In this episode, KJK Student Defense attorneys Susan Stone and Kristina Supler talk with Dr. Michelle Forcier, a Professor of Pediatrics, Assistant Dean of Medicine at The Warren Alpert Medical School of Brown University. Dr. Forcier specializes in gender, sexual and reproductive health. In this episode, they talk about what all the terms of LGBTQ+ mean, how pediatricians work with parents and children about gender identity, and resources for parents to learn more about this complicated issue.
3 Main Points:
- What do all the terms in LGBTQ+ mean
- How Pediatricians work with Kids and Parents about Gender Identity Issues
- Things for Parents to Consider When Faced with this issue.
- (04:12) Understanding the Gender Terminology within LGBTQ+
- (06:59) How Does Type of Care Different from Heteronormative
- (09:27) Assigned Gender versus Gender Identity: What is the Difference?
- (12:16) Is the Child Just Playing With Identities? Or Do We Need to Act?
- (15:02) When Does a Physician Decide if Hormones are Required?
- (16:44) Do We Want Puberty in Children to Happen Later?
- (18:11) How Pediatricians Work With Children to Keep Them Safe
- (19:15) What are the Side Effects of Hormones?
- (20:52) Blockers: What Do They Do?
- (22:43) Conversations with Parents Who Are Not on Board with Hormones or Blockers
- (24:45) When Do Children Go Through Surgery?
- (25:32) When Surgery for Minors may be Necessary
- (27:46) What are LARCs? How Do They Prevent STIs?
- (30:36) Dual Method for Birth Control and STI prevention
- (31:46) Consider This Thought If Your 14 Year Old Child is Sexually Active
- (34:19) Resources for Parents to Learn More
Susan Stone: So everybody out there listening to this podcast know that my, this is Susan and my daughter got married this weekend, and I’m a little tired.
Kristina Supler: though you think everyone knows that. Everyone doesn’t actually know that.
Susan Stone: I know, but I felt the need. This is Real Talk guys out there on listening land. I am exhausted. But I had to come into work today cuz they knew that we had, the books, the recording of this podcast. And we’re gonna talk about pediatric health for the L G P.
Lg, I told you I’m tired. BTQ Plus community and I, Kristina, I just wanna have a conversation about the health needs and not a political conversation.
Kristina Supler: Yeah. I’m really looking forward to today’s episode because I think there’s so muchto talk about and learn to have more real conversations about the issues versus some of the politicized language that has pushed people into corners and people have in many ways shut down and are not open to learning new information.
Susan Stone: and I think we’re just forgetting that we’re still talking about kids. So why don’t you kick off the guest so we can just launch in and talk about whatever the health needs are of the kids and guys, let’s leave the politics out. Okay? For once.
Kristina Supler: Today we are really happy to be joined by Dr. Michelle Fourier, who is an associate professor of pediatrics and an assistant dean at the medical school at Brown University.
And with extensive training and experience in adolescent health and sexual healthcare, she’s dedicated her career to addressing the unique needs of the LGBTQ plus youth.
Susan Stone: That is the guest we needed for today’s podcast, a Doctor.
Dr. Michelle Forcier: So let’s jump in.
Susan Stone: Let’s just jump in. Dr. Fourier, can you explain exactly what you do for that population?
Dr. Michelle Forcier: I have been a pediatrician for about 25 plus years. And I’ve been providing gender, sex and reproductive justice care, basically across the lifespanfor this period of time. And it’s been a pretty exciting, community, pretty wonderful and satisfying community to work for and to work with.
And the way I look at providing care for the L G B T Q community is that it really is primary care. Basically gender and sexuality are part of human identity. And they’re there before we leave the womb. There’s a neat study about in utero masturbation, which is kind of cool. So we get started early and we are gendered and sexual persons, until we die.
So if we look at gender and sexuality as being a ubiquitous part of the human experience, and we look at biology as absolutely diversity is a part of biology. It’s one of the basic tenets of biology. Then we understand that both sex and gender are gonna be diverse experiences for a range of different people and folks.
And my role has been to provide care for some of our most marginalized community members, which is the L B G T Q I A plus. Sometimes it’s easier just to say rainbow population. I like that.
