Seattle Children’s

Sex Change Treatments Offered

Gender Clinic

Seattle Children’s Hospital offers a Gender Clinic that “provides gender-affirming medical care for adolescents.” It accepts “new patients ages 9 to 17.75” “who have already started puberty.”

The Gender Clinic does not require parental permission to schedule an appointment, but consent is required from parents or guardians for certain “gender-affirming care” for patients under 18. Complete parental consent is not required for medication to suppress menstrual cycles or some testosterone treatments.

“Gender-affirming hormones (estradiol or testosterone) do require parental consent from all parents who have medical decision-making power, because these treatments have the potential for irreversible long-term effects. Puberty blockers (Lupron injections or histrelin implant) are a reversible treatment but do require parental consent, as patients are typically at a younger age when this treatment is being considered. Complete parental consent is not required for medications used to suppress menstrual cycles in transgender boys or for some testosterone blockers in transgender girls. Parental permission is also not required to schedule an appointment in the Gender Clinic.”

Puberty Blockers

The Gender Clinic offers puberty blockers to children who have “started puberty but have not yet completed.” Parental consent is required before treatment.

Hormone Therapy

Seattle Children’s offers hormones to “help make a person’s physical body match their inner gender identity.” Parental consent is required. The hospital offers to “partner with you to explore your insurance coverage and any other resources to make sure you get the care you need.”

Surgical Gender Affiliation Program

Seattle Children’s “performs gender-affirming surgery through [their] Surgical Gender Affiliation Program” and “is the only pediatric academic medical center with fellowship-trained plastic surgeons while provide gender-affirming surgery” in the region.

Patients must be at least 18 for sex change procedures. Other surgeries are dependent on other factors including the stage of puberty but are typically around “mid-teens or older.”

Sex change surgeries offered include:

• Face and neck surgery: facial “gender-affirming” surgery and thyroid cartilage surgery
• Top surgery: breast augmentation, mastectomy, breast/chest reduction
• Bottom surgery: penile inversion vaginoplasty, peritoneal vaginoplasty, intestinal vaginoplasty, valvopathy, phalloplasty

Fertility Preservation

Seattle Children’s recommends and offers fertility preservation for transgender youth before starting sex change treatment.

“We strongly recommend talking with your medical provider about fertility preservation before starting gender-affirming medications. Starting earlier can make it less likely for fertility preservation to delay other parts of your care. If you want to preserve sperm or eggs, you must do so before having surgical removal of the testes (orchiectomy) or removal of the ovaries (oophorectomy).”

Other Resources

• Chest Binding
• Tucking
• Menstrual Health (“bodies of all genders menstruate”)

Definitions

SEX CHANGE PATIENTS: Total unique children who underwent “gender-affirming” surgical procedures or hormone/puberty blocker therapy.

TOTAL SURGERY PATIENTS: Total unique children who underwent “gender-affirming” surgical procedures.

TOTAL HORMONE AND PUBERTY BLOCKERS PATIENTS: Total unique children who were prescribed puberty blockers or received gender-affirming hormone therapy.

TOTAL PRESCRIPTIONS WRITTEN: Total number of prescriptions written by a provider for puberty blockers or gender-affirming hormones for children.

TOTAL SUBMITTED CHARGES: This is the initial amount a healthcare provider or pharmacy submits to the insurance company for a specific service, treatment, or prescription before the insurance company reviews and adjusts the payment. This value includes both the pharmacy-submitted cost of prescription drug claims and the line-item charges associated with medical procedures. Please note that this amount does not necessarily reflect the full cost of the procedure or prescription, as it is subject to adjustments and negotiations by the insurance company.