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Abstract

School nurses provide support to all students within their schools. Children and youth who are exploring their gender identity need support from caring adults and their school environment. This article is the second in a series exploring the topic of gender identity and transgender youth.

Keywords

school nurses gender gender identity transgender gender-affirming care

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References

American Academy of Child & Adolescent Psychiatry. (2024, June). Policy statement on access to gender-affirming healthcare. https://www.aacap.org/AACAP/Policy_Statements/2024/Access_Gender-Affirming_Healthcare.aspx

American Medical Association. (2024). Clarification of evidence-based gender-affirming care H-185.927. Policy Statement. https://policysearch.ama-assn.org/policyfinder/detail/%22Clarification%20of%20Evidence-Based%20Gender-Affirming%20Care%22?uri=%2FAMADoc%2FHOD-185.927.xml

American Psychiatric Association. (2023). Diagnostic and statistical manual of mental disorders (5th ed.—TR). https://psychiatryonline.org/doi/book/10.1176/appi.books.9780890425787

American Psychological Association Council of Representatives. (2024, February). APA policy statement on affirming evidence-based inclusive care for transgender, gender diverse, and nonbinary individuals, addressing misinformation, and the role of psychological practice and science. https://www.apa.org/about/policy/transgender-nonbinary-inclusive-care

Bruce

Khouri

Bolze

Ibarra

Richards

Khalatbari

Blasdel

Hamill

J. B.

Hsu

J. J.

Wilkins

E. G.

Morrison

S. D.

Lane

(2023, August 9). Long-term regret and satisfaction with decision following gender-affirming mastectomy. JAMA Surgery, 158(10), 1070–1077. https://www.doi.org/10.0110/jamasurg.2023.3352

Coleman

Radix

Bouman

W. P.

Brown

G. R.

de Vries

A. L. C

Deutsch

M. B.

Ettner

Fraser

Goodman

Green

Hancock

A. B.

Johnson

T. W.

Karasic

D. H.

Knudson

G. A.

Leibowitz

S. F.

Meyer-Bahlburg

H. F. L.

Monstrey

S. J.

Motmans

Nahata

Nieder

T. O.

(2022). Standards of care for the health of transgender and gender diverse people, Version 8. International Journal of Transgender Health, 23(Suppl. 1), S1–S259. https://doi.org/10.1080/26895269.2022.2100644

Dai

Charleton

Boskey

Hughes

Hughto

Orav

Figueroa

(2024). Prevalence of gender-affirming surgical procedures among minors and adults in the U.S. JAMA Network Open, 7(6), e2418814. https://doi.org/10.1001/jamanetworkopen.2024.18814.

Dawson

Kates

(2025, June 18). Policy tracker: Youth access to gender affirming care and state policy restrictions. KFF. https://www.kff.org/other/dashboard/gender-affirming-care-policy-tracker/

Hedian

H. F.

(n.d.). Gender-affirming hormone therapy (GAHT). Johns Hopkins Medicine. https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/gender-affirming-hormone-therapy-gaht

10.

Hembree

W. C.

Cohen-Kettenis

P. T.

Gooren

Hannema

S. E.

Meyer

W. J.

Murad

M. H.

Rosentahl

S. M.

Safer

J. D.

Tangpricha

T’Sjoen

G. G.

(2024, October). Gender dysphoria/gender incongruence guideline resources. Endocrine Society. https://www.endocrine.org/clinical-practice-guidelines/gender-dysphoria-gender-incongruence

11.

Herman

Flores

O’Neill

(2022, June). How many adults and youth identify as transgender in the United States? The Williams Institute: UCLA School of Law. https://williamsinstitute.law.ucla.edu/publications/trans-adults-united-states/

12.

Hughes

L. D.

Charlton

B. M.

Berzansky

Corman

J. D.

(2025, January 6). Gender-affirming medications among transgender adolescents in the US, 2018–2022. JAMA Pediatrics, 179(3). 342–344. https://doi.org/10.1001/jamapediatrics.2024.6081

13.

Human Rights Campaign. (2023). LGBTQ+ youth report. https://reports.hrc.org/2023-lgbtq-youth-report

14.

