Gender Center Opens

At age 14, Oliver was browsing the internet when he stumbled upon a word that would change his life: “transgender.” Until then he had been living as female, the sex he was assigned at birth, and becoming increasingly miserable.

For young people like Oliver, growing up with gender dysphoria – their body at odds with their identity – causes significant distress. Oliver is part of an often misunderstood and marginalized population facing a high degree of risk for depression, drug addiction, and suicide.

 “In the rawest form, the Center saved my life.” – Oliver, CAGC patient

In 2010, a consortium of professionals specializing in gender issues came together to form the Childhood and Adolescent Gender Center (CAGC) at UCSF. Spearheaded by Stephen Rosenthal, MD, who serves as its medical director, the Center provides transgender youth and their families with a unique model of one-stop care.

“Our patients simply want to be who they are,” Dr. Rosenthal says. “They just need support to do that.”

Patients – who range from as young as three years old through their mid-20s – receive mental and physical evaluations; from early puberty through young adulthood, they are also eligible for hormone treatments. Legal and advocacy staff members are also available to help them navigate issues ranging from insurance reimbursement and coming out at school, to changing names and genders on legal documents. The family-focused approach is key: Parents often need guidance as much as their children.

The Center’s patient load – now more than 500, with about 10 new referrals a month – reflects the explosion in the number of transgender youth seeking specialized services across the country, says Dr. Rosenthal. Families have come to the CAGC from as far as Alaska, Florida, and Egypt for weekly clinics offered in San Francisco, San Mateo, and Oakland.

“This is much more common than we would have expected,” Dr. Rosenthal says.

A CAGC patient can be treated with hormone blockers that suppress puberty, a fully reversible treatment that offers time to reflect and grow without their body becoming even further misaligned with their identity. Eventually, patients can receive sex hormones – estrogen or testosterone – that match their affirmed gender identity.

In July 2015, UCSF and three other academic institutions with dedicated transgender youth clinics received a $5.7-million grant from the National Institutes of Health. The five-year study – the first of U.S. transgender youth funded by the NIH – will evaluate the physiological and psychosocial impact of puberty blockers and cross-sex hormones.

“We have consistently seen for many years that our patients are thriving and that the treatments are effective and safe, but it is important to have long-term outcomes data to optimize care,” Dr. Rosenthal says. “We hope that our study will help move the field forward.”

Oliver is one clear success story. After transitioning and undergoing hormone therapy at the CAGC, he went from contemplating suicide to being well-adjusted and popular, with excellent grades.

“In the rawest form, the Center saved my life,” he says.

Now a college freshman, Oliver received the ultimate stamp of approval from his peers as a high school senior: He was voted homecoming king. And while Dr. Rosenthal was pleased to learn about this achievement, it was no shock.

“It’s wonderful to see our patients being accepted for who they are,” Dr. Rosenthal says. “But the more I do this work, the more I learn that young people are accepting of diversity. Stories like that don’t surprise me anymore.”