Kristina Supler: Before we dive in further, just to get some terminology nailed down for our listeners who maybe aren’t as familiar. you’ve spoken about gender and sex and we’re referencing the plus, but can you just define those terms for our listeners, particularly the plus as well?
Dr. Michelle Forcier: Sure. For many gender has been considered in this very binary, traditional way of male, female. Or heterosexual and homosexual. Sexuality is about who we love and who we’re attracted to and who we have different sexual behaviors with. Gender is who we are. It’s a part of our identity in terms of being masculine, feminine, non-binary and all the other ways that we could express, a gendered self.
And the world for many years has been pretty limited in terms of only discussing these binary identities. I think with time, with improved social discourse, with the advent of the internet and increasing knowledge spread in, in diverse ways and diverse communities, we understand that there are many, many ways to be sexual and many ways to be gendered.
So the L stands for lesbian, which are persons, we might say women who are attracted to or have sex with women. Gay usually is referenced to either, males or females who are attracted to the same gender partner, bisexual, historically has been the term for people who identify as being attracted to both males and females. But now we have even more inclusive terms, which are things like pansexual, which means gender doesn’t factor into who I’m attracted to. Transgender or gender diverse are persons whose gender identity doesn’t exactly match the gender they were assigned by their parts, chromosomes or hormones and birth.
I is another. Initial for intersex or persons who have differences, in sexual development in the parts and organs they were born with. And A can mean asexual or persons who really don’t have a sexual affinity or an interest in, sexual activity.
allied, And the plus means there are probably a million different ways, and we know there are a million different ways people may identify in terms of how they see themselves as a gendered person and their gender expression and gender role and gender self in the world, as well as their sexual, um, attraction, their sexual behaviors and their sexual identity in the world.
Susan Stone: That’s a lot. That’s a lot. But here’s messy. Something that comes into my mind, because you are a pediatrician. How do those differences make a difference in terms of just treatment for well visits? What is, what type of care is specific and unique to that population as opposed to what I would call a heteronormative child.
Dr. Michelle Forcier: Sure. to be honest, in any visit, and again whether it’s children or whether it’s adults, we should be talking about these aspects of selfhood and behavior and health needs across the lifespan. Of course, we should do it in a developmentally appropriate way. So if we’re gonna talk to a six year old about their gender identity, we might ask them, they’re like, what is it like to be a boy or a girl?
How does that feel to you? How do you express boyness? How do you express girlness, For a 16 year old, that may have very different words in terms of, how do you view your gender identity? What parts of it are comfortable for you, what parts are not comfortable? Do you have any questions?
Again, the same with sexuality. Who might you have a crush on versus, a full sexual history forlater teen or young adult who’s sexually active with one or more partners. So it’s all about, again, using the language of the patient and understanding where they are developmentally to continue to talk about these aspects of both selfhood and wellness during health visits.
Susan Stone: Well, I guess I wanna press you on that because I’m a mother of three. And I would say for the first 14 years of, checkups. It’s, you know, height, weight, weight, vaccinations,
Kristina Supler: poking and prodding,
Susan Stone: poking and prodding, talking about school and milestones. We really,
Kristina Supler: or at least that was your experience with your child’s children’s pediatrician.
Susan Stone: Yeah, but I just don’t rem I don’t think conversations regarding sex came into play until when the making a decision about the H P V vaccine or maybe when does menstruation start for that being the end of growth? I guess that’s what I’m confused. Or birth control when that comes in. But other than that, I think of, how big is the baby?
Dr. Michelle Forcier: And I’m thrilled that you ask about this. Because what I’m proposing is a slightly more advanced model of care in the sense that, again, if we know that there is gender diversity in the world and some youth present as gender diverse, gender exploratory as early as four, five, and six. Shouldn’t we be talking to parents about, say again, educating people?
Your child who is assigned male or female at birth. But we don’t know what their gender identity may be later down the line. And that’s the one or two sentences that a pediatrician can have with a parent to, again, describe and educate the difference between an assigned gender at birth and the fact that potentially two or three of probably more percent of the population of young people are going to be, or exploring gender, or at least talking about it over time.