James

S. E.

Herman

J. L.

Durso

L.E.

Heng-Lehtinen

(2024, February). Early insights: A report of the 2022 U.S. Transgender Survey. National Center for Transgender Equality. https://transequality.org/sites/default/files/2024-02/2022%20USTS%20Early%20Insights%20Report_FINAL.pdf

15.

Ladies Professional Golf Association. (2025). LGPA gender policy for competition eligibility. https://www.lpga.com/gender-policy

16.

Lee

Hobbs

Hobaica

DeChants

Price

Nath

(2024). State-level anti-transgender laws increase past-year suicide attempts among transgender and non-binary young people in the USA. Nature Human Behavior, 8, 2096–2106. https://www.nature.com/articles/s41562-024-01979-5

17.

National Association of School Nurses. (2025). Gender and sexual diversity supports in schools [Position statement].

18.

Newhouse

M. E.

(2025, May 9). Policy that let federal employees use preferred bathroom formally overturned by Trump administration. Government Executive. https://www.govexec.com/workforce/2025/05/policy-let-federal-employees-use-preferred-bathroom-formally-overturned-trump-administration/405206/#:~:text=Civil%20Rights-,Sean%20Michael%20Newhouse,%2C%E2%80%9D%20according%20to%20Friday's%20notice

19.

Olson

Durwood

Horton

Gallagher

Devor

(2022). Gender identify 5 years after social transition. Pediatrics, 150(2), 1. https://doi.org/10.1542/peds.2021-056082

20.

Ralph

(2022, December 6). How to cultivate a sense of belonging in schools. Edutopia. https://www.edutopia.org/article/importance-belonging-in-school

21.

Selekman

(2025). School nurse primer on gender identity and transgender youth: Part I. NASN School Nurse, 40(5).

22.

Sulaski

(2023, August 4). AAP reaffirms gender-affirming care policy, authorizes systematic review of evidence to guide update. https://publications.aap.org/aapnews/news/25340/AAP-reaffirms-gender-affirming-care-policy?autologincheck=redirected

23.

Thornton

Edalatpour

Gastm

(2024). A systematic review of patient regret after surgery—A common phenomenon in many specialties but rare with gender-affirmation surgery. The American Journal of Surgery, 234, 68–73. https://www.doi.org/10.1016/j.amjsurg.2024.04.021

24.

Trump

(2025). Executive order 14190: Ending radical indoctrination in K-12 schooling. Federal Register. https://www.federalregister.gov/documents/2025/02/03/2025-02232/ending-radical-indoctrination-in-k-12-schooling

25.

Tucker

(2016, May 12). Obama directs public schools to accommodate transgender students. PBS News. https://www.pbs.org/newshour/nation/obama-administration-to-decree-transgender-access-for-public-school-bathrooms

26.

Van der Loos

Hannema

Klink

Heijer

Wiepjes

. (2022) Continuation of gender-affirming hormones in transgender people starting puberty suppression in adolescence: A cohort study in the Netherlands. The Lancet Child and Adolescent Health, 6(12), 869–875. https://www.doi.org/10.1016/S2352-4642(22)00254-1

27.

Vitali

Williams

O’Hara

M.E.

(2017, February 22). White House reverses Obama-era transgender bathroom protections. NBC News: White House. https://www.nbcnews.com/politics/white-house/white-house-reverses-obama-era-transgender-bathroom-protections-n724426

28.

Wright

Chen

Suzuki

Matsuo

Hershman

(2023). National estimates of gender-affirming surgery in the U.S. JAMA Network Open, 6(8), e2330348. https://www.doi.org/101001/jamanetworkopen.2023.30348

29.

Ybarra

Goodman

Saewyc

Scheer

Stroem

(2022). Youth characteristics associated with sexual violence perpetration among transgender boys and girls, cisgender boys and girls, and nonbinary youth. JAMA NetworkOpen, 5(6), e2215863. https://www.doi.org/10.1001/jamanetworkopen.2022.15863

School Nurse Primer on Gender Identity and Transgender Youth: Part II

Abstract

Keywords

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References