Our entire team is dedicated to the physical, emotional and mental well-being of your child. We do this by getting to know your child and your family so we can establish a partnership with your best interests in mind. To best prepare you and your child, we want you to understand our process.

Please feel free to call our behavioral health clinician 503-413-5443 with any questions you might have before starting the process.

Step 1: Referral

Ask your primary care or mental health provider to refer your child electronically or through fax at 503-413-2419.


Refer your child directly by calling 503-413-1600 and follow the cues for referrals.


Step 2: Intake

We will call you to schedule an intake appointment with our behavioral health clinician. That may be in-person, over video, or over phone, depending on your insurance coverage for behavioral health (see attached)Please fill out the below forms and bring it to this appointment:

Our goal in this appointment is to learn more about your child and family, your child's health goals, and for you to learn more about our team. We will answer any questions you may have, as well as provide you a space to share any concerns you may have. We also offer personalized resources to provide your child and your family the best support on this journey.

If you are already working with a mental health provider, please ask them to fill out the below forms below:


Step 3: Preparation

This step looks different for everyone based on the age of your child, their readiness and their health goals. 

  • If your child has yet to begin puberty, medical intervention may not be needed at this time. You may still decide to see the medical provider to establish care or you may make the choice to wait.

For the medical provider to prescribe medical intervention in the next step, a mental health providerideally one with experience working with gendermust make the diagnosis of Gender Dysphoria and provide a letter of support indicating your child's readiness.

  • Some youth are already working with a mental health provider and are ready to schedule with a medical provider.

  • Some youth may benefit from working with Gender Care Center behavioral health clinician around medical assessment, short-term therapy, or ongoing support around transition.

We strongly encourage our patients to have therapeutic support through the transition process. Our team can help you and your child initially with this process to find a good fit for your child and your family. Learn more about finding a therapist.

Step 4: Meet your Medical Provider

After the medical provider talks with you and your child, they may need to perform a physical exam. As it relates to puberty, the exam may include a breast exam for assigned females at birth or a testicular exam for assigned males at birth.

  • If you think this exam may be stressful for your child, please talk with them ahead of time and inform us so we may help ease the process.  

Typically, routine labs are obtained at the first visit to safely move forward with next steps.

  • Again, please talk to your child about the possibility of a blood draw, as well as an X-Ray of the hand (if indicated for bone age).
  • We can help with anxiety about blood draws by providing numbing cream prior to the poke.

As is standard of care around the U.S., our medical providers do not prescribe any medications at the first visit. We want you to know this so you and your child are not disappointed. 

Step 5: Begin treatment

Our team puts all of this important information together and discusses a plan for your child. We follow up with your family so everyone is on the same page. Our team will help you to understand your insurance requirements, as needed.

Treatment may include pubertal suppression, cross hormone therapy, menses cessation, or androgen blockade.   

If medications are to be initiated, we arrange with your pharmacy and these will begin before your next follow up visit. (You do not have to wait to come in for the next provider visit to get started.)

Step 6: On-going & Future Treatment

Once a path has been determined, we’ll schedule to meet with you and your child about every four to six months, and we’ll check blood samples a couple of times a year.

We can treat youth until around age 18, at which point we can help you find an adult trans-friendly healthcare provider.


We look forward to embarking on this journey with you and working together as a team to help your child. If you have any questions, please contact 503-413-5443.

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