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We wish to offer comment on “Health Disparities Facing Transgender and Gender Nonconforming Youth Are Not Inevitable” by Daniel Shumer, which summarized findings from a previous empirical study (doi: 10.1542/peds.2017-1683). In their companion editorial, Shumer offered speculations regarding the size and characteristics of the transgender and gender non-conforming (trans/GNC) youth population. First, we begin at a place of agreement; we agree with Dr. Shumer in their assertions that health inequities for trans/GNC youth are avoidable and that all health care providers, school systems and communities should be prepared to serve trans/GNC youth. Second, we offer some caution and advice related to estimation of the size and characteristics of the trans/GNC population. Schumer’s commentary drew the conclusion that the size of the trans/GNC youth population has either grown significantly or that previous reported population sizes were gross underestimates. The research of the authors of this comment were cited as evidence of this major population shift or as examples of previous underestimates. However, Shumer’s statement was based on a misunderstanding or misrepresentation of prior work in this area.
We highly value the scientific process and appreciate that scholars will employ different techniques and operationalize these constructs in varied ways. In addition to scholars and practitioners, the size of the trans/GNC population is of great interest to the media, inc...
We highly value the scientific process and appreciate that scholars will employ different techniques and operationalize these constructs in varied ways. In addition to scholars and practitioners, the size of the trans/GNC population is of great interest to the media, including major media outlets like the Associated Press, the New York Times, CNN, and NPR. These news organizations reach thousands of readers and listeners every day, and as a result of Shumer’s companion editorial, engaged in widespread misinformation about the size of the trans/GNC youth population. Promoting findings that are unreliable or lack appropriate context or caveats can undermine the overall credibility of the study in question and other related studies that might inform public policy. Given this, we think it is important to help the public health field, practitioners and community groups understand the nuances of how to interpret findings from different studies related to the size of the trans/GNC population.
The Minnesota study cited by Shumer was based on a survey that used an experimental version of a more commonly employed measure to identify transgender youth. Previous studies attempting to estimate the size of the transgender youth population have included those who either identified as transgender or those who reported a sex assigned at birth different from their current gender identity. The Minnesota survey identified youth who considered themselves to be transgender, genderqueer, genderfluid, or unsure about their gender identity. Therefore, this definition of gender minority youth is a much broader population than has been defined in other studies.
The inclusion of the same measures over time in population-based surveys will allow us to make statements about the size and any observable changes in the trans/GNC youth population. Until then, we encourage researchers to continue to employ best practices for measurement development and the reporting of results, and clinicians to continue to work toward better health care, access to support, and freedom from anti-trans bias for trans/GNC youth.
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