The THRIVE program works with families of transgender youth and adolescents to help them receive the treatment they desire. Our team consists of endocrinology, psychiatry, adolescent medicine, behavioral health therapists, and medical social work. To start hormone therapy, the patient has to have a psychological evaluation by our psychiatrist. Once the psychiatrist recommends hormone therapy and parental consent is given, the patient can begin treatment with the endocrinologist. Please note that not all patient transitions look the same or move at the same rate. Some patients and families simply want to be linked to behavioral health services or to primary care services and not move forward to see the endocrinologist.
For those wanting medical therapy, after a medical evaluation by the endocrinologist, medication can be prescribed that ultimately block or stop the production of the body’s natural, but undesired hormones. After an agreed upon time between doctor and patient/caregivers and once the patient is over the age of 16, then either estrogen or testosterone can be administered depending on the direction of transition. Both estrogen and testosterone can be given in various ways and the doctor will discuss options with the patient and family.
It is recommended that those participating in the THRIVE program and receiving hormone therapy be linked and attend follow up behavioral health sessions. Behavioral health services can be attended through Nationwide Children’s Hospital or through a provider in the family’s community. Additionally, a medical social worker is available to answer questions, offer support to patients and family, and assist with school and/or community needs (issues with bullying, bathrooms, school activities, etc.).
Gender Concern Explanations
Gender Dysphoria (Transgender)
Gender Dysphoria is diagnosed when an individual feels their gender does not match their physiological sex and due to this the person experiences distress. Gender Dysphoria differs from gender non-conformity when someone experiences marked distress due to the development of their body in a sex that does not match their gender identity. In some cases an individual can start to identify as the opposite gender as early as 3 years of age. For others, it may be more of a process and identification occurs later in development. It has been shown that treating adolescents with hormones and therapy early in puberty significantly improves social adjustment and decreases anxiety, depression, and suicidality in transgender individuals. Also, it is important to respect individuals by using their preferred names and pronouns, and thus validate who they are.
Male to Female (MTF)
Male to Female transition is when a male-bodied individual makes social and physical changes to match their female identity. At a young age male-bodied children may begin asking when they will become a girl or when their penis will go away. Male-bodied youth may begin dressing and presenting as female (social transition). During early stages of puberty, she may begin hormone suppression therapy followed by estrogen replacement. Once adult age is reached, the patient may decide to have genital reconstructive (bottom) surgery*. Please note that this is a generic example of one possible transition. Individuals in transition may stop or be content at various states along this path.
Female to Male (FTM)
Female to Male transition is when a female-bodied individual makes social and physical changes to match their male identity. At a young age female-bodied children may ask why they do not have a penis. Female-bodied youth may begin dressing and presenting as male (social transition). Marked anxiety often occurs at puberty when these male-identified persons begin to develop breasts and start their period. During early stages of puberty, he may begin hormone suppression therapy followed by testosterone replacement. Patients may decide to have their breasts removed and a male contoured chest constructed (top) surgery*. Some go on to have genital reconstruction (bottom) surgery* once they reach adulthood. Please note that this is a generic example of one possible transition. Individuals in transition may stop or be content at various states along this path.
*Disclaimer: Transition surgeries are not currently offered at Nationwide Children’s Hospital