Gender-diverse youth (GDY) face significant health disparities, which can be mitigated by gender-affirming medical care. Understanding parents' experiences seeking care for their GDY can identify barriers to care and improve access. This study sought to understand parents' experiences accessing gender-affirming medical care with their GDY. We asked parents of GDY in the United States to describe their experiences with gender-affirming medical care through a single open-ended item on an online survey disseminated through social media in February of 2020. Open-ended survey responses were analyzed through inductive thematic analysis by two authors using an iteratively developed codebook adjudicated by consensus. This codebook was used to identify key themes. We analyzed 277 responses from majority White (93.9%) parents from 41 U.S. states. Themes included (1) Experiences accessing care: finding a provider, financial and insurance-related considerations, the impact of geography on care access; (2) Experiences receiving care: factors in successful or unsuccessful patient-provider interactions, differing approaches to initiating care, sense of community with other families; and (3) Outcomes related to receiving care: how care for their child was perceived to be lifesaving or helped their child thrive. Parents highlighted how access to gender-affirming medical care improved their GDY's health and wellbeing, and described numerous barriers they experienced with finding and receiving this care. Given the evidence that gender-affirming medical care mitigates health disparities, providers, policymakers, insurance companies, and health systems leaders should urgently address these challenges to ensure equitable receipt of care for all GDY.

Many adolescents use the emergency department (ED) as their primary source of health care. As a result, the ED serves as a unique opportunity to reach adolescents. Although many adolescent visits to the ED are related to reproductive health, ED providers report barriers to providing this care, including lack of training. Nurse practitioners (NPs) and physician assistants (PAs) serve a vital role in the provision of consistent care to adolescents in the ED. The purpose of this study was to create a curriculum to train NPs and PAs at two pediatric institutions to provide patient-centered contraceptive counseling to adolescents in the pediatric ED regardless of their chief complaint. To do this, we created a four-part webinar followed by an in-person training session. Participants completed training and then conducted counseling sessions with adolescents in the ED. Counseling sessions were recorded and reviewed for fidelity to delineated counseling principles, and data from post-counseling surveys were collected. 27 NPs and PAs completed the training and conducted 99 counseling sessions. Nearly all sessions incorporated essential content and communication principles such as shared decision making (90%) and teach-back methods (75%). All NPs and PAs who participated reported satisfaction and subjective improvement in knowledge and competence from the training. This curriculum offers a novel and feasible approach to train NPs and PAs to deliver patient-centered contraception counseling to adolescents in the ED setting, and it can serve as a model for how to educate different providers to incorporate reproductive health education into the busy ED visit.

OBJECTIVES: Numerous U.S. state legislatures have proposed bills to ban gender-affirming medical interventions for minors. Parents and caregivers play a critical role in advocating for and supporting their transgender and gender-diverse youth (TGDY). We aimed to understand parent and caregiver perspectives about this potential legislation and perceived effects on their TGDY's mental health.

METHODS: We developed and launched a social-media based, anonymous online survey in February 2020 to assess parent and caregiver perspectives on proposed laws to ban gender-affirming medical interventions for minors. Participants were asked to respond to two open-ended questions about these laws; responses were coded to identify key themes.

RESULTS: We analyzed responses from 273 participants from 43 states. Most identified as white (86.4%) female (90.0%) mothers (93.8%), and 83.6% of their TGDY had received gender-affirming medical interventions before age 18 years. The most salient theme, which appeared in the majority of responses, described parent and caregiver fears that these laws would lead to worsening mental health and suicide for their TGDY. Additional themes included a fear that their TGDY would face increased discrimination, lose access to gender-affirming medical interventions, and lose autonomy over medical decision-making due to government overreach.

CONCLUSIONS: In this convenience sample, parents and caregivers overwhelmingly expressed fear that the proposed legislation will lead to worsening mental health and increased suicidal ideation for their TGDY. They implored lawmakers to hear their stories and to leave critical decisions about gender-affirming medical interventions to families and their medical providers.

