Gender Clinic
Gender Care at Yakima Pediatrics Teen Health Clinic
We care for children, adolescents, and young adults who report their gender identity is different from their sex at birth. Our team strives to provide compassionate care for transgender youth, and peoples who do not identify with traditional definitions of male or female.
Our care team includes medical providers, behavioral health consultants, nurses, medical assistants, and social workers – all in one clinic location!
Our Philosophy of Care
- Treat all persons with dignity and respect
- Provide a judgment-free zone, where each person is accepted
- Work with local and state-wide partners in providing evidenced-based care for the whole person
- Follow nationwide best practices in the care of transgender and non-binary persons for transition-related treatments
- Partner with you and your family to make sure all are comfortable with the treatment options individually tailored to meet your transition goals
Thinking about gender identity, gender concerns, and sexuality:
You will need a letter of support from a therapist for both stages of transition (e.g. hormonal replacement therapy [HRT] and surgery). This can take up to a year depending on your supports, resources, other diagnoses, and medical conditions. Start this process early, even if you are unsure what your long-term goals will be; that way you are prepared.
The SPACE is a great resource here in Yakima to meet other kids going through similar experiences, and get support for free.
Gender Clinic Roadmap:
#1 - Call Us
Refer yourself directly, or have your provider refer you by calling (509) 575-0114.
#4 - Meet Our Gender Clinic Team
When you are ready, our gender team will call you to schedule your first medical appointment. Here we will talk about your medical history, do a brief exam and talk about treatment options.
#2 - Our Care Navigator Will Reach Out
Once we have your referral, we will schedule a 30-minute intake phone call with our care navigator.
#5 - Begin Gender Affirming Treatment
We can start you on puberty blockers, monitoring, or cross-sex hormones. See treatment options in the links below.
#3 - Mental Health Support
Get connected to mental health support. We will help you get connected before starting treatment.
#6 - Continue Adult Care
We can treat you until age 22. After that, we can refer you to an adult trans healthcare provider.
#4 - Meet Our Gender Clinic Team
When you are ready, our gender team will call you to schedule your first medical appointment. Here we will talk about your medical history, do a brief exam and talk about treatment options.
#5 - Begin Gender Affirming Treatment
We will start you on puberty blockers, monitoring, or cross-sex hormones. See treatment options in the links below.
#6 - Continue Adult Care
We can treat you until age 22. After that, we can refer you to an adult trans healthcare provider.
What You Need:
This section talks about what you need as you prepare to complete the parts of gender care and transition at Yakima Pediatrics Teen Health Clinic.
In general, it is always a good idea to keep all your information in one location (e.g., notes from conversations w/doctors, insurance companies, mental/behavioral health professionals, etc.).
You will need to have started the process of social transition and have parental support. Talk to your doctor or medical provider about what this means. They can help you with having this conversation with your parents and other people in your community.
You will also work on any behavioral health or mental health conditions that may be impacting your overall health (e.g. anxiety, depression, PTSD, weight management, sleep, eating disorders, etc.).
During your first visits with your therapist or behavioral health consultant, please let them know you are looking for a Letter of Support for Gender Transitions, so they can start structuring the time appropriately.
- Answering the questions to write the Letter of Support can take 6-12 months, depending on your personal circumstances and if you have ever worked with a therapist or behavioral health provider before.
Know that you will be asked to start social transitioning (living as your true gender)
- For any gender affirming surgeries, you will need to live as your preferred gender for a year before they will do the surgeries.
Services We Provide
Mental Health Support and Readiness Discussion
How We Can Help
Our team can help you cope with feelings and concerns related to your gender identity and your transition path. Transgender youth are at high risk for low self-esteem, substance abuse and other emotional and mental health problems. Finding respectful relationships is a challenge for many. We can help. If you want to start hormone therapy or make other physical changes, our team carefully checks that you are ready to begin. This includes treating your mental health, too.
Mental Health Books
Depression
- How I Stayed Alive When My Brain Was Trying To Kill Me – by Susan Rose Blauner
- The Feeling Good Handbook– By David Burns (research backed workbook on strategies to manage and improve mood)
- When Living Hurts: (for you or someone you care about who feels discouraged, sad, lonely, etc.) – by Sol Gordon
- The Mindfulness and Acceptance Workbook for Depression: Using ACT to Move Through Depression and Create a Life Worth Living, 2nd Edition by Kirk Strosahl & Patti Robinson
Anxiety
- The Relaxation & Stress Reduction Workbook by Martha Davis, et al
- The Stress and Relaxation Handbook: A Practical Guide to Self-Help Techniques by Jane Madders
- Wherever You Go, There You Are: Mindfulness Meditation in Everyday Life by Jon Kabat-Zinn
- The Mindfulness & Acceptance Workbook for Anxiety: A Guide to Breaking Free from Anxiety…Using ACT, 2nd Edition by John P. Forsyth & Georg Eifert
Anxiety & Depression
- Get Out of Your Mind and Into Your Life by Steven C. Hayes
- In This Moment: Five Steps to Transcending Stress Using Mindfulness and Neuroscience by Kirk D. Strosahl & Patricia Robinson
Mental Health Web Links
Mental Brakes to Avoid Mental Breaks | Steven Hayes | TEDxDavidsonAcademy for “How can we best deal with difficult or negative thoughts?”
