v LGBTQ+: Support and Care SERIES INTRODUCTION Michelle Forcier (she/they), MD, MPH AAP Section on LGBT Health and Wellness Professor, Division of Pediatrics, Alpert School of Medicine, Brown University, Providence RI with an acknowledgements of my privilege as a white, able, queer, gender-expansive and medically educated person living in land belonging to Narragansett, Wampanoag, Niantic, Nipmuc, Pequot indigenous peoples. Ilana Sherer (she/her), MD AAP Section on LGBT Health and Wellness, Pediatrician, Palo Alto Medical Foundation, Clinical Faculty, Pediatrics, University of California San Francisco. White, queer, cisgender, educated person living on Ohlone land. In 2012, the Human Rights Campaign released the results of a survey of more than 10,000 LGBT teenagers.1 The statistic that haunts us from that report is the percentage of youths who believed they could be happy as an adult if they stayed in their current city or town—a little less than half, compared to 86% of their heterosexual/cisgender peers. This inability to envision a happy future is, we believe, at the basis of the health disparities described in the articles included in this special 3-part edition of Pediatric Collections, entitled LGBTQ+: Support and Care. It is the murder of Matthew Shepard in Wyoming in 1998. It is the murder—by her classmates— of Gwen Araujo in California in 2002. It is the suicide of Tyler Clementi in New Jersey in 2010. It is the suicide of Leelah Alcorn in Ohio in 2017. It is the faces of those who died in the Pulse nightclub in Florida in 2016 that our youths have grown up with. How can we expect them to grow into healthy adults with these images seared into their minds as images of their LGBTQ future? This is where the research presented in this collection can help us zoom in on opportunities to promote resiliency, health, and optimism to allow our youths to grow into healthy and happy adults. This 3-part series provides a framework with which to understand the growing evidence relating to the lived experience of our LGBTQ+ youths and families. This population experiences tremendous health disparities, which is best understood under the lens of minority stress and trauma. LGBTQ+ communities have faced unique and hostile stressors related to systemic homophobia and transphobia, and as a result they suffer long-term health consequences. It is important for providers to recognize the profound ways in which our field of medicine has perpetuated this stigma and traumatized LGBTQ+ individuals by pathologizing their identities and creating unnecessary barriers to care. In the face of these obstacles, however, LGBTQ+ individuals also have displayed remarkable resilience. Each child and each family has stories and journeys of identity, and that diversity and individuality is a ubiquitous aspect of child and human development. Pediatric providers can model and celebrate the diversity that is an expected and welcomed aspect of biology, humanity, and community. Providing trauma-informed care in the effort toward health justice for LGBTQIA++ children and families is a form of social justice work that we all can participate in. We present this information in 3 parts. Part 1 provides background information about bias and discrimination that contributes to the minority stress impacting our LGBTQ+ youths both on an individual basis, such as bullying, and on a systemic level, such as restricting access to appropri- ate restroom facilities. Part 2 will offer more information about LGBTQIA++ lived experiences that affect both short- and long-term health. While historically, evidence has focused on risks and poorer health outcomes for gender and sexual minoritized persons, this section will offer opportu- nities for pediatricians to understand ways to promote resiliency and healthier outcomes for our patients. Part 3 is focused on gender diverse youths, a growing population who will benefit from LGBTQ+: Support and Care
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