Gender Development Program

Gender development services at Lurie Children's are outpatient services aimed at supporting the physical, mental and social health of patients and their families as youth progress through gender identity development. As specialists in pediatric and adolescent gender development, we recognize that when it comes to providing effective care “no one size fits all.” Therefore, our goal is to keep our families most informed of their treatment options, supporting them with medical and behavioral health care along the way.

Patients come to our gender identity clinic to receive high-quality, family-centered care. New patients may begin care with us up to age 22. These patients may continue services in our programs until their 25th birthday. 

Our patients generally fall within one or more of the following groups:

  • Gender expansive or gender non-conforming children: Children and adolescents who exhibit behavior that is not typical of their assigned birth sex.
  • Gender-questioning youth: Children and adolescents who are questioning their gender identities (e.g., “I was born a girl, but I wonder if I’m really a boy?”).
  • Transgender and gender-fluid youth: Children and adolescents who identify as a gender different from their assigned birth sex (e.g., “I was born a girl, but I am really a boy.”).

Learn more about respectful gender terminology

Services & Support

Lurie Children's provides medical consultation, medical intervention (e.g., cross sex and pubertal delaying hormones) and health research with gender non-conforming youth across the developmental spectrum of pediatrics and adolescence. In 2013, we expanded our program to include mental health services, non-clinical support services and capacity building with other youth-serving organizations. Our services include:

  • Comprehensive medical and psychological consultation for families with gender non-conforming, gender-questioning and transgender children and teenagers
  • Routine consultation, administration and monitoring of medical treatments:
    • To reversibly pause pubertal development among gender-questioning youth entering puberty
    • To initiate gender affirming hormones among transgender adolescents

In addition to these services, we offer access to support services, including:

  • A growing research program that aims to advance the understanding of gender identity development from childhood to young adulthood, develop strategies to facilitate medical decision-making, and evaluate outcomes of gender-affirming interventions.
  • Connection to legal consultation services (e.g., legal name changing, etc.)
  • Consultation for community providers and clinicians to enhance gender-affirming care
    • Community mental health clinicians collaborating with our behavioral health team have the option to join our Gender-Affirming Clinician's Collaborative (GCC), a group of gender-affirming behavioral health providers in the Midwest that meet quarterly via conference call to discuss complex cases and obtain peer consultation. To find out more about the GCC or to request an application to join please contact Janay Joyce-Ward at 312.227.3779 or
  • Ongoing play, socializing and support groups:
  • Peer to peer parent mentor program ParentWISE®
  • Trainings and consultation with school systems
  • TransMentor
  • Vocal therapy (in collaboration with Northwestern University)

Support for Transgender Gender Expansive Students in School​

As school districts strive to include all students and celebrate diversity, a need for comprehensive gender inclusion on a systemic level has emerged. Schools and educators are working to support a growing population of transgender and gender diverse youth living as their affirmed gender identity. To address this, Lurie Children's and other collaborators created the Model Policy and Administrative Procedure to guide schools as they navigate how to support gender inclusion, something that is important for all students.​ Download the Model Policy and Administrative Procedure guide.​

To find out more information about our education program, contact Jennifer Leininger at 312.227.7721 or

We are also actively advocating for transgender and gender non-conforming youth in matters of public policy. View our policy statement.

TransMentor One-on-One Mentoring Program

Housed within the Gender Sex Development Program, TransMentor pairs trans, gender expansive, and gender questioning youth ages 13-20 with trans and gender expansive adults. Support includes weekly check-ins and bimonthly social events with a one-year commitment.

Learn more and apply for the program.

Our Philosophy

For even the most loving, affirming and resilient families, navigating childhood gender identity development can be confusing. It can become more challenging as our patients and their families encounter difficulties posed by others, including extended family members, school officials and other community members. We help navigate these challenges by providing our families with education, exceptional and affirming clinical care, support, and ongoing consultation to ensure that children and families flourish safely in an environment that is both nurturing and affirming.

Watch Family Testimonials

Our Specialists

Our entire staff is dedicated to evaluating and treating pediatric patients from infancy through adolescence. Our specialists include:

  • Clinical psychologists
  • Endocrinologists 
  • Ethics consultants
  • Nurse practitioners 
  • Pediatricians 
  • School consultants 
  • Social workers 
  • Urologists

The heads of the programs, Director Robert Garofalo, MD, MPH (Gender Development Program), and Director Earl Cheng, MD (Sex Development Program), started the program in 2013. 

Dr. Garofalo is board-certified in pediatrics and adolescent medicine. He also directs Lurie Children’s Adolescent/Young Adult HIV Program, the Division of Adolescent Medicine and the Center for Gender, Sexuality and HIV Prevention at the Stanley Manne Research Institute. He is a national expert on lesbian, gay, bisexual and transgender (LGBT) health issues, as well as adolescent sexuality and HIV infection.


Meet all of our specialists



To find out more information about our gender development services or to request an appointment, call Janay Joyce-Ward at 312.227.3779 or e-mail

To schedule a follow up appointment with any of the following behavioral health providers: Dr. Diane Chen, Dr. Claire Coyne or Javier Thompson, LCSW, please call our administrative assistant Olive Stefanski at 312.227.7743

Tests & Treatments

We want to work with you to determine the best care for you and your family. Some of our most common treatments include pubertal suppression therapy and hormone therapy for transgender males and transgender females.

