Laura P. Richardson’s research while affiliated with University of Washington and other places

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Publications (87)


Transgender and Nonbinary Young Adult-Perceived Facilitators of Parental Consent for Gender-Affirming Medical Care as a Minor
  • Article

April 2025

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1 Read

Transgender Health

Kacie M. Kidd

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Nicole F. Kahn

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Peter G. Asante

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[...]

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Gina M. Sequeira







Indigenous, Black, and Latine Adolescents Disproportionately Experience Barriers to Pediatric Gender-Affirming Care

September 2024

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10 Reads

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1 Citation

Annals of LGBTQ Public and Population Health

Although prior studies have explored the barriers that transgender and nonbinary (TNB) adolescents experience in receiving gender-affirming medical care (GAMC), few have sought to understand how these barriers may differ among racial and ethnic minority groups. Accordingly, this study used data from a survey of TNB young adults (ages 18–20 years) to explore how barriers to GAMC during adolescence varied by race and ethnicity. Differences in the impact of 11 potential barriers when comparing the members of each racial and ethnic group with those who did not identify with that racial or ethnic group were evaluated using t tests. The results showed that Indigenous respondents indicated that parental unwillingness to consent for GAMC and attend a clinic visit and not being able to find a clinic contributed significantly more compared with those who did not identify as Indigenous. Black respondents indicated that not knowing it was possible to receive GAMC during adolescence and previous negative experiences in healthcare related to race or ethnicity contributed significantly more to their inability to receive GAMC during adolescence compared with those who did not identify as Black. Latine respondents indicated that parental unwillingness to consent for GAMC and attend a clinic visit, worries about cost, and previous negative experiences in healthcare due to race or ethnicity contributed significantly more compared with those who did not identify as Latine. Overall, the results suggest disproportionate barriers in access to GAMC during adolescence among Indigenous, Black, and Latine TNB individuals and illustrate a need for additional resources and interventions to promote more equitable access.




Citations (41)


... Some of the diversity in trans young people's embodiment is within group (i.e., not all trans girls desire to change their body), but more diversity in embodiment goals exists between subgroups of trans individuals. One study of trans young people in the US found significant differences between gender identity subgroups in the types of GAMC desired; for example, compared to trans women, nonbinary individuals were less likely to want both puberty blockers and gender-affirming hormones, but more likely to want only pubertal blockers (Sequeira et al., 2025). Result from a Canadian study of trans youth in clinical care found that while hormone therapy was desired by all youth attending clinics, surgery was not desired by all, and type of surgery differed by groups, with trans masculine youth wanting more generally top surgery, while trans feminine youth tended to desire more bottom surgery and nonbinary youth felt constrained by binary medical protocols (Pullen Sansfaçon et al., 2019). ...

Reference:

Navigating Normative Narratives: Understanding Familial Communicative Behaviors and Practices About Trans Young People’s Embodiment
Desire for Gender-Affirming Medical Care Before Age 18 in Transgender and Nonbinary Young Adults
  • Citing Article
  • May 2024

LGBT Health

... A large majority of the sample consisted of mothers (over 85%) compared to fathers and nonbinary parents, which is consistent with research in clinical populations. Approximately half of the youth sample identified as male/transmasculine (48.4%) compared to female/transfeminine or nonbinary, which is similarly consistent with research conducted in pediatric gender clinics (Kahn et al., 2024). See Table 4 for a full summary of participant characteristics. ...

Estimating Transgender and Gender-Diverse Youth Populations in Health Systems and Survey Data
  • Citing Article
  • May 2024

... Subspecialties as diverse as pediatric emergency medicine, 46 pediatric gastroenterology, 28 adolescent medicine, 47 and developmental-behavioral pediatrics 17 also called attention to the burgeoning pediatric mental health crisis. This epidemic existed before the coronavirus disease 2019 (COVID-19) pandemic and has subsequently worsened; the current system is not prepared to care for these children. ...

Child Health Needs and the Adolescent Medicine Workforce Supply: 2020-2040
  • Citing Article
  • February 2024

... often have one or more comorbid psychiatric disorders, as the features of ASD cause various difficulties in daily life [5,6]. ASD often has comorbid internalizing disorders such as depression and anxiety, but an occasional comorbidity is GD [5,7,8]. ...

Mental Health of Youth With Autism Spectrum Disorder and Gender Dysphoria
  • Citing Article
  • November 2023

... As in our findings, researchers in that study reported that predominant emotions about abortion restrictions included feeling scared and sad (42%), with reasons for these feelings ranging from favoring a right to abortion to concern for autonomy, safety, and choice [4]. Our study also contributes to knowledge regarding adolescent perspectives on genderaffirming care restrictions and access; past research with adolescents and parents has suggested similar negative emotions and concerns [20][21][22]. ...

Adolescent and Caregiver Perspectives on Receiving Gender-Affirming Care in Primary Care
  • Citing Article
  • September 2023

... Not surprisingly, given these striking shifts since 2018, the number of studies and topics covered has grown rapidly, as have gender-related clinical referrals (Expósito-Campos, et al., 2023;Jones et al., 2022). Included among the more recent publications are several systematic reviews or metaanalyses on specific topics related to the intersection of autism and gender diversity that were published during or after 2018. ...

Co-occurring Autism Spectrum Disorder and Gender Dysphoria in Adolescents
  • Citing Article
  • July 2023

... Despite an awareness of the need for comprehensive medical and mental health care for TGD youth, pediatric providers report a lack of confidence in their ability to provide care to this population [9][10][11][12]. This lack of confidence stems from insufficient clinical training and experience with TGD-specific care [9,10,12]. ...

Barriers Pediatric PCP's Identify To Providing Gender-Affirming Care For Adolescents
  • Citing Article
  • June 2023

Journal of Adolescent Health

... 11 Additionally, another study among Americans demonstrated that the rate of a positive depression screen was higher for those with insufficient sleep (OR =1.58). 39 Although the exact mechanism linking insufficient sleep and depressive symptoms remains unclear, several potential explanations exist, including altered neurodevelopment, 40,41 increased limbic system activity, endocrine and immune system disorders. 42,43 Among these mechanisms, neurocognitive factors and emotional memory need a special focus. ...

Associations Between Sleep Duration and Positive Mental Health Screens During Adolescent Preventive Visits in Primary Care
  • Citing Article
  • March 2023

Academic Pediatrics

... Several avenues for intervention emerge. Ricklefs et al. (2023) and the psychological toll noted by Hughes et al. (2023), it is evident that community collaboration and emotional support are intertwined. Providers and community leaders must unite to co-create protective spaces and robust mechanisms to counteract harassment. ...

107. Resources Pediatric Primary Care Providers Need to Provide Gender-Affirming Care to Transgender and Gender Diverse Youth
  • Citing Article
  • March 2023

Journal of Adolescent Health

... Traditional infrastructure, insufficient technology, and lack of psychological readiness were the primary barriers to its large-scale adoption [7]. However, the pandemic demonstrated telemedicine's effectiveness and potential impact in managing COVID-19, shifting global perceptions [8,9], and offering comfort, safety, and flexibility for timely consultations from home. ...

Telemedicine Utilization Among Transgender and Gender-Diverse Adolescents Before and After the COVID-19 Pandemic
  • Citing Article
  • February 2023

Telemedicine and e-Health