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In the Disorders
of Sex Development (DSD) and Gender Management Service (GeMS) Clinics at Boston Children’s Hospital, we do our best to
make each visit as convenient and comfortable as possible for you and your
child. The phone number above is the best way to contact our program for
scheduling or changing appointments or for general questions.
In both of these clinics,
it is helpful to plan ahead before your appointment. If we sent you forms, please complete them
before the visit. It is also helpful to check with your child’s providers to
make sure that they have sent any medical records that were requested prior to
the visit. Please bring your current insurance information. It is also helpful
to bring small snacks and a book, toy or tablet to entertain your child in case
there is a waiting period before your appointment.
Disorders of Sex Development Program
Program provides medical, surgical, and mental
health consultation and treatment for youth with Disorders of Sex Development.
Our providers offer both sensitivity and expertise in the wide range of DSD
diagnoses. Patents are seen from birth through young adulthood, and mental
health services including psychologists and clinical social workers are an
integral part of our team.
Our goal is to guide
families through the complex decisions involved in the care of infants, children
and adolescents with DSDs. Even if your child already has a primary
endocrinologist and/or urologist, our DSD Program provides an opportunity to
focus specifically on these sensitive issues through a multidisciplinary
approach. Issues related to DSDs we help with include:
Trying to determine the cause of the DSD
Deciding whether to raise a child as a boy
or a girl
Whether surgery is needed
Treatment with hormones, if needed
How parents/caregivers can discuss the DSD
diagnosis with their child in an age-appropriate manner, and how the child can
later discuss the diagnosis with others
Discussing the potential for future
fertility and sexual function
Transitioning from pediatric to adult care
Psychosocial needs at all ages
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. Our
mission is to help children cope with the disconnect they may feel between the
body in which they were born and the gender with which they identify. We
provide comprehensive psychological assessment, mental health support and
medical care to gender non-conforming children and
our multidisciplinary team. GeMS also provides support to parents and families
and collaboration with schools, therapists in the community, pediatricians and
other providers. Our team consults with parents of youth between the ages of 3 and
18 years, though the formal psychological evaluation and medical treatment
generally begin at the early signs of puberty.
GeMS Services begin when parents
or caregivers complete a brief intake with Program Coordinator at the general
DSD/GeMS phone number. Our Program Coordinator will provide basic information about
the program. The caller is then referred to our clinical social worker for a
more extensive and detailed appointment, either over the phone, at the hospital
or at a satellite location. The purpose of this first clinical consultation is for
us to learn about your family, discuss your child’s gender identity in detail, discuss
our protocol and assist you with referrals and resources. Since we do not currently
provide ongoing therapy in our program, your child will be referred to an
experienced therapist in your community who is familiar with gender issues as
well as other issues related to your child’s age and maturity.
The next step is a
psychological evaluation to learn more about your child’s gender identity and
specific mental health needs, your family history and additional concerns.
We require that your child be in therapy for at least 3-6 months before
proceeding with our psychological evaluation. We ask the therapist to
complete a detailed report when they and the youth feel it is time to move
forward with the GeMS evaluation. All parent(s)/guardian(s) and the youth meet
with one of our psychologists for this detailed interview and specialized
gender-related testing. The results from this evaluation and the information
from your child’s therapist are presented to the team and help the medical
providers choose appropriate medical treatments.
A feedback session is
scheduled with the psychologist or social worker to review the results and
recommendations of the full mental health evaluation. This is followed (often on
the same day) by an appointment with one of our endocrinologists or our nurse
practitioned to discuss the possible medical interventions, a timetable for
these interventions and issues regarding consent for treatment.
The future of pediatrics will be forged by thinking differently, breaking paradigms and joining together in a shared vision of tackling the toughest challenges before us.”