While we believe in providing safe and effective care for our patients, the long-term consequences of some of the treatments are still unknown. Learn more about our treatments:

Behavioral Health Services Specific to the Gender Program

Patients referred for behavioral health support within our Gender Sex Development Program may benefit from the services outlined below.

Multidisciplinary Clinic Services

  • Initial Psychosocial Screening – All patients new to the multidisciplinary gender clinic meet with one of our behavioral health providers for a general psychosocial screening with the goal of identifying potential behavioral health and supportive service needs. This screening is informed by a battery of measures assessing gender dysphoria, behavioral and emotional concerns, and parenting stress and support to be completed by patients and parents/guardians during their initial appointment. Patients may be referred for behavioral health supports with one of our in-house behavioral health providers or referred to clinicians in the community, as needed.

Outpatient Services

  • Comprehensive Diagnostic Assessment – This assessment occurs across two to three sessions lasting 60 minutes each. In each of these sessions, the patient and their family will meet with one of our behavioral health providers who will conduct a comprehensive assessment on matters related to the child/adolescent’s psychological, behavioral and social well-being. The assessment will also focus on matters specific to the child or adolescent’s gender development (e.g., identity exploration, identity formation). This service may be used for gender expansive youth who are already in treatment with a behavioral health provider but may be seeking additional consultation on gender issues. The family will receive recommendations for treatment on the final session of the assessment period.
  • Individual and Family Psychotherapy - When indicated, families who have completed a Comprehensive Diagnostic Assessment may continue to meet for gender-affirming and/or evidence-based psychotherapy with one of our behavioral health providers. The behavioral health provider will meet with the patient, their parents and/or families (including siblings, when indicated) at a frequency that is guided by the focus of treatment. When necessary, the provider will consult with the patient’s primary care or prescribing physicians.
  • Group Psychotherapy - When indicated, families who have completed a Comprehensive Diagnostic Assessment and/or families already in individual/family psychotherapy may continue to meet for gender-affirming group psychotherapy. Group psychotherapy is conducted periodically by our behavioral health providers, and groups may involve patients only, parents and/or siblings.

Resources & Support

We have many helpful resources for gender-questioning, gender expansive, and transgender youth, as well as their educators, fellow students, parents and allies.

In the News

View a list of articles to learn how our work fits into the community and what the media is saying about us. 


Transgender Youth Care Study, “The Impact of Early Medical Treatment in Transgender Youth” (RO1 NIH)

This is a longitudinal observational study at four sites (Lurie Children’s, Children’s Hospital Los Angeles, Boston Children’s Hospital and the University of California at San Francisco) to examine the outcomes of existing medical treatment protocols for gender dysphoria in two distinct cohorts: youth initiating puberty suppression and youth pursuing a phenotypic gender change.

Survey instruments are used to collect demographic, mental health, psychosocial and behavioral data. Routinely collected anthropometric and physiologic parameters are obtained through chart abstraction. Enrollment began in August 2016 and will go through December 2018.

Trans Youth Fertility Study ​(Society of Pediatric Psychology & Internal REACH Grant from Northwestern University Department of Psychiatry and Behavioral Sciences​)

Puberty blocking medications and gender-affirming hormones are becoming more widely accepted as standard of care for transgender youth, but they may have an effect on long-term fertility potential. The goal of this study is to explore existing knowledge, attitudes and beliefs related to fertility and reproductive health among two cohorts of transgender youth (ages 9-13 and ages 14-24) and their parents/guardians. The study will examine whether current practices for fertility counseling are meeting patient/family needs to make informed treatment decisions. Key-informant interviews will be conducted to identify fertility-related decisional needs, which will aid in the creation of a fertility-related decision aid for trans youth.

If you are interested in learning more about the study, please contact project coordinator, Afiya Sajwani, BA, at 312.227.8372 or

Trans Youth Decision-Making Project (R21 NICHD)

Puberty suppressing medications are becoming more widely accepted as standard of care for transgender youth in early puberty. Guidelines provided by the World Professional Association of Transgender Health recommend youth meet with a mental health clinician to assess understanding and expectations of treatment prior to initiating these medications. The goal of this study is to better understand how cognitive and emotional functioning affects transgender youth’s medical decision-making. Study findings also will inform the development of an assessment tool that would assist mental health clinicians in objectively assessing youth’s breadth and depth of understanding the potential risks and benefits of pubertal suppression treatment.

If you are interested in learning more about the study, please contact project coordinator, Victoria Kolbuck, LSW, MSW at 312.227.6336 or


The creation of the  Gender and Sex Development Program at Lurie Children’s was made possible, in part, through private contributions. Your support is vital in helping us continue to make a difference in the lives of all of our patients and families. Lurie Children’s relies on philanthropic funding to enhance its programs, services and research for children. To learn more, please contact Ann & Robert H. Lurie Children’s Hospital of Chicago Foundation at or call 312.227.7251.