Then when we know that many youth undergo puberty and it’s considered normal. As early as seven or eight year old, you can start having breast buds. By age seven or eight, it’s considered within the normal range. You can be having a period by the age of 10. So if you’re waiting for the magic number of teen years, 13, you’ve missed a whole bunch of folks that have already started many and of the stages of puberty and actually maybe completely, adult in their hormones and progressing toward adulthood very quickly in terms of their bodies.
So by waiting till kids are teens until quote unquote, they’re ready to be sexual or ready to go through the process of puberty, we’ve missed the boat in preparing both parents and kids for helping their children approach adolescence, approach the changes of puberty. Approach the concepts of being a gendered or a sexual person in a healthy and supportive way.
Think about it. Wouldn’t it be easy as a parent or easier as a parent to talk about sexuality when it’s theoretical? Versus you’re coming in because your daughter’s pregnant and you didn’t even know she was having sex?
I would prefer to talk with kids in a developmentally appropriate way over time. So that kids are prepared to make decisions and that we’re not going back and saying, okay, now we need to deal with an issue. Now we need to deal with a problem. Now we need to deal with some sort of health need versus let’s talk about anticipatory guidance.
Let’s have our kids be healthy.
Susan Stone: I know that you are involved in giving T blockers or hormones.
Kristina Supler: Oh, I was gonna ask about that.
Susan Stone: Yeah. I’m really curious, when do you decide that’s appropriate? What are the side effects? Are they safe and are they safe? And also, how do you know, and this is a lot, that a child’s just not playing with identities and trying on what suit fits because there is discussion versus this is real and we need to act.
Dr. Michelle Forcier: Sure. So we know that gender play trying on identities is common among kids. It’s how again, we explore and figure ourselves out. But every kid that plays with their gender identity and gender rules and gender expression doesn’t get hormones and doesn’t go to a clinician to go get hormones.
So if a child is really thinking hard and long about their gender identity, and oftentimes they’ll think about it quite a bit before they even talk to their parents, they’ll have that conversation with their parents about maybe the gender they were B with were born with doesn’t quite fit them. Or maybe it absolutely doesn’t fit them.
And we have kids really at young ages, just like they know their cisgender identity. We have some kids at very young ages know their transgender identity. Regardless as a parent, in some ways, it really shouldn’t matter what their gender identity is. What you want is to create a home situation and ideally again, or early clinical situation where kids and parents have lots of information so they can explore gender in whatever ways make sense for that child in a safe and healthy way.
If you look at the studies by Kay Olson, the Trans Youth, project, she shows that kids that grow up in supportive environments, kids who present early as gender diverse and exploring gender identity, she demonstrates that they look just like their cisgender peers in terms of anxiety and depression growing up in supportive households.
Now a supportive household doesn’t care. The endpoint is a happy and safe child. It doesn’t matter which directions the child goes in terms of gender identity, because as an accepting and loving parent, I don’t care what their gender identity is. I want my child to be authentic.
I want my child to feel safe. I want my child to feel loved. I want my child to feel heard and respected. And it doesn’t matter what their gender identity is. They’re my child.
Kristina Supler: Is there an average age when the research shows children start to explore gender identity and conversations are starting to be had within households or is it different for everyone?
Dr. Michelle Forcier: It’s different for everyone. I’ve had 80 year old patients come to me and say, now is the time that they’re ready to start their gender affirmation process.
Susan Stone: But I do wanna press back on the question. Yeah. Because there are parents who do want to help their child. Yep. Good hormones are a health option. And I think Kristina’s question was a good one.
When does a physician make, how does a physician, and when does a physician make a choice that this is appropriate and are they safe?
Dr. Michelle Forcier: It’s not based on age. It’s based on need. And so a patient will go through a very thorough evaluation. People don’t just walk in clinic and get a shot of puberty blockers, people.
Kristina Supler: What do those evaluations entail?
Dr. Michelle Forcier: Oh, long history. About home, about activities, about the family medical history, their medical history, their social history, substances, self harm and mental health issues, exposures at home, in school,
Kristina Supler: it’s like I assume questionnaires are given to children and parents as well.
