Date of Award

January 2017

Document Type


Degree Name

Medical Doctor (MD)



First Advisor

Andres Martin


The approach to treating youth with an incongruence between their gender assigned at birth and their gender identity (i.e. ‘transgender’ youth) has evolved dramatically since the beginning of the millennium. This work is divided into four parts: part one highlights key milestones in the evolution of the psychological and medical treatment of such youth. Part two describes a series of projects intended to improve practicing child and adolescent psychiatrists’ care of these youth, and culminates with a statement written with and under review by the American Academy of Child & Adolescent Psychiatry, stating that therapeutics with the specific goal of promoting identification with a patient’s gender assigned at birth are unethical. Rather, practitioners should work with patients to explore the topics of gender identity and sexuality with no identity outcome as the desired goal. Part three describes an undergraduate medical education curriculum on the treatment of transgender youth that was created at Yale School of Medicine, intended to train a new generation of physicians competent in the care of this underserved population. This section culminates in a quantitative study that explores medical students’ knowledge of and ethical perspectives toward transgender pediatric patient care following the curricular intervention. It raises the question of whether didactic information alone is sufficient to develop cultural competency. Part four tells the story of a single transgender adolescent and will be published in the popular press to improve the public’s perception of and acceptance toward transgender youth.


This thesis is restricted to Yale network users only. This thesis is permanently embargoed from public release.