Discussing and Identifying Behavioral Changes in Adolescents
By Victor Cruz

Addressing behavioral changes in adolescents is a crucial step in identifying the core of what social, mental, physical, and environmental factors impact an adolescent’s behavior. InCrowd gathered pediatricians’ insight on what behavior and mental changes they see in their patients and how those issues are detected during a visit. While identifying symptoms is vital, data collected showed how a pediatrician’s training, most commonly used tools, and ongoing education play a key role in adolescents’ behavioral and mental health support.

InCrowd asked 100 pediatricians who treat patients 12 to 18 years of age for mental and behavioral health issues to reveal which key symptoms they look for when supporting patient behavioral growth and development as part of good overall health.  

“Disordered eating, body image concerns, separating from friends or changes in friend groups, increased isolation, substance use, gender dysphoria, failing grades, decreased hygiene, sleep issues, loss of interest in activities previously enjoyed.” were some of the changes one Cincinnati based pediatrician said she looked for.

While such symptoms were proven to impact an ever-evolving adolescent’s behavior, we also wanted to determine what else factors in. In our research we asked about the frequency of interaction pediatricians have with patients that have mental health issues that are directly connected to gender and sexual identity.

One contributor discussed the following changes in her patient population on the topic of gender and sexual identity: “we are seeing an increase in depression, anxiety, overdoses and suicidal ideation in the hospital setting. Gender identity is an increasing link to these admissions and further psychiatric hospitalization or outpatient treatment.” 

Before pediatricians create a treatment plan for their patients, they need to have access to the tools and support their patients need. 

“This was not an issue that was taught when I trained, and while guidelines do now exist I feel that the high risk of suicide and bullying ,trauma, experienced by this population as well as the specific issues related to gender dysphoria requires trained [mental health] professionals with expertise in this field.” said one Ohio-based pediatrician about what her training needed to provide further support to her patients.

We asked if these pediatricians felt they have been adequately trained and have the necessary tools available to assist and treat their patients of 12 to 18 years of age on their mental health issues connected to gender and sexual identity.

It is clear that some pediatricians are being faced with patient needs they may not have received appropriate training for or may not have access to the proper support or tools necessary to provide quality patient care in this area. The gap between getting adolescents connected to the proper channel(s) and effective pediatrician support can be resolved by understanding how much pediatrician training and education on sexual and gender identity is available before and after the commencement of their careers. 

A percentage of pediatricians explained they didn’t have sufficient training to bridge that gap, so we asked 32 medical residents in a pediatrician program  if their medical school or residency program included education on gender and sexual identity issues.

While this is a small sample size, it does show there seems to be an additional focus on identification and treatment of gender and sexuality issues in adolescent based medicine which is reassuring for both the patients and physician treaters.

The insights gained from these pediatricians not only help identify mental and behavioral health complications of an adolescent population but also inform on the gaps that may exist in training and tools that may become more commonplace in the future. 

Are you a healthcare professional with experience in this space? If you’re interested in sharing your experience in a guest writing piece, please contact

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