“I Don’t Know if I Would’ve Made It Through High School Without It”: Transgender Adolescents’ Perspectives on the Impact of Gender-Affirming Care

Purpose: Research suggests that gender-affirming medical care (GAMC) is associated with improved health outcomes; however, there are increasing efforts to limit access to this care for minors. Little prior research has explored transgender and nonbinary (TNB) adolescents’ perspectives regarding the impact of accessing GAMC. The goal of this study was to understand the impact receiving GAMC as minors has had on the lives of TNB adolescents. Methods: Adolescents ages 14–17 who reported having received GAMC were recruited in August 2023 via their electronic health record portal account to participate in an anonymous, qualitative study. Participants completed an electronic survey containing two open-ended questions about how accessing GAMC in adolescence had impacted their life. Free-text responses were reviewed to develop a de novo codebook. Each response was coded and themes were generated iteratively using an inductive thematic analysis framework. Results: In total, 60 adolescents (82% White, 55% identified as a boy or man) completed the survey. Three themes and two subthemes were identified from participants ( n = 60): (1) Congruence, involving ways accessing GAMC enhanced alignment between their gender identity and physical appearance and their ability to self-love, (2) Mental Health, describing how receiving GAMC impacted adolescents’ mental health, and (3) Thriving, focusing on how GAMC impacted adolescents’ ability to engage with others and become more future-oriented. Conclusions: Findings from this study highlight the positive impact GAMC has on adolescent mental health and social well-being and thus add to our growing understanding of the impact of GAMC and the possible harms associated with limiting access.