AAP Voices Blog

Shelly was a very articulate and precocious 9-year-old who identified strongly from a young age as a girl. She was here for her first visit. She needed to get to know us, and we needed to build trust and offer resources for her and her family.

She was quick to educate a new intern who asked: “What sort of toys do you like to play with? Girl toys or boy toys?” with a side-eye glance and a clear redirection: “There are no girl or boy toys. There are just toys!”

I offer all my patients the option to “hire me or fire me” as their provider during these first visits, and Shelly decided to hire us and continued to delight us with her insight and charm.

I am constantly amazed by what my LGBTQIA+ kids say to me in clinic. I wondered how easy it was for many of them to walk through the door for some heartfelt and honest discussions. As someone who did not grow up with safe spaces and people with whom I could share thoughts, feelings, and fears about tough, sensitive, and private concerns, I admire these fearless youth who continue to bravely come to clinic and are open to having these conversations.

“We, as pediatricians, really need to continue to raise our voices and shout louder than the ignorant and bigoted people making threats and discriminatory proposals to silence youth and shut down access to important medical care.”

I have been thinking about this lately amid the media and political chatter about closing those doors to communication, to access, and to validation. We, as pediatricians, really need to continue to raise our voices and shout louder than the ignorant and bigoted people making threats and discriminatory proposals to silence youth and shut down access to important medical care. We need to make an extra effort to make sure our kids hear us above the din of politics and know that all children should be listened to, respected, accepted, and loved for their very wonderful, unique, authentic selves.

In honor and recognition of this brave generation, I think back to moments of openness, trust, and compassion that Shelly and my other patients have shared with me over the years.

A transgender teenage boy shared with us the important experience of his “baptism” or new name ceremony at his church. The parents and patient really glowed as they talked about how their faith rose to greet them. And how that inclusion and acceptance and celebration made them even closer to their community, and their god.

A young adult in our program easily recounted some experiences with sex and that, for them, getting HIV was less important than having sex without a condom. He was smart; he knew about HIV and that condoms prevented this infection. As a medical provider, it took a moment to really appreciate the door he opened, and not go full on into prevent-disease-doctor mode. I used the wisdom a social worker colleague taught me, and by using silence (counting to 10), we created a space in which an honest and respectful patient-centered conversation could happen

Terry went through her college experience without much support from her mom and dad. In addition to graduating with honors in neurosciences, she built a network of chosen family and friends. During clinic, Terry would share episodes of such apathy or antipathy from her mother, that we would both begin to tear up and swallow a hard lump at the back of our throats. Upon completing graduate school, we shared in her joy. We were all so proud, not just because of her academic achievements (despite lack of family support), but more so because she is as kind and compassionate as she is successful.

These patients, their shared stories, and their experiences of both joy and pain, have been such gifts in my professional life and in shaping my view of a world in which openness and acceptance are truly crucial for all persons to grow and thrive. The art of listening to your patients and waiting for them to tell you what they need. The ability to open our eyes, minds, and hearts to new things, uncomfortable things, and acknowledge the importance of another’s journey and lived experience is something we owe all our children and adolescents.

The role of family, both biologic and chosen, the place for schools and faith-based communities, and our ability as medical providers to create safe spaces is one of the most predictive factors in long-term positive health outcomes for our LGBTQIA+ kids.

All children deserve to be listened to and heard. I want to keep those doors open, those stories and shared moments coming, and grow even more safe spaces for youth to be their most wonderful, authentic selves.

I hope you’ll do the same, during Pride month and every month.

*The views expressed in this article are those of the author, and not necessarily those of the American Academy of Pediatrics.