Journal of Pediatric Surgical Nursing

The acronym LGBT (lesbian, gay, bisexual, and transgender) has expanded to LGBTQIA (lesbian, gay, bisexual, transgender, queer or questioning, intersex, and asexual or allies). The health needs of this community are often grouped together, yet each of these letters represents a distinct population with its own health concerns. Youth who identify as transgender usually experience multiple physical, psychological, and social challenges from childhood through adolescence. Gender-affirming surgical interventions improve both one's mental health and one's quality of life for those who are transgender but often occur later in the transgender journey. This article will focus on the healthcare needs and experiences of transgender youth in the school setting before coming to the attention of the surgical team.

Supplemental digital content is available in the text.

This article will review the pharmacology used for patients with gender dysphoria who wish to use puberty blockers or cross-sex hormonal support. Dosages, proper usage, adverse effects, and monitoring parameters for each treatment period are described.

A growing number of young people identify as gender diverse, both as transgender and nonbinary. In addition to gender-affirming care such as puberty blockers, hormones, and gender-affirming surgeries, these youth also need to access the full range of other medical and surgical care. As such, it is critical for pediatric healthcare providers to develop competence in working with gender-diverse youth, regardless of whether the facilities they work offer gender-affirming medical or surgical care. This article addresses perioperative care concerns for gender-diverse youth as well as psychosocial assessment for gender-affirming surgeries.

Gender affirmation surgeries have become increasingly accessible over the past decade, and more youth and young adults are seeking surgical solutions to align their physical characteristics with their gender identity. This article describes several major types of gender affirming surgeries, reviews the guidelines outlined by the World Professional Association for Transgender Health, and covers practical surgical care concerns. It is addressed to the healthcare provider taking care of gender-diverse youth with emphasis on best practice guidelines, informed consent, and ethical issues in transgender medicine.

Supplemental digital content is available in the text.

Medically unnecessary female genital alteration (MUFGA) aka female genital mutilation or female circumcision is a cultural practice in several countries in the Middle East and Africa. There are four major types of MUFGA where parts of external genitalia of a girl are removed to varying levels leading to several complications such as infection, hemorrhage, obstetric complications, and even death. The United Nations has condemned this practice and called for abolition of MUFGA. However, this practice is continued in these countries, and when people migrate, they continue the practice. It is considered abuse or violation of human rights. Knowledge about MUFGA is scanty among health care providers in the West. This brief article attempts to raise awareness among health care providers, particularly nurses, so that they will provide the right care, both physical and emotional, to the girls and women who have experienced having MUFGA.