Dr. Michelle Forcier: It depends. And I mean, I find that most kids would rather talk to me than fill out a piece of paper.
Susan Stone: Yeah. So we talk. So if you make the decision that it’s appropriate, what are the, the benefits and what are the risks?
Dr. Michelle Forcier: So the benefits, again, just remember we’re not having the same conversation about, say, kids that are using the same medication for precocious puberty.
Again, just to remind yourself in the context of avoiding political chatter, same medicine, kids not talking about it at all. So these are very safe medicines that have been around for many, many years. And we’ve used them in first, studied them with precocious puberty. Again, completely reversible.
Susan Stone: because Provo, is it true doctor, that precocious puberty, which just for our listeners who mm-hmm. don’t know what that is, that’s the onset of pub. Pub of puberty, very, very early at life. And we wanna delay that as much as possible because they’re now finding that, especially for females, you want a puberty go in later and menopause to be later.
Dr. Michelle Forcier: Well, you want puberty to be later for a couple reasons.
Number one, it would be really, really weird to have a fully feminized body at age six. Horrible. Yes. So they’re social as well as biological consequences. And these kids use puberty blockers far longer than many of our trans kids. Again without all the bruja about safety and effectiveness.
So puberty blockers basically are an hormone analog, and they fool glands in the brain to shut down and stop secreting the hormones that trigger ovaries and testes to secrete testosterone and estrogen, the sort of puberty hormones that start to create adult body and adult sort of physiology.
And by putting this temporary pause on those brain gland signals, the ovaries and testes just sort of rust. They stop secreting. And when we take away that hormone, the ovaries and testes start secreting again. So it’s sort of like putting a pause button on your Spotify or your, your music player.
Pause, lift it back up. The music starts right back where it was. It just has a delay in time.
Susan Stone: Have children ever gone back but forth and said to you, you were, they were on the medication and then said they changed their mind? Or do you see that when kids are evaluated, you make that choice, they’re happier, more fulfilled, and they’ll stay on it long-term?
Or is it across the board?
Dr. Michelle Forcier: It’s across the board. as a pediatrician, we wanna keep asking kids, is this the right path for you? Should we be doing this? Does this still help you figure out who you need to be, where you need to go? Or are, have you figured some of these things out and don’t need puberty blockers anymore?
Or have you figured these things out and now need gender hormones? It all depends on the child. So our job is not to push someone forward through gender hormones or puberty blockers. It’s to keep asking kids, what do you need? And that’s medicine 1 0 1 patient. Sure. What do you need? Where are we now?
Things change in our body. Things change in our heart and mind. We have to keep talking and listening to kids to find out what they need. So if they need to stop, they should. And if they need to, start again because stopping actually demonstrated that they are really uncomfortable with the changes of puberty.
Then, yeah, we can honor that request and honor their experience.
Kristina Supler: So what are the, what are some of the risks though, that can be attendant to taking these hormones?
Dr. Michelle Forcier: Well, the way I tell kids and parents having to come to the doctor to get a shot kind of stinks. So that’s a risk and that’s a bummer. Let’s see if kids start these medicines very early in puberty, there’s very little change in their internal hormone environment.
So they don’t have side effects like say, menopause, some hot flashes and some little bit of irritability as hormones are shifting.
Is growth impacted?
Growth usually, is, that’s a great question. Impacted in the sense that, trans boys may have the potential to grow a little bit taller because we’re gonna block estrogen’s effect on growth plates.
And for trans girls, again, we can work with them to look at again, their potential height or their, high trajectory to figure out how tall they are gonna be. And will that factor into, again, starting estrogen or gender hormones so we can use it again to inform our patients what their options are. So that they can be in a body that’s comfortable and safe for them.
Susan Stone: Well, is, are those blockers different than hor gender hormones to help, let’s say in a trans. Would it be a child who identifies as trans male wanting to be female? I hope, again, I’m terms right and forgive me if I’m getting ’em wrong. So if you want to help someone develop the other way, or maybe a female by birth sex, who wants to be a male, is that a different type of hormone or medication protocol?
