What is the Gender Clinic?

Seattle Children’s Gender Clinic cares for children, adolescents and young adults:

  • Whose gender identity is different from their sex at birth
  • Who do not identify with traditional definitions of male or female

We give gender-affirming care to people up to 21 years old. That means we:

  • Fully accept and treat each individual with respect.
  • Give each person personalized care.
  • Follow current best practices for transition-related treatments.
  • Refer you to surgical treatment, as needed. Seattle Children’s does not perform transition-related surgery.

Why choose Seattle Children’s Gender Clinic?

  • Seattle Children's is the only multidisciplinary clinic in our region for youth who are transgender or gender nonconforming. Only 5 children’s hospitals in the United States have clinics dedicated to caring for young people with gender identity concerns.
  • Our doctors have special training in adolescent medicine, hormones (endocrinology) and emotional health. This team approach is called multidisciplinary care. Social workers, nurses and medical assistants are also part of the team.
  • We are working to create best practices for children, adolescents and young adults who are transgender and gender nonconforming. We base our treatments on the most current research.
  • We tailor treatment to you and your family. We take into account your age, stage of puberty, desired future treatments, your support systems and any health problems you may have.
  • Our specialists work together to coordinate care – all in one place when possible.
  • Our team works with you and your whole family to make sure all are comfortable moving forward with treatment options.

Services We Provide

  • Some people want to delay puberty from starting. This option is available to youth who have not yet started puberty or who have just started puberty. The medicine to block puberty is called a GnRH agonist. It stops the body from making the hormones that start puberty. Puberty delay is temporary. If you stop taking the medicine, you will go through the puberty of the sex you were born into. We work with you and your family to decide if this is a good choice for you. We also talk about the cost and the best time to start.

  • Cross-sex hormones help make a person’s physical body match their inner gender. These hormones let a person develop in a way that is different from the sex they were born into. For trans-female identified teens, estrogen is the main hormone used. For trans-male identified teens, testosterone is used. Starting hormones changes the body in various ways. Some of the changes may be permanent. Other changes may be reversible. We do a careful evaluation before helping you take any steps toward physical change.

  • Our team can help you cope with feelings and concerns related to your gender identity and your transition path. Transgender youth are at high risk for low self-esteem, substance abuse and other emotional and mental health problems. Finding respectful relationships is a challenge for many. We can help. If you want to start hormone therapy or make other physical changes, our team carefully checks that you are ready to begin. This includes treating your mental health, too.

What to Expect

Your family members will be accepted and treated with respect. We will call you by your preferred name and pronouns. Your preferences will be part of your medical record.

    • We recommend you establish care with a mental health professional in the community. Connect with our care navigator at 206-987-8319 if you need help with this.
    • Ask your primary care provider to fax us your medical records. Our fax number is 206-987-3959.
    • Provide any test results related to your gender or your puberty stage. Bring copies or ask your doctor to fax them. This avoids repeating tests.
    • Learn more about what to do before your appointment.

  • A first visit is usually a full hour. It may take longer if you need blood tests. You will meet doctors who specialize in hormones or in adolescent health. You and your family will meet with our care navigator to help build a roadmap for next steps.

    For some patients, the roadmap may include a mental health evaluation before some types of therapy can begin. Your roadmap is tailored to you and your family. It takes into account previous evaluations and insurance requirements.

    Follow-up visits are usually 30 minutes. The providers you see at each visit depend on what you need.

    Appointments are scheduled on Tuesdays. The clinic is located at the Springbrook Professional Center in Northeast Seattle.

Who’s on the team?

At Seattle Children’s Gender Clinic, you will get care from compassionate doctors and nurses. We help young people be comfortable in their bodies and fulfill their affirmed gender identity. Providers in the Gender Clinic include:

Adolescent medicine and behavioral health

The director of our clinic is David Breland, MD, MPH. He has special training in adolescent medicine and adolescent behavioral health.


Our endocrinologists are doctors with special training and experience in how hormones regulate the body.


  • Gail Allen, RN, BSN
  • Pam Budge, RN, BSN
  • Julie Burns, RN, BSN
  • RaNette Schaff, RN, BSN, CPN

Scheduling an Appointment with the Gender Clinic

  • Call 206-987-2028 to make an appointment or to refer a patient.
  • Before an appointment will be scheduled, our care navigator will call you back to get needed information.
  • You do not need a doctor’s referral to make an appointment; however, we do encourage you to coordinate with your primary care provider when coming to Seattle Children's. If you have questions or need help working with your primary care provider, contact our care navigator at 206-987-8319.
  • If you already have an appointment, learn more about how to prepare.
  • Learn about adolescent health resources such as useful links, videos and recommended reading for you and your family.