Gender Clinic

What to Expect

Gender Clinic Visit 

Our clinic primarily provides gender-affirming medical care. This includes offering puberty blockers (PDF) (Spanish) and gender-affirming hormones, such as feminizing hormone therapy (PDF) and masculinizing hormone therapy (PDF). We also provide short-term mental health support focused on family decision-making and mental health readiness before starting gender-affirming medical care. See our Gender Clinic visual roadmap (PDF) (Spanish) for treatment steps and options.

Before your appointment

  • We recommend you start care with a mental health professional in the community. For more information, see How to Find a Therapist (PDF) (Spanish). We do not provide ongoing mental health therapy appointments in the Gender Clinic. Visits with our mental health providers are focused on providing decision-making support for patients who are interested in receiving gender-affirming medical care and their families.
  • Please talk to your primary care provider if you want to learn more about menstrual suppression (PDF) (Spanish), contraception, sexual health or medicine for mental health conditions. Many primary care providers offer this care and may be able to provide these services before your first Gender Clinic visit. Your primary care provider can submit an electronic consultation form (PDF) if they would like to consult with a member of the Gender Clinic team.
  • Talk to your primary care provider about lab tests (PDF) you may want them to order before your first visit to the Gender Clinic. Getting these tests done before your appointment is not required, but it can help get you started on medical treatments like puberty blockers or gender-affirming hormones sooner. You do not need to get labs done before the first visit if you are not sure if you want to start these treatments. We can order lab tests at your visit.
  • Provide any test results related to your hormones or puberty stage so you do not have to repeat tests. This may include lab results or bone age X-rays (PDF). You can either bring copies to your appointment, ask your primary care provider to fax them to 206-985-3499 or send them to us through MyChart (instructions for signing up below) (Spanish).
  • Sign up for a MyChart account (Spanish) to manage your child’s care and communicate with their healthcare team more easily.
  • Learn more about appointments at Seattle Children’s.

During the first visit

During your first visit, you will either meet with a mental health provider or a medical provider who specializes in adolescent health or endocrinology (how hormones regulate the body).

  • Your first visit will be with a mental health provider if you are within a certain age range where we will be discussing starting gender-affirming hormones like estrogen or testosterone. After your first visit, we will schedule a visit with either a mental health provider or a medical provider.
  • Your first visit will be with a medical provider if you are within a certain age range where we will be discussing starting puberty blockers. You may schedule a visit with 1 of our mental health providers at another time, if needed.
    • You will have 1 to 4 visits with a mental health provider from the Gender Clinic. We will discuss goals, options and decisions related to gender-affirming care with you and your caregiver. During these visits, the mental health provider will discuss gender dysphoria and whether you meet the criteria for this.
    • The Gender Clinic asks that your parent or caregiver attend these visits with you. Part of the first visit will be with you and your parent or caregiver together. The second part of the visit will be a confidential visit between you and the mental health provider.
    • After the first visit, the mental health provider will create a plan with next steps for you and your parent or caregiver. This may include scheduling more visits with a mental health provider, connecting you and your family to supportive resources or referring you to medical care or other services within the hospital. Since mental health support in the Gender Clinic is a short-term service, the care team can refer you to mental health providers in the community for ongoing support.
    • Before starting puberty blockers (PDF) (Spanish), the provider will need to determine whether puberty has already started by checking your blood work. Sometimes a physical exam is also needed.
      • For all patients under age 18, consent from a parent or guardian who has medical decision-making rights for the patient is required. Our team can help answer questions about consent.
    • Gender-affirming hormones like estradiol (PDF) or testosterone (PDF) are usually started after age 13.5. Blood work is required before starting gender-affirming hormones and is often monitored every 3 months after starting.
      • For all patients under age 18, consent from a parent or guardian who has medical decision-making rights for the patient is required. Documentation of mental health readiness is also needed to receive gender-affirming hormones. This may be completed by 1 of our mental health therapists or can be provided by your therapist.
  • Your first visit is usually 60 to 90 minutes. It may take longer if you need lab tests. Follow-up visits are usually 30 to 60 minutes. The providers you see at each visit depend on your needs.

  • Our clinic is in Seattle. We will provide location details when we confirm your appointment. Please check in 15 minutes before your appointment to allow time for registration.

More information

For more information on visiting Seattle Children's clinics, please see Your Child's Clinic Visit.

Contact Us

Contact the Gender Clinic at 206-987-2028 to make an appointment or for questions about scheduling.

Patients or families who need additional support or resources that are not available on our website can contact our care navigators at 206-987-5768. The care navigators are not able to help with scheduling questions.

Providers, see how to refer a patient.

Paying for Care

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