Gender Management Service (GeMS)

The Gender Management Service (GeMS) at Boston Children’s Hospital is committed to providing the highest level of individualized, safe and affirmative care to gender-expansive and transgender individuals and their families. Founded in 2007, GeMS was the first major program in the U.S. to focus on treating gender-expansive and transgender adolescents. Since that time, we have expanded our program to welcome patients from ages 3 to 25.

Our approach

Gender dysphoria occurs when there is a conflict between the sex someone was assigned at birth and the gender with which they identify, which can cause significant distress. The term “gender expansive” refers to individuals who experience, explore and express their gender identity on the continuum between male and female. At GeMS, our mission is to assess and care for gender-expansive children, teens and young adults and those with gender dysphoria through excellence in clinical care, advancement of research and training other clinicians. We take a team approach to gender-affirmative care, partnering with experts from many different specialties, both at Boston Children’s and the community. These include:

  • primary care
  • adolescent medicine
  • individual, group and family therapists
  • plastic surgery and the Center for Gender Surgery 
  • reproductive endocrinology
  • urology
  • schools and academic institutions
  • LGBTQ+ support groups and organizations

Together, we provide physical and psychological assessment, ongoing care and additional referrals as needed.

Our areas of innovation

The GeMS program is actively engaged in research with the hope that it will ultimately benefit the children, adolescents, young adults and families with whom we work. We have received funding for our research form the National Institutes of Health and collaborate with many other gender centers throughout the United States.

Our research interests span medical, psychological, developmental and social issues and include:

  • impact of medical treatments on health and well-being
  • impact of medical treatments on psychological well-being
  • reproductive health, including fertility counseling and disease prevention
  • gender development and well-being of prepubescent gender-diverse children
  • predictors of well-being in transgender and gender-diverse children, including family and social support