THRIVE Program (DSD & Complex Urological & Gender Concerns)

THRIVE is a program that specializes in care for differences/ disorders of sex development (DSD), complex urological conditions, and gender concerns.

Our program is dedicated to providing optimal care for individuals and family members diagnosed with a DSD, and/or a complex urological condition, including but not limited to bladder exstrophy, cloacal abnormalities, severe hypospadias and gonadal agenesis, as well as gender non-conformity.

Our mission is to provide best-practice, patient specific, evidence based care in a manner that values mental health and emphasizes emotional support. Additionally, we are committed to working with community physicians and organizations on the behalf of our patients and families.

What To Expect

Before the initial visit, our program coordinator will ask you to complete an intake form. This will aide in determining which members of the team will need to be available for the appointment.

Depending on you or your child’s specific need, you will meet with two to five members of our interdisciplinary team.

As a new patient, the appointment may take a few hours to complete. This time frame should allow for sufficient time to ask questions regarding diagnosis and available treatment options.

Additionally, this will give our team time to get to know your family and assess possible needs. Further contact information will be provided so that questions and concerns can be addressed as they often come up after official appointment times.

Meet Your Care Team

The program is comprised of a team including Urology, Endocrinology, Gynecology, Psychology/Psychiatry, Genetics, Adolescent Medicine, Pediatric Surgery and Social Work.

We take pride in the relationship we build with your family because we don’t want you to simply receive treatment at Nationwide Children’s, we want you to THRIVE!

THRIVE provides a multidisciplinary approach to caring for our patients. You will be seen by a team of specialists including:


  • Evaluate and explain the underlying anatomical condition.

  • Discuss the long term functional expectations with patients and families and help determine if surgical intervention is needed.

  • Discuss the type of surgery that might be performed and expected outcomes.

  • Offer long term follow-up to ensure adequate preparation and transition to adult life.


  • Evaluate and diagnose any underlying hormone abnormalities.

  • Explain and educate families about the normal and abnormal processes associated with the disorder.

  • Design and monitor a treatment plan that may include hormone replacement or substitution to promote growth and puberty.

  • Optimize psychosocial function and future sexual function.

  • Provide long term follow up from the neonatal period through childhood and adolescence and through the transition to adult care.


  • Aid in diagnosis and evaluation of underlying condition.
  • Discuss short and long term reproductive and sexual health concerns.
  • Help diagnose, manage and treat medical and surgical gynecologic conditions.
  • Assist with menstrual suppression, contraception and hormonal replacement therapy.
  • Facilitate transition to adult care.


  • Work with patients and families to help adjust to the stress of living with a chronic illness.

  • Assist with issues related to body image, disclosure, and relationships.

  • Can meet regularly with patients to work on significant mood, anxiety, or behavioral issues.


  • Evaluate and Diagnose mental disorders.

  • Facilitate treatment planning and implementation with patients.

  • Prescribe medication if needed for specific diagnosis or treatment plan.

Social Work

  • Assess intake form and coordinate appointments.

  • Provide initial assessments regarding psychological, social and financial need.

  • Offer psychosocial support for parents, guardians and patients regarding diagnosis.

  • Offer psycho-education to develop skills around healthy emotional and sexual well-being.


  • Evaluate and diagnose possible underlying genetic causation of condition.

  • Consider other medical issues that may arise from a genetic cause.

  • Offer information about possible family link and transmission of genetic issue or concern.

Adolescent Medicine

  • Provide primary care services to adolescents ages 12-21 in a safe, affirming environment.

  • Evaluation and management of common medical conditions.

  • Reproductive health services.

  • Testing and treatment of sexually transmitted infections.


THRIVE Resources

Access resources for differences/ disorders of sex development, complex urological concerns, gender concerns and more.

Differences of Sex Development

The THRIVE program specializes in the care of individuals with Differences/ Disorders of Sex Development (DSDs). Learn more.

Gender Concerns

The THRIVE program works with families of transgender youth and adolescents to help them receive the treatment they desire. Learn more about gender concerns.

Complex Urological Concerns

Learn about bladder exstrophy and other complex urological concerns.


Read questions THRIVE families frequently ask.