Funded Projects

Strengthening Gender-Affirming-Care Access for NYC Youth

Project Year

2025

City & State

New York, New York

Program Name

CATCH Planning

Topic

LGBTQ Health

Program Description

Problem and Overview:  Gender non-conforming (GNC) youth face significant barriers to timely and necessary gender-affirming care (GAC) in NYC and across the U.S. Despite NYC’s reputation as an LGBTQ+ hub, challenges such as social stigma, safety concerns, lack of knowledgeable providers, insurance denials, and restrictive parental consent laws persist. These barriers disproportionately affect marginalized racial and ethnic groups, youth experiencing homelessness, and those without supportive families, leading to delayed care and poor mental health outcomes.  This project aims to identify barriers and facilitators to GAC access through the perspectives of GNC youth and service providers in NYC. Findings will inform the potential development of a coalition of service providers, community organizers, and youth leaders to strengthen GAC access and improve outcomes.  Primary Setting:  The project focuses on GNC youth in NYC, particularly those engaged with LGBTQ+ organizations and homeless shelters. Collaboration with groups such as The Center, The Door, The Ali Forney Center, The Hetrick Martin Institute, and PFLAG will help reach youth most affected by barriers to GAC access.  Number of Children Affected:  Approximately 30-50 GNC youth aged 18-26 will participate, recruited through partnerships with five or more LGBTQ+ organizations and shelters.  Project Goal:  Using the Consolidated Framework for Implementation Research (CFIR Diagram, Figure 1), the project will engage GNC youth and service providers through focus groups to identify barriers, facilitators, and potential solutions to GAC access. Findings may support the establishment of a coalition of service providers, community organizers, and youth leaders in the post-award period. This coalition would initially focus on enhancing GAC access through networking, advocacy, and resource development, with the potential to generate long-term, sustainable solutions.  Proposal Objectives:  Objective 1: Develop community partnerships to identify participants and build collaboration  - Aim 1a: Partner with five or more LGBTQ+ organizations and shelters to engage youth and inform of GAC services at Mount Sinai AHC  - Aim 1b: Recruit participants for focus groups assessing GAC barriers and facilitators  - Aim 1c: Establish ongoing relationships for outreach and recruitment for focus groups  Objective 2: Conduct three to five focus groups with GNC youth (~10 participants each) in order to discuss perceived barriers and facilitators to GAC access and identify possible solutions  - Aim 2a: Use CFIR-informed focus group methodology with GNC youth to discuss barriers, facilitators, and solutions to GAC access   - Aim 2b: Conduct inductive qualitative analysis to identify key themes and prioritize prominent barriers and facilitators  - Aim 2c: Explore interest in forming an affinity group and coalition for improved collaboration and networking among service providers and youth  Objective 3: Conduct two focus groups with GAC service providers to explore barriers and facilitators to care   - Aim 3a: Conduct focus groups with service providers (e.g., community leaders, social workers, medical providers), using a similar CFIR-informed approach as in Aim 2  - Aim 3b: Utilize inductive qualitative analysis to identify key themes regarding barriers and facilitators  - Aim 3c: Triangulate these findings with our Aim 2 findings from youth focus groups to identify salient themes and proposed solutions that are common across both collaborator (youth and providers) groups  - Aim 4: Conduct member checking sessions and assess interest in forming a collaborative affinity group and coalition to address common barriers and advance tangible solutions to improving GAC access  Anticipated Outcomes:  1. Qualitative analysis identifying key barriers, facilitators, and potential solutions that are unique and common across youth and their service providers  2. Development of a collaborative network of GAC service providers, community organizers, and youth leaders 3. Creation of a working agenda for advocacy and resource development to enhance GAC access in NYC

Project Goal

Our overarching goal is to engage gender nonconforming (GNC) youth and their service providers to delineate the predominant barriers and facilitators to delivering gender-affirming care (GAC) in NYC and develop an agenda for addressing these barriers in the post-award period through a coalition of GAC service providers (physicians, social workers, and community leaders) and youth leaders aimed at improving the GAC experience for NYC's GNC youth. 

Project Objective 1

By March 2026, identify key barriers, facilitators, and solutions to accessing GAC for underserved GNC Youth in NYC by conducting focus groups with two different focus groups populations–racially and ethnically-diverse GNC youth participants from local LGBTQ+ youth shelters and community organizations (at least 10 participants in three or more groups), and GAC service provider participants from local community organizations and medical establishments (at least 10 participants in two groups)

Project Objective 2

Triangulate findings from Objective 1 focus groups to develop an agenda and proposed initiatives for collaborative advocacy efforts, sustainability, and continued partnership for improving GAC, particularly for underserved and marginalized youth in NYC 

Project Objective 3

By June 2026, recruit GAC service providers (community leaders, social workers, and medical providers), and GNC youth leaders to a newly established coalition and affinity group aiming to improve GAC in NYC with the plan to launch the meeting by reviewing the agenda and initiatives developed in Objective 2

AAP District

District II

Institutional Name

Mount Sinai Hospital - Mount Sinai Adolescent Health Center

Contact 1

Daniel Birkhead, MD

Contact 2

Sarah Wood, MD