Stanford Children's Health treats transgender youth at new clinic

Professionals continue to see increasing need for services

Midpeninsula families seeking medical services for transgender and gender non-conforming youth no longer have to travel long distances or to multiple locations to get the care they need with the opening of the multidisciplinary Stanford Children's Health Gender Clinic in Sunnyvale.

The clinic -- which Stanford believes to be the only one of its kind in the South Bay -- brings subspecialties that transgender youth and their families might need under one convenient, collaborative roof. The clinic’s staff includes a pediatric endocrinologist, adolescent medicine specialist, pediatric nurse practitioner from urology, adolescent gynecologist and a social worker. The staff meets on a weekly basis to talk as a whole about their patients, including "who's coming in, what the needs are and how as a group we can better serve the families," said Tandy Aye, a Stanford pediatric endocrinologist who works at the Gender Clinic.

Previously, many local families seeking such care would go to the Child and Adolescent Gender Center at University of California, San Francisco (UCSF), which offers comprehensive medical and psychological care, as well as advocacy and legal support, to transgender and gender non-conforming youth and adolescents. Families who approached Stanford for support would often be referred to UCSF, said Aye, who recognized a growing need for this type of care and started treating transgender children and adolescents in 2015.

With the new clinic, "we're better able to serve our community that’s local to us without families having to commute for so long of a distance," Aye said.

The clinic's multidisciplinary nature also means patients can schedule multiple appointments in a row at one place, cutting down on the amount of school they might have to miss.

While the clinic does not yet offer in-house mental-health services (but plans to in the future), patients are required to be under the care of a mental-health provider, Aye said.

New patients go through an intake process with a licensed clinical social worker to identify an existing provider, with whom the Stanford staff will coordinate care. If the patient does not have an existing provider, the clinic will refer them to a psychologist who specializes in working gender non-conforming youth, Aye said. The clinic can also refer patients to a psychiatrist if needed.

Last October, Aye had nine patients. A year later, the clinic is actively seeing about 50 patients -- a number she said she expects to continue to grow. Many patients are local, but one comes from as far as seven hours away, Aye said.

The new Gender Clinic, which opened in July, offers services to patients as young as 4 years old and as old as 25 years old. Treatment looks very different depending on the patient’s age, Aye noted. For the family of a very young child, it might be simply understanding their options and being connected with resources.

It could also be working with the family younger child who has yet to enter puberty to identify when that will happen and determine if the child will be a candidate for puberty blockers, a set of medications that are prescribed by an endocrinologist to suppress or inhibit the production of sex hormones.

A teenager who has already gone through puberty, however, might opt for cross-sex hormone treatment, which can induce the physical and psychological characteristics of the sex that matches the patient's gender identity.

Patients must be evaluated by a mental-health professional before receiving these treatments.

The Gender Clinic is located within Stanford Children’s Health Sunnyvale site, which also houses a fertility-preservation facility for both men and women that the clinic patients can access.

Another next "major step" will be bringing surgeons in for clinic visits for patients interested in gender reassignment surgery, Aye said.

As the clinic grows, Aye also hopes to add an advocacy and mentorship piece for parents. She wants to replicate a position that other specialized Stanford clinics have -- a parent-advisor who could help support families and serve as a resource.

Anyone interested in scheduling an appointment at the Gender Clinic can ask their primary provider to contact the clinic’s referral line or call it directly at 800-995-5724.

Related content:

Palo Alto students, families push district to evolve with changing gender norms

On privacy, early intervention and medical advances

Palo Alto school district eyes new gender-identity policy

Palo Alto school board expresses support for new gender-identity policy

Stanford Children's Health begins to offer transgender care

Outlet offers LGBTQQ teens a place to be


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19 people like this
Posted by Sarah1000
a resident of Los Altos
on Oct 20, 2016 at 3:25 pm

According to "LGBTQ individuals are almost 3 times more likely than others to experience a mental health condition such as major depression or generalized anxiety disorder", yet Stanford won't provide psychiatric and psychological services for these youth? The newly expanded Children's Hospital is set to open without a single bed to treat youth who are in a mental health crisis. The doctors, nurses and the community all want these services. Our children have been dying for 15 years because Stanford won't provide them. It's time for Stanford's administration to put our youth's wellbeing over profit.

