Browse Family Systems and Communication

For professionals who work with children and adolescents, policies like Florida’s “Don’t Say Gay” law have outsized cruelty — even beyond the enormous harm they will do to the young people we serve.

A 16-year-old boy was seen in the infectious disease clinic for consideration of preexposure prophylaxis against human immunodeficiency virus infection. He identified as a cisgender male and reported having had more than 10 male sexual partners. He requested that the content of the visit remain confidential. Management decisions were made.

The 11-year-old girl knew that her mother had cancer, but it fell to me to tell her that the cancer had spread to her mother’s brain. Breaking such devastating news to a patient’s young child is not normally my job, though I am no stranger to devastation.

A sliver of light interrupts the dark and marks this room as foreign. In this hospital bed, I listen to voices that are too loud for nighttime. This room, this night, this bed, feel like a punishment. The crime is clear to me: I have eaten too much sugar on...

If U.S. social spending levels are similar to those of other high-income countries and health care spending is higher, why does U.S. health lag behind? Our social spending mix may be skewed so investments have less impact on population health outcomes than they might.

Despite long-standing opposition among professional medical organizations and documented harms, most states have not banned conversion therapy — efforts to change people’s sexual orientation — for minors.

As part of an ongoing effort to deter immigrants from attempting to enter the United States, a new government proposal would permit the detention of noncitizen children and their families for indefinite periods in facilities without appropriate and independent monitoring.

Patients reveal their most personal and painful life experiences when we build trusting relationships and encourage open dialogue. But how can we encourage the dialogue required for trauma-informed care in today’s health care climate?

In this letter, the authors report no differences in the mental health of 25-year-olds conceived through donor insemination and enrolled prenatally in a large, prospective study of children of sexual-minority parents, as compared with an age-matched normative sample.

As Hannah was wheeled out of the ICU, the transport nurse whispered, “I can’t get the oxygen saturation monitor to pick up much of anything.” I paused. Was Hannah already dying? Should we turn around and deny her parents their last hope? “Let’s keep going,” I said.

As his colleagues perform a code on his 2-year-old daughter, a frightened young physician finds himself unmoored from time and space. Then he draws on the recalled strength of his patients and their families, overcome by a new empathy.

Though he no longer claims the policy would aim to deter other migrant families, Secretary of Homeland Security John Kelly has left open the possibility of separating children from their parents at the border — threatening children’s growth, health, and well-being.

Evaluation of infants and young children for suspected inflicted trauma includes a careful history; examination of the skin, oral cavity, and fundi; brain and skull imaging; a skeletal survey; assessment of hepatic and pancreatic enzymes; and abdominal CT if abdominal trauma is suspected.

A pediatrician who assesses children for possible abuse constantly grapples with uncertainty as she weighs the evidence to differentiate inflicted and accidental injury, refusing to let the gravity of her decisions or her emotions sabotage her actions.

Commercial sexual exploitation and sex trafficking of children and adolescents have both immediate and long-term physical and mental health consequences. A new IOM–NRC report argues that clinicians can help prevent these crimes and identify and respond to the victims.

More than 15 million U.S. children live in families affected by intimate partner violence; about 7 million witness severe violence, such as the assault of one parent by another. Exposure to such violence has been linked to higher rates of physical health problems.