Self-Help Resources
- https://www.psychologytools.com/download-therapy-worksheets/ (Click on “Self-Help” tab)
- https://www.therapistaid.com/therapy-worksheets/goals/none (Goal setting worksheets and problem solving packets)
Parenting:
https://depts.washington.edu/hcsats/PDF/TF-%20CBT/pages/positive_parenting.html
Yoga & stress relief for kids:
Mental Health Free Apps
What’s Up: The Idea Monk (can search topics to help with motivation, guidance, etc.)
https://play.google.com/store/apps/details?id=com.whats.up&hl=en_US
CBT Thought Record Diary (use CBT to become more aware of/track thinking patterns)
https://play.google.com/store/apps/details?id=com.moodtools.cbtassistant.app&hl=en_US
MindShift (aimed at helping teens & young adults cope with anxiety)
https://www.anxietycanada.com/resources/mindshift-app
Breathr: Mindful Moments (help introduce mindfulness and those new to this practice)
http://keltymentalhealth.ca/breathr
Stop, Breath, and Think (guide people through meditations for mindfulness & compassion)
Puberty Blockers
Puberty Blockers Handout
Starting puberty blockers is a decision that is different for everyone. To make the most informed decision, this handout is meant to help you understand what pubety blockers do, what changes will happen to your body, and what are the benefits and risks associated.
Puberty Blockers Informational Video
This video explains how puberty blockers work, as well as the benefits and risks associated with this treatment.
Masculinizing Hormones
Masculinizing Hormones Handout
Hormone therapy is an option that can help transgender people feel more comfortable in their bodies. Like other medical treatments, there are benefits and risks. Knowing what to expect will help us partner to maximize the benefits and minimize the risks.
Masculinizing Hormones Informational Video
Masculinizing hormone therapy is an option that can help people who are transgender fulfill their affirmed masculine gender identity and feel more comfortable in their bodies. This video explains how masculinizing hormone therapy works, as well as the benefits and risks associated with this treatment.
Resources for Chest Binders
Good general information about using binders safely
- http://www.transyouthequality.org/binders
- https://www.nytimes.com/2019/05/31/well/transgender-teens-binders.html
General overview of best binders on the market
Gc2b Transition Apparel: https://www.gc2b.co/
- Many young people like this brand, adjustable
Shapeshifters: https://www.shapeshifters.co/binders
- This is a good company for customization and adjustment without extra fees.
The SPACE in Yakima also helps young people with getting customized binders
Safer Binding Practices
The following PDF will exaplin safe chest binding practices, methods for binding, as well as offer some low cost binders:
Feminizing Hormones
Feminizing Hormones Handout
Hormone therapy is an option that can help transgender people feel more comfortable in their bodies. Like other medical treatments, there are benefits and risks. Knowing what to expect will help us partner to maximize the benefits and minimize the risks.
Feminizing Hormones Informational Video
Feminizing hormone therapy is an option that can help people who are transgender fulfill their affirmed feminine gender identity and feel more comfortable in their bodies. This video explains how feminizing hormone therapy works, as well as the benefits and risks associated with this treatment.
Padded Hips and/or Bras
Talk to your medical team and The SPACE, if you have questions about getting padded hips or bras
Safer Tucking Methods and Tips
This is a useful PDF to help teach safer tucking methods: HOTT-Safer-Tucking-PDF
Resources
From the American Psychological Association
From the American Academy of Pediatrics
Know Your Rights
A good resource for knowing your resources and facts around trans rights
From the CDC
Good informational websites, articles, and resources for teens, parents, and schools
From Gender Spectrum
Gender Spectrum is a non-profit whose mission statement is to create a social environment of inclusivity around gender. They have an amazing list of resources for all ages of children and all family types.
Blog for Parents
A blog for parents whose children are nonbinary
lifeoutsidethebinary.com/post/96149381358/so-your-child-is-nonbinary-a-guide-for-parents
Stories
A site from a group in the UK, features some great stories from parents and teens
Frequently Asked Questions
Does my insurance cover hormone replacement therapy (HRT)?
Medicaid:
- https://www.hca.wa.gov/health-care-services-supports/apple-health-medicaid-coverage/transgender-health-program
- ****Ask about prior authorization and what specific information they need before they will cover these services****
Private Insurance
- You will need to call your insurance, and ask exactly what they will cover, and who is in your network that can prescribe/oversee this
- Call the number on the back of your insurance card
- If you don’t know your insurance you can call the clinic to get this information
****Ask about prior authorization and what specific information they need before they will cover these services****
Does my insurance cover top or bottom surgeries?
Medicaid:
- Often times, it will cover the surgery, but there can be out of pocket costs as well
- Call and ask what is specifically covered
- https://www.hca.wa.gov/health-care-services-supports/apple-health-medicaid-coverage/transgender-health-program
- ****Ask about prior authorization and what specific information they need before they will cover these services****
Private Insurance:
- Call and ask what they cover, and who is in network to provide these services
****Ask about prior authorization and what specific information they need before they will cover these services****
The Transgender and Gender Non-Conforming Support Group
WHAT: This group is a place for patients to get support with issues related to their gender journeys regardless of where they are in their journey. Topics may include overview of the transition process, proper use of binders and packers, navigating the coming out process, steps in the legal process (e.g., changing your name and gender markers), how to advocate for yourself in public spaces (e.g., PE, bathrooms, sports, schools, etc.), resilience and values work, health topics (e.g., acne with hormone changes, weight gain, healthy eating, sleep, etc.) and any other areas that might be of interest for the group.
WHO: Patients of CHCW (e.g. Teen Health Clinic, Yakima Pediatrics, Central Washington Family Medicine, Naches, Highland, Davis Health Clinic) who are 13-21 years old, and identify as trans or non-binary
WHERE: Yakima Pediatrics, 2nd Tuesday of the month from 3:30p – 4:30p
HOW: Ask your medical or behavioral health provider about group at your next visit, or call (509-424-4288) to be added to the list