Community Scholar Project Addresses Needs of Gender Variant Youth

Transgender, gender non-conforming, and gender variant youth oftentimes are misunderstood or ignored when they try to get the attention of healthcare providers. Pediatrician and adolescent medicine specialist Nadia Dowshen, MD, founder and co-director of The Children’s Hospital of Philadelphia’s Gender and Sexuality Development Clinic, wants to help alleviate the frustration of these marginalized youth by improving their access to health resources and services.

“This care is really a matter of life and death,” said Dr. Dowshen, who also is a faculty member at CHOP’s PolicyLab and serves as director of Adolescent HIV Services in the Craig-Dalsimer Division of Adolescent Medicine at CHOP. “Among people who are transgender, 40 percent have attempted to commit suicide at some point in their life, which are numbers that are staggeringly high. We need to do a better job of identifying who these youth are and offering support.”

In order to accomplish this, Dr. Dowshen has been selected to participate in the 2015-2016 inaugural cohort of the Community Scholars-in-Residence Program, a collaboration that includes CHOP and the University of Pennsylvania’s Community Engagement and Research Core, School of Nursing, Office of Inclusion and Diversity, Center for Public Health Initiatives, and the Implementation Science Working Group. The program is designed to provide exceptional junior faculty with dedicated time, mentoring, and support so that they can pursue research projects that cultivate engagement with community partners.

“The ultimate goals are to demonstrate that these kinds of resources and support can improve the quality and quantity of research funding, scholarship, and translation to improve population health,” said Karen Glanz, PhD, MPH, George A. Weiss University Professor and director of the UPenn Prevention Research Center. “This is a pilot program that we hope to build on for the future. We’re excited that our first cohort of Scholars includes Dr. Dowshen, who has already initiated productive research collaborations in the community.”

Over the next two years, Dr. Dowshen will work with the City of Philadelphia Department of Public Health’s Division of Maternal, Child, and Family Health (MCFH) to gain insights from the thoughts and experiences of transgender and gender non-conforming youth and other key stakeholders. She will use this information to increase healthcare providers’ knowledge and increase access to needed services.

“In order to develop programs and policies that will improve health outcomes among marginalized youth, I believe that our key stakeholders — the youth themselves and those in the community who work closely with them — need to be involved in all aspect of the research process in order for the research to be relevant and implementation of findings to be successful,” Dr. Dowshen said.

For the first part of the project, Dr. Dowshen and her colleagues at the MCFH will interview these adolescents, their parents, and community groups to identify and summarize their healthcare needs. The study team also will compile national policies that affect transgender and non-conforming youth and determine how they apply practically in the Philadelphia area. These steps will lead to the formation a community advisory board.

The second part will be to survey providers both throughout the CHOP Care Network and within the city health department clinics about their knowledge, attitudes, and practices with transgender and gender non-conforming youth. Based on the responses, Dr. Dowshen will identify focus areas for a curriculum to train the providers on ways that they can help to better care for this patient population.

“We know that when they do have the support of a multidisciplinary team of medical and mental health providers and a family and community, that gender non-conforming youth can grow up to be happy and healthy, productive adults,” Dr. Dowshen said.