<p><strong>PURPOSE: </strong>Racial/ethnic disparities exist in young men's contraceptive knowledge. This study examines whether the likelihood of receiving sexual health education varies by race/ethnicity.</p>

<p><strong>METHODS: </strong>We examined racial/ethnic differences in sex and contraceptive education both in school and from parents with multivariable logistic regression models among 4,104 men aged 15-24 years using data from the 2006-2010 National Survey of Family Growth.</p>

<p><strong>RESULTS: </strong>Nearly all respondents (96.6%) reported formal sex education. Fewer reported formal birth control education (66.6%), parental sex discussions (66.8%), and parental discussions specifically about birth control (49.2%). In multivariable analysis, black men were less likely than white men to report receiving formal contraceptive education (adjusted odds ratio [aOR], .70; 95% CI, .51-.96). Both black and U.S.-born Hispanic men reported more parental sex discussions than white men (aOR, 1.44; 95% CI, 1.07-1.94, aOR, 1.47; 95% CI, 1.09-1.99, respectively).</p>

<p><strong>CONCLUSIONS: </strong>Nearly all respondents reported having received formal sexual health education. Fewer reported receiving education about birth control either at school or at home. Black men were less likely to report receiving formal contraceptive education.</p>

<p><strong>STUDY OBJECTIVE: </strong>To identify barriers to long-acting reversible contraception (LARC) uptake among homeless young women.</p>

<p><strong>DESIGN: </strong>In this mixed methods study surveys and guided interviews were used to explore women's contraceptive and reproductive experiences, interactions with the health care system, and their histories of homelessness.</p>

<p><strong>SETTING: </strong>All surveys and interviews were conducted at a homeless drop-in center or shelter.</p>

<p><strong>PARTICIPANTS: </strong>Fifteen women between 18 and 24&nbsp;years of age with a past year history of homelessness.</p>

<p><strong>INTERVENTIONS: </strong>None.</p>

<p><strong>MAIN OUTCOME MEASURES: </strong>Perceived barriers to contraceptive use, including knowledge and access barriers and interactions with the health care system around reproductive health.</p>

<p><strong>RESULTS: </strong>Confusion about the possibility of early termination of LARC, and the perception that providers deliberately withhold selective information about contraceptive options to bias contraceptive decision-making, were 2 key new findings. Women also reported interest in visual aids accompanying verbal contraceptive counseling. Pregnancy attitudes and history of reproductive and sexual coercion also influenced contraceptive decision-making and reported interest in LARC methods.</p>

<p><strong>CONCLUSION: </strong>Comprehensive counseling about all contraceptive options, including LARC, are important for targeting the perceived gaps in contraceptive education and care among homeless young women.</p>

<p><strong>STUDY OBJECTIVE: </strong>We sought to investigate the associations between race and/or ethnicity and young women's formal sex education and sex education by parents.</p>

<p><strong>DESIGN, SETTING, AND PARTICIPANTS: </strong>Cross-sectional analysis of a nationally representative sample of 1768 women aged 15-24&nbsp;years who participated in the 2011-2013 National Survey of Family Growth.</p>

<p><strong>INTERVENTIONS AND MAIN OUTCOME MEASURES: </strong>We assessed 6 main outcomes: participants' report of: (1) any formal sex education; (2) formal contraceptive education; (3) formal sexually transmitted infection (STI) education; (4) any sex education by parents; (5) contraceptive education by parents; and (6) STI education by parents. The primary independent variable was self-reported race and/or ethnicity.</p>

<p><strong>RESULTS: </strong>Nearly all of participants (95%) reported any formal sex education, 68% reported formal contraceptive education, and 92% reported formal STI education. Seventy-five percent of participants reported not having any sex education by parents and only 61% and 56% reported contraceptive and STI education by parents, respectively. US-born Hispanic women were more likely than white women to report STI education by parents (adjusted odds ratio&nbsp;=&nbsp;1.87; 95% confidence interval, 1.17-2.99). No other significant racial and/or ethnic differences in sex education were found.</p>

<p><strong>CONCLUSION: </strong>There are few racial and/or ethnic differences in formal sex education and sex education by parents among young women.</p>