Dr. Michelle Forcier: So blockers are used basically just to stop the current gonads, ovaries and testes from secreting, estrogen and testosterone. If a patient is either way past the beginning of puberty or a patient is on gender blockers, you know, puberty blockers, they can start the other hormones in the past referred to as cross-gender hormones to basically start the puberty that makes sense for them.
So if I am identifying as female, and I have been on puberty blockers, At age, say 13 or 14 or 15 or 16, whenever again that child, that patient says it’s appropriate for them, they have parent support and we all have a plan. They may start estrogen so that they can develop just like their peers. Which we think, again, has a positive health benefit in terms of, again, that congruence.
Socially with my body is developing just like my friends. I feel normal, I feel accepted, I feel like,I’m a part of my community. So for boys puberty usually happens a little bit later, so sometimes they might start their male testosterone hormones a little bit later, say, than females.
But again, It’s all dependent on when we first see a patient, how far they’ve gone through puberty, what they understand of their gender identity and where they are in terms of making a plan to affirm their gender identity or not, or just learn more and explore.
Kristina Supler: What do you say to parents who are in your office with the child and the parent you can tell, just isn’t on board with the child’s desire to start hormone therapy or whatever the circumstance may be. What sort of conversations do you have?
Dr. Michelle Forcier: Would that ever happen? Never. So yes, that happens quite frequently.
We have parents that want us to say, this is just a phase or a fad. Let me tell you, being transgender or gender diverse is hard in our culture. It’s hard. And when we see kids in our clinic, the vast majority of the time, they’re there for real issues, real goals, and real pain. And we need again to start with taking our patients at their word and carefully explore what they mean by their experience, their dysphoria or their goals.
So I tell parents, listen, you and I are coming from the same place. I want a safe kid, a kid who’s around alive participating in the world, the kid who’s healthy. Who’s mentally and physically healthy. We may come at it from slightly different approaches. You’re coming at it as I expected my child to be cisgender and to I wanna walk them down the aisle, at their wedding and they’re gonna have a baby and provide me with grandchildren.
And my job as that child’s pediatrician is to say, your child is telling me that their body, if it’s to continue to develop, say, into a female body, is gonna create such harm, such discomfort with their physical self, such anxiety and depression because in their heart and head they identify as male. And so we have to really listen to your, your child and hear what they say in terms of how do we explore the identity you were assigned at birth with the identity that you are telling me you experience now.
Susan Stone: When do you talk about surgery? When does that enter into the conversation? Because it’s, I think, One, I think it’s a very different conversation.
When do you start maybe blockers or hormones versus when do you actually put a child through radical surgery that you can’t reverse?
Dr. Michelle Forcier: Most children don’t go through quote unquote radical surgeries. In fact, children have far more radical surgeries for lots of other issues or problems, and they ascent to the process of surgery for whatever their healthcare needs, along with the consent of their parents.
So I think that’s the first thing to take that. would some children
Susan Stone: wa, I would say would wanna com complete the process right?
Dr. Michelle Forcier: But many children don’t have necessarily the support or the resources to necessarily go through some of the more major and intensive surgeries.
Vaginoplasty and phalloplasty creating a vagina and a penis are very intensive. People don’t usually do that until after age 18.
Susan Stone: Okay. So it’s not really a pediatric issue then?
Dr. Michelle Forcier: No. Now say there are some youth, and this is the more quote unquote common surgery, although again, with blockers, we don’t have to do this quite as often now is say a child’s developed breast at age seven or eight and say they identify longstanding as a trans male. Why? When they come see me at age 16, or they come see me at age 14 and by age 16 they’re gender dysphoria regarding their adult size breasts, which they’ve had now for eight years is killing them.
They’re not showering. They’re wearing a binder 24 7. They have suicidality and again, nothing’s changed in their gender identity. Why would I say you need to wait two more years until the magic number of 18 to have a male chest construction knowing that nothing has changed from age six to now 16, and you have had eight years of female breast tissue
That’s harmful. The harm in that is far greater than the harm of saying you’re 16, you’ve been through years of care with us. You’re gonna be as assessed by a surgeon. The surgeon may require other information before they do your surgery. And then through this long standing process, not I come in the clinic and tomorrow I have my chest removed, oftentimes months to years I get my chest surgery and I no longer have to wear a binder 24 7 and I can take a shower. And look in the mirror.
