DSDs, or Disorders of Sexual Differentiation, refer to medical conditions where average sexual development does not occur. DSDs can include genitourinary or hormonal disorders - medical issues that may make it difficult to determine a child's sex or conditions that interfere with a patient's sexual and reproductive function.

Because there is such a wide variety of conditions that fall under DSDs, we work closely with the child and their family members to come up with the most appropriate method of treatment that works best for their specific condition.

Our GeMS clinic also cares for transgendered children and young adults.

• endocrinologists
• geneticists
• nurses
• psychologists
• social workers
• urologists

Today, medical treatment of DSDs has changed dramatically, thanks in large part to national DSD advocacy groups formed by adult patients.

Our clinic encourages parents to take part in the decision-making process of how to treat their child's DSD. We do not require an immediate decision so we can give family members and our physicians adequate time to choose the best treatment for the patient. In some cases, a decision can take weeks - a time frame that was unheard of in the past when decisions were made in only a few days.

In addition to treating DSDs, we care for transgendered children and young adults - patients with no known anatomic or biochemical disorder who feel like a member of the opposite sex.

Such feelings can emerge early, even in the preschool years, and cause significant psychological distress. With a high number of adolescent transgendered patients attempting suicide, we work with them to alleviate their negative feelings and treat medical and psychological issues they may experience.

Dr. Norman Spack talks about gender identity in the online version of ABC's 20/20.

We conduct follow-up research on the patients we treat throughout their adolescence and adult years. Keeping track of their progress helps us determine our treatment efficacy.