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.