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Transgender and gender diverse children and youth experience significant health disparities and adverse health outcomes. Pediatricians have an opportunity to improve those outcomes by practicing gender-affirming care. This includes creating a welcoming environment through changes in office settings, intake forms, communication skills, language used, and support for families. Clinicians should be comfortable discussing social transition, puberty blockers, and gender-affirming hormone therapy with patients as needed. For clinicians caring for teenagers, adaptations in sexual health counseling and fertility counseling are necessary. Clinicians should also be aware of the trauma that has been historically inflicted by the medical and mental health system against people who identify as transgender/nonbinary, and that significant disparities exist even within this group along racial and gender lines. These aspects of caring for gender diverse youth are part of primary care pediatrics, and further education in these areas will improve access to care and health outcomes for these youth. [Pediatr Ann. 2021;50(2):e65-e71.]. [ABSTRACT FROM AUTHOR]

Electrophilic trisubstituted ethylene monomers, ring-substituted methyl 2-cyano-3-phenyl2-propenoates, RC6H4CH=C(CN)CO2 CH3 (where R = H, 2-CH3, 3-CH3, 4-CH3, 2-C2H5, 4-C2H5, 4-iC3H7, 4-C4H9 and 2,4,6-(CH3)3), were synthesized by the piperidine-catalyzed Knoevenagel condensation of ring-substituted benzaldehydes and methyl cyanoacetate, and characterized by CHN elemental analysis, IR, 1H- and 13C-NMR. Co-polymerization of the propenoates and vinyl acetate in solution with radical initiation (AIBN) at 70°C yielded equimolar alternating co-polymers. The composition of the co-polymers was calculated from nitrogen analysis and the structures were analyzed by IR, 1H- and 13C-NMR, GPC, DSC and TGA. The high Tg of the co-polymers in comparison with that of polyvinyl acetate indicates a substantial decrease in chain mobility of the co-polymer due to the high dipolar character of the trisubstituted ethylene monomer unit. The gravimetric analysis indicated that the co-polymers decompose in the 214–400°C range. [ABSTRACT FROM AUTHOR]