The July issue of Pediatrics, the journal of the American Academy of Pediatrics (AAP), includes a policy statement from the organization’s Committee on Adolescence. Called Office-Based Care for Lesbian, Gay, Bisexual, Transgender, and Questioning Youth, the policy updates one that was written in 2004. The policy starts by saying, “Although most lesbian, gay, bisexual, transgender, and questioning (LGBTQ) youth are quite resilient and emerge from adolescence as healthy adults, the effects of homophobia and heterosexism can contribute to health disparities in mental health with higher rates of depression and suicidal ideation, higher rates of substance abuse, and more sexually transmitted and HIV infections.”

It goes on to make a number of recommendations on how pediatricians can help these young people and their families. Recommendations include:

• Pediatricians’ offices should be teen-friendly and welcoming to all adolescents, regardless of sexual orientation and behavior; this includes training all office staff and ensuring that office forms do not presume heterosexuality of patients (or parents).
• If a pediatrician does not feel competent to provide specialized care for sexual minority teenagers and their families, he or she has the responsibility to evaluate families and then refer for medically appropriate care.
• LGBTQ adolescents and [men who have sex with men] MSM and [women who have sex with women] WSW should have sexual behaviors and risks assessed and should be provided STI/HIV testing according to recommendations in the most recent sexually transmitted diseases treatment guidelines from the [Centers for Disease Control and Prevention] CDC.
• Contraception, including use of emergency contraceptives, should be offered to women regardless of their stated sexual orientation, and the importance of consistent condom/dental dam use should be discussed.
• Pediatricians should be available to answer questions, to correct misinformation, and to provide the context that being LGBTQ is normal, just different.
• Transgender adolescents need to be supported and affirmed; they need education and referral for the process of transition and about avoiding the pitfalls of using treatments that were not prescribed by a licensed physician.
• Pediatricians should support parents in working through adjustment issues related to having a child who is LGBTQ while continuing to demonstrate love and support for their children.

The full committee report with all of the recommendations is available on AAP’s website.