Referrals to our clinic

We have developed a Gender Clinic Roadmap to help you better understand the referral and appointment process. As well, we have a Frequently Asked Questions for new patients with more information about our clinic.

To get a referral to the Gender Clinic at BC Children’s Hospital, your referring provider (family physician, pediatrician, nurse practitioner, or psychiatrist) needs to use this referral form and attach any relevant reports (labs, history).

Readiness & assessment

Our clinic, as do most clinics caring for transgender and gender-questioning children/youth in Europe and North America, follows the Standards of Care (SOC) for the Health of Transsexual, Transgender, and Gender Nonconforming People, Version 8, established by the World Professional Association for Transgender Health (WPATH).

These guidelines recommend that a trans-competent mental-health professional assess transgender and gender-questioning children/youth prior to consideration of medical treatment (puberty blockers/affirming hormones) by the Pediatric Endocrinologist. This professional can be a Psychiatrist, Psychologist, Adolescent Medicine specialist, Pediatrician, Nurse Practitioner, Registered Clinical Social Worker, or other specialist with expertise in diagnosing and treating the psycho developmental issues of children and youth. The goals of this readiness assessment are to explore the youth’s gender and to assess their mental health and capacity to consent or assent to reversible and potentially irreversible treatment prior to the possible initiation of medical treatment. An exploration of family dynamics and the level of support—both that provided by the family to the youth, and that available to the family themselves—is also an important part of this assessment. 

After the readiness assessment is completed and received by the gender clinic, you will be placed on the wait list to see an endocrinologist at the gender clinic. This is an opportunity to continue the conversations about puberty blockers and/or gender affirming hormones. The conversation with the endocrinologists is an opportunity to consider the timing of starting puberty blockers and/or gender affirming hormones, side-effects, co-existing medical conditions, and ask questions. 

Your first visit

We have developed a Gender Clinic Roadmap to help you better understand the referral and appointment process.

Intake visit: The Intake appointment is not a medical appointment, but it’s the first step to connecting with our gender clinic. During this visit, you will meet the nurse and/or social worker, who will get some background information on your gender journey, social history, and supports, etc.

During the intake appointment, the nurse and/or social worker will discuss the next steps of your gender journey, which may include a readiness assessment. If you are seeking medical treatment (puberty blockers and/or gender-affirming hormones), a readiness assessment must be completed by a trans-competent mental health assessor prior to seeing a pediatric endocrinologist. Options for a readiness assessment can be explored during the intake appointment. While it is not necessary to complete a readiness assessment before the intake appointment, some families like to begin the process. Please reach out to the clinic if you'd like help finding a trans-competent mental health assessor.

The intake visit is usually done virtually.

First medical visit: Once our clinic has received the readiness assessment from a trans-competent mental health assessor recommending medical treatment, you will be scheduled to see a pediatric endocrinologist.

The clinic endocrinologist, who may be assisted by a endocrinologist-in-training, will talk to you about your health and perhaps do a “physical” (check-up). This check-up includes checking your vital signs, listening to your heart and lungs, gently palpating your abdomen, and checking your thyroid (located on the front part of the neck). More sensitive exams are not always needed. If the doctor feels this information would be helpful, a plan to complete the exam will be discussed with you. 

Youth and parents are welcome to see the clinic staff separately, if desired.

Based on your visit and your referring doctor’s information, the endocrinologist will discuss the next step of the process with you. Occasionally, further tests (blood tests) are done elsewhere in the hospital or possibly at an outside lab.

Your first medical visit will be a minimum of 2 hours. This visit can be done virtually or in-person at the hospital. If coming to the hospital, plan on being there for at least 2½ hours. Younger siblings will find this tiring, and we highly suggest alternative babysitting arrangements to make your visit more comfortable. If alternative babysitting arrangements cannot be found, The Sibling Support Centre provides safe, short-term sibling support (up to two hours in the Centre) with play in a creative setting while their sibling is in care or receiving care on campus.

If you have questions

Please let us know your questions and any way we can make this visit more comfortable for you. Check out our Frequently Asked Questions for patients new to the Gender Clinic.

What to bring

Please bring the following to each clinic visit:

• your BC CareCard/Service Card
• If you have a number of questions, make a list to bring with you
  
• A list of the medications you're taking, along with the doses. Some people find it easier to bring the medications with them to the appointment.
  
• At your first clinic visit, you will be asked about your medical history. It may be useful for you to bring an adult who has this information.

If you need to cancel

If you need to cancel your appointment, please contact us as soon as possible (at least 48 hours ahead of time) so that your appointment time can be used by another patient.

If you have an infection

If you have been in contact with any infectious diseases (such as chicken pox or measles) during the three weeks before your appointment, please let us know immediately. We might need to reschedule your appointment.

If you need an interpreter

If an interpreter would be helpful for you, please phone us as soon as possible and we will arrange for this.