The University of California San Francisco (UCSF) children's hospital is offering treatments through its transgender health center to patients as young as age 3.
UCSF's Child and Adolescent Gender Center "offers comprehensive medical and psychological care, as well as advocacy and legal support, to transgender, nonbinary and gender-expansive kids," according to its website. "We bring together experts from within as well as outside UCSF to promote gender health and support positive outcomes for children and adolescents exploring gender identity and expression."
The center accepts new patients ages 3 through 17, but patients may continue to receive care through age 25. Through its program housed within the UCSF Division of Pediatric Endocrinology, the center says it is able to "offer the most advanced medical care" through various treatment options.
The opening message on the page names one such treatment as "gonadotropin-releasing hormone agonists," which, according to the website, is "medication that can safely suppress puberty by blocking production of the principal sex hormones, estrogen and testosterone."
"Fully reversible, this treatment gives young people time to achieve greater self-awareness of their gender identity," the website says. "For other patients, if appropriate, our experts may administer gender-affirming sex hormones."
A spokesperson for the center stressed that getting sign-off for adolescents to begin puberty-blocking treatment is a multi-step process.
"Once an adolescent has begun puberty, the patient must be thoroughly evaluated by a qualified mental health gender specialist, been determined to meet the diagnostic criteria for gender dysphoria, and believed by the interdisciplinary team to be an appropriate candidate for a course of treatment with puberty blockers," the hospital spokesperson said. "Then and only then are puberty blockers started."
The center adds the caveat that "exceptions may be made while maintaining UCSF Benioff Children's Hospitals' mission and prioritizing social justice and health equity."
There are four locations in the Bay Area, including San Francisco, San Mateo, Oakland and San Ramon.
UCSF’s Transgender Care page admits that care for children categorized as "transgender and gender non-conforming (TGNC) youth" lacks solid evidence in some facets and even "lends itself to controversy among professionals."
Published guidance titled "Health considerations for gender non-conforming children and transgender adolescents" released on June, 17, 2016, includes a warning in the Editor’s Note, referring to how treatment sometimes relies on innovators and "thought leaders" in the "absences of solid evidence."
"Gender-affirming care for transgender youth is a young and rapidly evolving field. In the absence of solid evidence, providers often must rely on the expert opinions of innovators and thought leaders in the field; many of these expert opinions are expressed in this youth guideline," according to the Editor’s Note.
"The four primary authors for this youth protocol represent many years of expertise in clinical care and research, in both academic and community practice settings, and within the disciplines of adolescent medicine, pediatric endocrinology, family medicine, and advanced practice nursing," it adds.