“Some come in, need our services briefly and leave, and some are with us longer,” she said. Parents and kids aren’t always on the same page, and sometimes kids just need time and support to figure out their own identity without being pushed, she said.
Mittleman is investigating the determinants of sharps-related injuries in healthcare.
Support for the patient and family are important throughout the patient’s “journey,” Middleman said. Mittleman’s group interviewed over 1,100 patients with acute traumatic injury to the hands in a variety of industrial sectors and evaluated the role of transient risk factors in the workplace (16-18). Some youths also decide to get “top surgery” - sculpting the chest - but relatively few get “bottom surgery” to reshape their genitalia, at least until adulthood, she said. If parents don’t consent, youths can pursue hormone treatment themselves after they turn 18. Only after kids have come to a firm conclusion about their gender identity, and their parents agree, do they consider hormone therapy, Middleman said. “There’s no harm in affirming your kid and letting them explore,” she said. Giving kids time allows them to hold off many of the changes of puberty until they are sure about their gender, but also prevents pushing them prematurely toward hormonal treatments that carry their own irreversible side effects, she said. Some families decide to use medications to pause puberty or menstrual cycles for kids who need more time to explore their identity, Lawlis said. The process for those still figuring out their identity always starts with supporting parents and youths as they explore the least-invasive changes, such as using a different name and pronouns, or changing the way they present themselves with hairstyles, clothing and cosmetics, Middleman said.
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