3 people like this
Posted by Annie
a resident of Los Altos
on Oct 20, 2016 at 4:06 pm

Wow! Great news I didn't realize this was such a great need. Can you share percentage of children identified to be at risk of mental health issues if this type of service wasn't provided?

6 people like this
Posted by CRP8DM
a resident of Los Altos
on Oct 20, 2016 at 4:10 pm

I am 100% for a clinic which would provide well needed services for the LBGTQ community.

8 people like this
Posted by Monique Kane
a resident of Duveneck/St. Francis
on Oct 20, 2016 at 4:13 pm

As a mental health professional I am surprised and disappointed that there are no licensed MFTs and/or licensed psychologists in this program to better need the mental health issues that this young population often suffer from such as depression, anxiety, dealing with bullying, issues with family etc.
I hope these professionals would be added to their staff.

11 people like this
Posted by Sarah1000
a resident of Los Altos
on Oct 20, 2016 at 4:18 pm

Annie- That is a good question and one that I have not seen data on. My daughter is LGBT and her trans friends definitely express great psychological relief when they can live as their "true" selves. It is wonderful that this clinic exists but irresponsible, at minimum, for psychological/psychiatric services not to be provided along with hormone therapy and surgical gender correction consults.

7 people like this
Posted by Bette
a resident of Los Altos
on Oct 20, 2016 at 6:01 pm

It's a step, but I agree with the comments above. Is it wise to provide these services without comprehensive psychological support. With such sensitive multiple concomitant issues, if my child wanted these services, I'd absolutely make the longer trip to UCSF.

6 people like this
Posted by LizL
a resident of Los Altos
on Oct 20, 2016 at 7:17 pm

I'm so happy to see such a comprehensive group of professionals: "a pediatric endocrinologist, adolescent medicine specialist, pediatric nurse practitioner from urology, adolescent gynecologist, and a social worker", but am at a loss to understand why there are no therapists or psychiatrists involved in this team. I actually reread this list of professionals a couple times to be sure I wasn't missing something. Years of working with young men and women who are undergoing some of the most painful times in their lives in middle and high school have convinced me how important and necessary on-going support through therapeutic services is for our most fragile of children. It is my most sincere hope that the team is expanded to include therapeutic services for the children and families.

12 people like this
Posted by profit?
a resident of Barron Park
on Oct 20, 2016 at 8:05 pm

The cynic in me thinks that putting existing clinicians into a new group for transgender youth was done largely to attract affluent patients. It's certainly likely to be more lucrative than an inpatient pediatric/adolescent psych facility–a much greater need in our community IMO.

2 people like this
Posted by @profit?
a resident of Mountain View
on Oct 20, 2016 at 8:11 pm

You're right -- the cynic in you definitely came out in that post.

Let us remember, though: LGBT youth exist in all economic categories.

16 people like this
Posted by Jason
a resident of Palo Alto Hills
on Oct 21, 2016 at 5:07 am

"A younger child who has yet to enter puberty could, however, be a candidate for puberty blockers, a set of medications that are prescribed by an endocrinologist to suppress or inhibit the production of sex hormones."

A clinic setup to encourage prepubescent children to play dress-up for the rest of their lives, wow. Only here would this be considered reasonable. Does anyone know if our tax dollars pay for this or is this privately funded?


1 person likes this
Posted by nat
a resident of Midtown
on Oct 21, 2016 at 1:27 pm

The quote above that Jason used bothers me too. I do not see why puberty would be stopped. This makes no sense.
Without sex hormones, would the person remain a child for the rest of their life?

The article needed to explain this more and I hope a future article will. Even a guest column in the Weekly print edition could explain this.

Sorry, but further commenting on this topic has been closed.

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