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Child and Adolescent Gender Center

The Child and Adolescent Gender Center (CAGC) at UCSF Benioff Children's Hospital Oakland offers comprehensive medical and psychological care, as well as advocacy and legal support, to transgender, nonbinary, and gender-expansive children and adolescents. Working in collaboration with our affiliated clinic at UCSF Benioff Children’s Hospital San Francisco, we bring together experts from within and outside UCSF to promote gender health and provide positive outcomes for children exploring gender identity and expression. A central component of this program is that it is housed within Division of Pediatric Endocrinology.

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Appointments and Referrals

With safety precautions in place, the Child and Adolescent Gender Center is continuing to see new and established patients.

New patients may be referred by their primary care provider or may self-refer.

UCSF Benioff Children’s Oakland continues to provide the trusted care you know and need amidst the COVID-19 Pandemic. We are able to offer both video and in-person visits. We urge families to not put off important medical visits and well-care appointments.

Referrals

 To refer a patient, schedule a new patient appointment or schedule a follow-up appointment, please contact:

Yesenia Alvarez, OA

 

Led by board certified, fellowship trained pediatric endocrinologists, The Child and Adolescent Gender Center clinic is a multidisciplinary program that brings all of the subspecialties that gender-exploring children and adolescents need to access – pediatric endocrinology, adolescent medicine, psychiatry, psychology, social work, legal, and educational professionals to ensure the best possible care, Often patients benefit from a multidisciplinary specialty approach in partnership with their primary care provider.

Transgender is an umbrella term used to describe people whose gender identity is not consistent with the sex assigned to them at birth. Non-binary is an umbrella term used to describe those whose gender identity cannot be exclusively categorized as male or female. Gender identity is not about sexual orientation. Gender identity refers to a person’s internal sense of being male, female, both, neither, or something else altogether. Gender expression refers to the way a person communicates gender to others through behavior, clothing, hairstyles, voice, or body characteristics.

The CAGC team operates from the gender affirmative model, in which gender diversity is considered a healthy component of development. The American Psychiatric Association, in the most recent edition of the Diagnostic Statistical Manuel (DSM-V) has replaced the term “gender identity disorder” with “gender dysphoria,” to emphasize a move away from pathologizing the child, and greater emphasis on the stress or distress a child or adolescent may feel around their gender status. Our clinic acknowledges the stress or distress are often caused by external factors such as lack of acceptance in their social environment. Our goal is to offer services to help children consolidate and align their body, gender identity, and gender expression to enhance gender resilience in both the child and family.

Treatment

Patients receive care at the CAGC clinic within the Division of Pediatric Endocrinology at UCSF Benioff Children’s Hospital Oakland.

Medical treatment may include administration of gonadotropin-releasing hormone agonists (GnRH-A). These hormones can safely suppress puberty by blocking the production of the principal sex hormones: estrogen and testosterone. Fully reversible, this treatment gives young people time to achieve greater self-awareness of their gender identity; and for those who socially transitioned at a young age, offers them the opportunity to continue developing in the gender they have already affirmed.

The second area of medical treatment involves cross-sex hormones, such as testosterone or estrogen, a partially reversible intervention to allow a child or adolescent to align their body with their affirmed gender identity.

Ongoing Research

UCSF has formed a research network consortium with Boston Children’s Hospital (Harvard), Lurie Children’s Hospital of Chicago (Northwestern University), and Children’s Hospital Los Angeles (University of Southern California) -- The Trans Youth Network. We are presently engaged in a research project funded by the National Institutes of Health studying metabolic and quality of life issues for transgender youth undergoing treatment with puberty blockers or cross-sex hormones.

Gathering this data will also be important to encourage insurers to cover medical treatment for gender dysphoria, as the drugs used do not have FDA approval for treatment of this condition. In addition to increasing our knowledge, it is hoped that the research findings will impact the future of trans care for children and adolescents. We have applied for a second grant through the National Institute of Health to study prepubertal children exploring their gender, assessing developmental pathways and psychological outcomes.