Gender-Affirming Care at Seattle Children’s
Seattle Children’s Gender Clinic provides gender-affirming medical care for adolescents:
- Whose gender identity is different from their sex at birth
- Who do not identify with the traditional definitions of male or female
We accept new patients ages 9 to 16, who have already started puberty. Patients ages 17 and older and patients who have not yet started puberty will be directed to community resources. Our clinic primarily provides gender-affirming medical care (such as puberty blockers and gender-affirming hormones). Gender-affirming medical care for patients under age 18 requires consent from any parent or guardian that has medical decision-making rights for that patient, unless the patient is an emancipated minor.
Brief mental health support focused on family decision making and mental health documentation prior to initiating gender-affirming care is also available. If you are looking for gender-affirming mental health services only, or for ongoing mental health support, here are some community resources.
- Fully accepts and treats each individual with respect
- Gives each patient personalized care
- Follows current best practices for transition-related treatments
- Provides referrals for gender-affirming surgery (which Seattle Children’s offers for patients through age 26 in some cases)
Services We Provide
Some people want to delay puberty from progressing. This option is available to youth who have started puberty but who have not yet completed puberty. The medicine to block puberty is called a gonadotropin-releasing hormone (GnRH) agonist. It stops the body from making the hormones that lead to puberty changes. Puberty delay is temporary. If you stop taking the medicine, you will go through 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. Read more (PDF) (Spanish).
Gender-affirming hormones help make a person’s physical body match their inner gender identity. These hormones let a person develop in a way that is different from the sex they were born into.
For people interested in feminizing hormones, estrogen is the main hormone used. For people interested in masculinizing hormones, testosterone is primarily 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 as we help you and your family navigate the medical transition process. Read more about feminizing hormone therapy (PDF) and masculinizing hormone therapy (PDF).
Youth who are gender diverse are more likely to be diagnosed with autism spectrum disorder or show similar social challenges than other children and teens. We work closely with the Seattle Children’s Autism Center team to coordinate care for children and teens with autism and related social challenges. Some providers at the Autism Center are experienced in caring for youth with autism who also have gender dysphoria.
Your first visit in the Gender Clinic may be with a mental health therapist (for patients 13 years and older) before you see a medical provider. Our team will continue to support you and your family with any questions or concerns that arise as you pursue gender-affirming medical care, but we do not offer ongoing mental health therapy appointments. If you are interested in finding an ongoing mental health therapist, here are some community resources. If you have an existing mental health provider and feel comfortable with our team collaborating with them, we can coordinate your care to ensure you are receiving all of the support you need.
Other Gender-Affirming Services Seattle Children’s Provides
Gender-affirming surgery for teens and young adults
Seattle Children’s plastic surgeons perform gender-affirming surgery through our Surgical Gender Affirmation Program. We work closely with patients and families to make decisions about surgery age and timing. Patients must be 18 or older by the time of surgery for gender-affirming genital procedures. For other surgeries, timing depends on many factors, like the patient’s stage of puberty and how surgery fits with the rest of their gender-related healthcare. A typical age is mid-teens or older.
The Surgical Gender Affirmation Program take referrals for established patients in Seattle Children’s Gender Clinic, as well as patients getting gender-affirming care from providers outside of Seattle Children’s. Read more.
Why choose Seattle Children’s Gender Clinic?
Seattle Children's Gender Clinic is a multidisciplinary clinic for youth who are transgender or gender diverse.
We employ best practices based on best medical evidence for our patients who are transgender and gender diverse. Dr. Cora Breuner co-authored the first policy statement by the American Academy of Pediatrics on the subject. We base our treatments on the most current research and continue to update our best practices accordingly.
Our medical providers have special training in adolescent medicine, how hormones regulate the body (endocrinology) and emotional health. This team approach is called multidisciplinary care. Social workers, nurses and medical assistants are also part of the team.
Seattle Children’s plastic surgeons have special training in gender-affirming surgery for teens and young adults.
We tailor treatment to you and your family. We take into account your age, stage of puberty, desired future treatments, support systems and any current or past health problems.
Our specialists work together to coordinate care – all in 1 place when possible. Our team works with you and your whole family to make sure everyone is comfortable with treatment options moving forward.
Our team is involved in research focused on improving the care provided to transgender and gender-diverse youth and their families. Some of our team’s recent research projects and publications are focused on:
- Autism and gender diversity
- Barriers to gender-affirming care
- Bone mineral density in gender-diverse people
- Family experiences in a gender clinic
- Peer support
- Transition to adult healthcare providers
- Use of names and pronouns in the electronic medical record
Scheduling an Appointment With the Gender Clinic
- If you are looking for mental health services only, please use these community resources as we do not provide ongoing mental health therapy.
- We require a referral from your primary care provider to make an appointment. Please call to make an appointment after a referral has been submitted.
- If your primary care provider or mental health provider would like to consult with one of the members of the Gender Clinic team regarding your care, please have them submit an electronic consultation.
- If you already have an appointment, learn more about how to prepare and what to expect.
- Learn about gender care resources such as useful links, videos and recommended reading for you and your family.
Confidentiality in Washington State
Parents and caregivers are very important for ensuring the growth and development of adolescents into healthy adults. We encourage adolescents to speak with their parents or caregivers about their health.
As providers, we are also dedicated to helping adolescents and young adults develop independence and practice being involved in medical decisions. As recommended by the American Academy of Pediatrics, the Society for Adolescent Health and Medicine and the American College of Obstetrics and Gynecology, we offer time in the Adolescent Medicine Clinic to talk with your provider alone.
Gender-affirming medical care (such as puberty blockers, estradiol, and testosterone) for patients under age 18 requires consent from any parent or guardian that has medical decision-making rights for that patient, unless the patient is an emancipated minor. Our team can help answer questions about consent if needed.
Under Washington state law, adolescents have the right to seek medical care for the following conditions, even without parent or caregiver consent:
- Birth control and pregnancy-related treatment
- Mental health conditions if 13 or older
- Alcohol and drug problems if 13 or older
- Sexually transmitted infections, including HIV/AIDS testing, if 14 or older
Washington state privacy laws limit parent and caregiver access to adolescents’ health information. Adolescents’ medical records are private and confidential. The patient chooses whether to consent to releasing medical information, including to parents or caregivers.
However, if a situation arises where someone’s health or well-being is in immediate danger, we must inform parents or caregivers immediately and include them in the plan to keep everyone safe.
Contact the Gender Clinic at to make an appointment or for questions about scheduling.
Youth or families who need additional support resources that are not available on our website can contact our care navigators at . The care navigators are not able to assist with scheduling questions.
Providers, see how to refer a patient.
Telemedicine at Seattle Children’s
You may be offered a telehealth (virtual) appointment. Learn more.