Disorders of Sex Development (DSD) and Gender Management Service (GeMS) Programs and Services

Disorders of Sex Development Program

Medical treatment of Disorders of Sex Development (DSDs) has changed dramatically, thanks to heightened sensitivity to and understanding about the medical and psychological issues starting in the newborn period and continuing throughout the developmental stages of childhood, adolescence, and young adulthood.

Our goal is to guide families through the complex decisions involved in the care of children and adolescents with DSDs. We address issues of gender assignment, reproductive and sexual function, and provide assessment of psychosocial needs starting at a young age.  Though patients may already have a primary endocrinologist/urologist, our program provides an opportunity to focus specifically on these sensitive issues through a multi-disciplinary approach.

Gender Management Service (GeMS)

The Gender Management Service (GeMS) at Boston Children’s Hospital believes that all children deserve to grow into confident and happy individuals who are able to take their rightful place in society. We specialize in providing comprehensive care to the unique group of gender non-conforming children and adolescents.Our team consists of providers from Endocrinology, Psychology, and Social Work, and works closely with specialists in other departments in the hospital such as Adolescent Medicine, Urology, and Plastic Surgery to develop individual care plans that meet every child's medical and emotional needs, as well as the family's need for information and support.

  • The first step in this process involves interacting with our clinical social worker to talk more about your child’s specific gender issue in more detail. Our clinical social worker will make sure that you fully understand our protocol and assist you with referrals and resources. Your child will be referred to a therapist in your community who is familiar with gender issues in youth. We recommend that your child be in therapy for at least 3 months before proceeding with our evaluation.

  • The next step is a consultation at Boston Children’s Hospital about your child’s gender non-conformity and specific mental health needs. Your child will meet with our psychologist for specialized gender-related evaluation. The results from these evaluations will allow the rest of the medical team to gain a full understanding of your child’s situation and any related concerns.

  • You and your child will then meet with a specialist from Pediatric Endocrinology to plan a course of treatment.