Susan Stone: So it can be a pediatric issue. Yeah. Something that a pediatrician. Okay. That’s all I wanted to understand. Yeah. Is this something that pediatricians deal with versus not?
Dr. Michelle Forcier: Not too often. And most of the time when we get to the point of surgery, again, there may be a number of people involved including gender specialists as well as including mental health people as well as the team that works with the surgeon. So we’re talking about a whole lot of people.
Kristina Supler: Dr. Forcier can you tell our listeners a little bit. I, in preparing for today, we came across the term or pneumonic I had never seen before. Lark.
Susan Stone: I looked it up too.
Kristina Supler: How do you work with this population in terms of contraception and tell our listeners what a lark is and yeah,
Susan Stone: Because a lark is not a bird, guys.
It’s an acronym.
Dr. Michelle Forcier: No, and it’s wonderful. It’s a long acting, completely reversible contraception. They are a little device we can put in the arm or an intrauterine device we put in the uterus. So the I U D, right? Yeah, exactly. They’re so effective in terms of preventing pregnancy.
Now we know that young people may not identify, they may identify as straight, but they have either same sex relationships. We also know that young women who have sex with women are actually at increased risk for STIs in pregnancy because they’re not prepared.
Susan Stone: Wait, wait. So I was gonna say, if you have a child who tells you that they’re interested in only sex with their own matching sex, not gender.
Mm-hmm. Because that can be an identity issue. Yeah. You know what? I have to be honest with you, Dr. I would think, why do I need to go down the contraception path?
Dr. Michelle Forcier: Because the data says that young women who have sex with women get STIs and get pregnant because they’re exploring well, but wait.
Susan Stone: But long act larks won’t prevent an sti I only condom use.
Correct. Or dances. They’re not
Dr. Michelle Forcier: having sex barriers prevent
Susan Stone: STIs. yes. But given we all know, we can all say that. But we are in the world. World and teens engage in sexual activity. I like the idea of a lark in terms of, you don’t have to depend on taking that pill and memory. You got, I gotta be honest with you though, it’s not as good though in terms of St I. Infection prevention, is it?
Dr. Michelle Forcier: No, it’s purpose is not to prevent STIs. To be like asking your microwave to show you a TV show. Your microwave isn’t gonna play Netflix. It’s a D, it’s a d it’s a device for a different purpose. So we need, so I feel like I’m missing about this. Talk about them as separate
Susan Stone: pieces.
Help me out. help me out. I’m getting confused.
Dr. Michelle Forcier: I dunno.
Kristina Supler: I’ll ask the dumb question. so I mean it’s essentially an i u d .
Dr. Michelle Forcier: What’s essentially an i u D? A lark. Well, no, there’s one that goes in the arm or and there’s one that goes in the uterus. There, there are different kinds of long, I was confused.
Thank you. Yeah. Got it. Cause it’s just about the location of the implant. Some young people don’t want people putting things in their uteruses. They don’t want a pelvic exam. They’re freaked out. And so that little rod in the arm that suppresses ovulation, wonderful. Very effective, very easy to put in and take out.
Kristina Supler: So it’s really about patient comfort and what the patient is more,open to.
Dr. Michelle Forcier: Shouldn’t that be patient care 1 0 1 anyway?
Susan Stone: Yes. Yeah. But, but, but we still need to insist that students are mindful of using condoms or other ways of preventing disease. So what do you recommend a LARC plus what
Dr. Michelle Forcier: I mean the lit well number when the literature shows that, dual methods are wonderful and especially dual methods of STI protection with some sort of barrier method or condom, internal external condom. Or again, a lark in terms of a long-acting reversible contraceptive.
So again,think about the story.
You have a parent coming in and she’s worried about her teen being sexually active, right? And she says, I don’t wanna, I don’t wanna allow her to have birth control, even though she tells me this is what she wants, cuz that’s gonna give her permission to have sex. Do you really think the parent allowing birth control gives that child permission to have sex?
