title: Health care providers' comfort with and barriers to care of transgender youth.
abstract: OBJECTIVE
  To explore providers' clinical experiences, comfort, and confidence with and barriers to providing care to transgender youth.
  
  
  METHODS
  An online survey was administered to members of the Society for Adolescent Health and Medicine and the Pediatric Endocrine Society with items querying about clinical exposure to transgender youth, familiarity with and adherence to existing clinical practice guidelines, perceived barriers to providing transgender-related care, and comfort and confidence with providing transgender-related care. The response rate was 21.9% (n = 475).
  
  
  RESULTS
  Of the respondents, 66.5% had provided care to transgender youth, 62.4% felt comfortable with providing transgender medical therapy, and 47.1% felt confident in doing so. Principal barriers to provision of transgender-related care were lack of the following: training, exposure to transgender patients, available qualified mental health providers, and insurance reimbursement.
  
  
  CONCLUSIONS
  This study suggests that more training in transgender-related care, available qualified mental health providers, and insurance reimbursement for transgender-related care are needed.
authors.affiliation: Division of Adolescent and Young Adult Medicine, Benioff Children's Hospital, University of California, San Francisco, San Francisco, California. Electronic address: vances@peds.ucsf.edu.
authors.forename: Stanley R
authors.initials: SR
authors.lastname: Vance
authors.affiliation: Division of Adolescent and Young Adult Medicine, Benioff Children's Hospital, University of California, San Francisco, San Francisco, California.
authors.forename: Bonnie L
authors.initials: BL
authors.lastname: Halpern-Felsher
authors.affiliation: Division of Pediatric Endocrinology, Benioff Children's Hospital, University of California, San Francisco, San Francisco, California.
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Rosenthal
mesh_terms: D000293:Adolescent; D001291:Attitude of Health Personnel; D002648:Child; D003695:Delivery of Health Care; D005260:Female; D005783:Gender Identity; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D008297:Male; D011795:Surveys and Questionnaires; D063106:Transgender Persons / Q000523:psychology*; D055815:Young Adult
keywords: Gender identity; Health services for transgender persons; Mental health services; Transgender persons