Gender Clinic

Gender-Affirming Care at Seattle Children’s

Seattle Children’s Gender Clinic cares for children and 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 16 and younger and provide gender-affirming care up to age 21 although we typically help them begin the transition to an adult care provider around age 17 or 18. Our team:

  • Fully accepts and treats each individual with respect
  • Gives each person personalized care
  • Follows current best practices for transition-related treatments
  • Provides referrals for gender-affirming surgical services

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 are working to create best practices 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. 

  • 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.

  • 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
    • Telehealth
    • Transition to adult healthcare providers
    • Use of names and pronouns in the electronic medical record

    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).

    • Our team will support you and your family with any questions or concerns that arise as we discuss your transition-related care goals. If interested, we can work with you to find a gender-affirming mental health provider. 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.

    • 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.

    • Dr. Russell Ettinger and Dr. Shane Morrison in the division of Plastic Surgery performs gender-affirming top surgery (PDF) (Spanish) at Seattle Children’s and Northwest Hospital. He is currently only taking referrals from established patients in Seattle Children’s Gender Clinic. Please contact your Gender Clinic medical provider to request a referral. Read more about gender-affirming top surgery (PDF) (Spanish).

    Scheduling an Appointment With the Gender Clinic

    • Call 206-987-2028 to make an appointment or to refer a patient.
    • Our care navigator will call you to gather information before an appointment is scheduled.
    • You do not need a provider’s referral to make an appointment; however, we do encourage you to coordinate with your primary care provider when coming to Seattle Children's. Contact our care navigators at 206-987-5768 if you have questions or need help working with your primary care provider.
    • If you already have an appointment, learn more about how to prepare and what to expect.
    • Learn about gender-diverse 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 you to speak with your parents or caregivers about your health.

    As providers, we are also dedicated to helping children, teens 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.

    Under Washington state law, you have the right to seek medical care for the following conditions, even without parent or caregiver consent, if you are capable of making sound decisions:

    • 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

    Your medical records are private and confidential. You will need to consent to releasing medical information to anyone, including your parents or caregivers.

    Washington state privacy laws make it complicated for parents and caregivers to access teen health information. If your health or someone else’s health or well-being is in immediate danger, however, we will tell your parents or caregivers immediately and include them in the plan to keep you or someone else safe.

    Contact Us

    For more information or to make an appointment, contact the Gender Clinic at 206-987-2028. Contact our care navigators at 206-987-5768 if you have questions or need help working with your primary care provider.

    Providers, see how to refer a patient.

    Telemedicine at Seattle Children’s

    You may be offered a telehealth (virtual) appointment. Learn more.

    Paying for Care

    Learn about paying for care at Seattle Children’s, such as insurance coverage, billing and financial assistance.

    Access additional resources

    Get resources for patients and families, including information on food, housing, transportation, financial assistance, mental health and more.