Elevating and empowering reproductive futures: Pediatric and adolescent gynecology's specialized care across the globe

Pediatric and adolescent gynecology (PAG) is an expanding subspecialty of obstetrics and gynecology that addresses the reproductive health needs of girls and young women worldwide. In regions with limited subspecialist healthcare providers, general obstetricians, gynecologists, and nurse-midwives, frontline healthcare providers provide essential PAG services. In this article, we examine the multifaceted role of PAG, encompassing preventive care counseling, clinical care, surgical expertise, endocrine management, genetic counseling, and advocacy, while offering resources for generalists. PAG specialists deliver age-tailored care for conditions such as menstrual disorders, Müllerian anomalies, and endometriosis, while managing complex cases involving developmental delays, cancer, and differences in sex development. They also support adolescents during pregnancy, offering prenatal care, postnatal contraception counseling, safe abortion care, and interventions aimed at reducing sequential adolescent births. PAG providers promote health and wellness in their care models through opportunistic prevention measures and screening. Globally, PAG training varies. Formal fellowships and integrated programs exist around the world. Organizations such as the North American Society for Pediatric and Adolescent Gynecology (NASPAG), the International Federation of Pediatric and Adolescent Gynecology (FIGIJ), the Asia Oceania Society of Pediatric and Adolescent Gynecology (AOSPAG), the Latin American Association of Pediatric and Adolescent Gynecology (ALOGIA), the European Association of Pediatric and Adolescent Gynecology (EURAPAG), and national associations drive education, research, capacity building, and policy advocacy, addressing disparities through initiatives including human papillomavirus vaccination and comprehensive sex education.