Cultural Considerations in the United States

Gender identity is a term that eludes research precision and represents a wide range of experiences and definitions. Similarly, gender-diverse youth are increasingly racially and ethnically diverse and hold an abundance of intersectional identities. As research attempts to clarify these groups’ unique vulnerabilities and resilience, some trends are clear. For both clinician and patient, approach of topics such as race may be fraught for a variety of reasons and require clinical vigilance and humility. With their potential for support and rejection, exploration of family, spirituality, and other emotionally salient areas of identity may be useful in appraising risk-mitigating influences of youths’ mental and physical health. Cultivation of a clinical style and space that keeps privacy and safety at its core, emphasizes gender-affirming communication, and acknowledges rejection sensitivity may serve as a fruitful frame for exploring these visible and invisible identities within gender in service of this diverse population.