Or do you think that child’s gonna make that decision to have sex on their own?
Susan Stone: You’re talking to two lawyers whose whole practice is dealing with students and issue sex issue. So and and I have to gather that people who listen to our podcast are well on the way of understand. I guess our questions are focused differently because really our parents all are very supportive of their students and their choices.
We’re very lucky that by large, by and large, not all of ’em, but. By and large. Yeah.
Dr. Michelle Forcier: but I think the main thing is your kid’s telling you they need something and you may not agree with the fact that you want them to be sexually active. Most of us aren’t super excited to think about like our 14 year old being sexually active, but I’m not a 14 year old.
But if my 14 year old is sexually active, I would really wanna make sure they had good birth control and I would really wanna make sure they understood things like consent. Saying no, saying you need to use a condom. And walking away from that encounter feeling empowered and safe. We don’t how Advocacy, yeah.
Yeah. If we don’t talk about sex and how to manage it, how are young people gonna make thoughtful decisions? And safe decisions.
Kristina Supler: What are some of the most promising or not promising, pressing health issues facing the lgbtq plus community today?
Dr. Michelle Forcier: I thought we weren’t gonna talk about politics and legislation.
so I’m gonna say health issue. Health issue. Health. Health issue. Yeah. Those are health issues though. Because those are about geographic and political access to care and a state by state basis.
Kristina Supler: So Access’s huge. Yeah, funda fundamentally just, it’s not even access so much access, the medicine or the science, it’s access.
Dr. Michelle Forcier: Sure. The science is actually a lot less exciting because the science is pretty consistent. In terms of avail, like different types of availability and access to care for larks is really important. The safety of abortion, the benefits, short term and long term of gender affirmative care.
The science, again, we’re not seeing there’s like a huge variance in terms of different outcomes in different studies. The outcomes are pretty consistent in terms of access to care improves outcomes. And a whole host of these sexual gender health issues.
Susan Stone: I have to tell you something. I learned something today because, I learned a lot. I did not know what a lot of these acronyms meant, and they’re missing, I have to be honest with you.
I like taking worries off the table and I did not think you had to worry about pregnancy when you have a child. I thought that, that’s, a huge benefit is that’s one issue off the table. Or I didn’t think about the s t I issue. So I thank you for educating me.
Kristina Supler: Absolutely. I think that this has been a really good discussion with a lot of information for our listeners.
And if, parents out there listeners want to learn more about you or any of your research or any good literature, where would you direct them?
Dr. Michelle Forcier: PubMed has lots of good information in terms of all the research. Not just me, but all the research that supports sort of making these types of decisions.
Up to date is a nice summary of different information about gender, sexuality, and reproductive healthcare. I’m happy to come on with you guys if you ever wanna have a question and answer session. This is really important stuff and I’m really excited to talk science and to talk evidence and to talk about listening to kids.
So I’m, I so appreciate what you’re doing and happy to be helpful in any way.
Susan Stone: Thank you, and I’m concerned. I can’t imagine, doctor, how many doctors in your area are across the country?
Dr. Michelle Forcier: I wish, that’s what, that’s why we keep talking about this healthcare being primary care. Primary care, pediatricians, family, medicine doc, nurse practitioners, we all should be comfortable talking about gender and sexuality because they’re a part of our lives and they’re a part of primary care.
Yeah. So we’re,
Susan Stone: I can, we’re doing more and more training. Yes. Yeah. We do need more discussion about this. Because like I said, when I think of a well visit with the child, I do think of weight, health, and, pumping meningitis, getting,yeah. Yeah. So thank you.
Dr. Michelle Forcier: My 14 year old did not wanna talk about pooping and peeing.
There were more pressing and more pertinent issues relevant to her life. Oh, than age 14.
Susan Stone: You need to spend a day at my house because, Pooping is an everyday conversation.
Dr. Michelle Forcier: Okay. And not that, I think it’s time to wrap it up.
Kristina Supler: Time to wrap it up. Dr. Forcier thanks so much for joining us and we, hope our listeners enjoyed this episode.
Dr. Michelle Forcier: Thank you. Bye-bye. Bye-bye.