the Academy’s new statement emphasizes that although most of these sexual minority youth emerge from adolescence as healthy adults, the potential for them to be affected by homophobia, heterosexism, stigmatization, ostracism, and/or parental rejection is great. As a result, these kids usually have higher rates of mental health problems, particularly of depression, suicidal ideation, eating disorders, and substance abuse. They may struggle with self-image and with self-esteem. They also may become victims of violence in school or at home.

Those who are sexually active require screening for sexually transmitted and HIV infections, according to the recommendations of the Sexually Transmitted Diseases Treatment Guidelines of the Centers for Disease Control and Prevention. Pediatricians should offer contraception, including emergency methods, if appropriate and discuss the importance of consistent condom and dental dam use.

Transgender youth may require education, particularly about the pitfalls of using treatments not prescribed by licensed physicians, and referral for transition.

The statement reminds that a teenager-friendly office that is welcoming to sexual minority youth is critical, as is obtaining a comprehensive, confidential, developmentally appropriate adolescent psychosocial history and providing referrals, if needed. Train all office staff appropriately and ensure that all office forms do not presume heterosexuality.

Additional key roles, according to the policy statement, include being available for both the youth and their parents to answer questions, to correct misinformation, and to provide a context that indicates that although being lesbian, gay, bisexual, transgender, or unsure of one’s sexuality may be different, all these adolescents are normal.

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