The Rheumatologist features an article written by HSS chief of pediatric rheumatology, Karen Brandt Onel, MD, and pediatric rheumatology fellows, Nayimisha Balmuri, MD, Jacob Spitznagle, MD, discussing whether rheumatologists should be asking their patients questions about their sexual orientation and gender identity.

According to the article, teens often struggle with psychosocial stressors involving mental health, substance abuse and sexuality, apart from any medical conditions. An especially vulnerable population of teens is the lesbian, gay, bisexual, transgender and questioning/queer (LGBTQ) community. Physicians have the unique opportunity to build relationships to help them navigate this challenging period of life.

Due to the lack of access to quality healthcare, gender nonconforming youth may resort to self-treatment by purchasing illicit parenteral and enteral growth hormones, estrogens and androgens, all of which “have been shown to intensify immune responses; therefore, inappropriate doses of these medications that are not being overseen by a physician may have increased consequences, such as exacerbating systemic autoimmune or inflammatory diseases”.

The writers conclude that the use of the HEADSS (home, education/employment, activities, drugs, sexuality, suicide/depression) assessment, including sexual orientation and gender identity-related questions, “can help normalize conversations with patients, offer more patient-specific and holistic treatment modalities for their rheumatologic illness and help establish an open dialogue regarding issues that may affect their overall well-being”.

Read the full article at the-rheumatologist.org.