Primary care
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Transgender and gender diverse youth (TGDY) experience modifiable health disparities and difficulty accessing the physical and mental health care systems. Providers and staff should understand the unique needs of this population and provide affirming spaces where these resilient young people can thrive. In addition to addressing social, setting, and system level barriers to access, providers should consider offering comprehensive gender care because this reduces barriers to medical services and can improve health outcomes. This article educates providers about TGDY, reviews the role of mental health care, and provides an overview of medical interventions for gender affirmation.
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Review
Human Trafficking in Adolescents: Adopting a Youth-centered Approach to Identification and Services.
This article describes core design features of a youth-centered approach to care that 2 organizations-Mount Sinai Adolescent Health Center and Covenant House New Jersey-use to serve clients in nontraditional primary care settings and subsequently illustrates the ways in which this approach succeeds at identifying and serving youth who have experienced human trafficking. Primary care providers are uniquely positioned to connect adolescent human trafficking survivors to existing protection and treatment resources. The primary care community can adapt these interventions for adolescent patients who have experienced human trafficking and become key personnel on the frontline of recovery and prevention.
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This article describes the current scope of immigration to the United States, defines the different categories of immigrants, and describes the Centers for Disease Control and Prevention-mandated overseas and postarrival medical assessment of adolescent refugees. Guidelines for primary care physicians who care for refugee youth are provided, including diagnosis and treatment of common medical and mental health conditions. Special considerations in caring for this vulnerable population include acknowledging prior traumas, acculturation and challenges to education such as bullying, and adjustment to a new health care system that emphasizes preventive care in addition to curative medical care.
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Adolescents often experience trauma that can affect their daily function and lead to health-related issues and outcomes. However, medical providers receive limited training on the impact of trauma on adolescents and how to incorporate that information into treatment practices. ⋯ An overview of current assessments and evidence-based interventions to address adolescent patients' crisis needs is provided. In addition, recommendations for community referrals and partnerships that could improve the health outcomes of these youth are discussed.
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Child sexual abuse is a severely underreported crime in the United States. The consequences of child sexual abuse extend beyond physical injury, including an increased likelihood to develop chronic physical and mental diseases/disorders, including substance abuse and suicide. ⋯ Medical providers should know the response process their facility, community, and state practices for victims of sexual abuse. Acknowledging and responding to victims of sexual abuse as a multidisciplinary team will ensure comprehensive care for the patient.