What to Expect at your GENECIS Appointment

What to Expect at your GENECIS Appointment


What type of provider(s) will my child see?

For the first visit, you will meet with a member of the GENECIS program mental health team (psychologist, clinical therapist or psychiatrist).

For the first medical visit, your child will see a pediatric endocrinologist, pediatric adolescent gynecologist and/or an adolescent medicine physician.

  • Pediatric endocrinologist – a provider who specializes in hormonal conditions
  • Pediatric/adolescent gynecologist – a provider who specialize in the evaluation and treatment of conditions associated with the reproductive system and provide care for gender dysphoria
  • Adolescent medicine provider – a provider who specialize in general adolescent care

Each of the medical providers in the GENECIS program provide the same gender affirming medical care. Patients are matched with providers based on availability, age and other presenting concerns.

What should we expect during my child’s first medical appointment?

  • You and your child will meet with the provider. 
  • The visit can last up to 3 hours.
  • All parents or legal guardians are asked to attend and participate in this first visit.
  • At this visit, we will discuss individualized recommendations and develop a treatment plan, which may include puberty suppression and/or hormone therapy.
  • Before your appointment, we recommend that you read the puberty suppression and/or hormone therapy consent  form sent to you. These forms will need to be signed during the clinic visit by all parents or legal guardians before treatment is started. If this is not possible, please contact us prior to the appointment.
  • A complete physical examination of your child will be performed, including chest and a superficial exam on the genitalia to determine the current stage of puberty. You should help prepare your child about this part of the visit before the appointment. If either you or your child has questions or concerns about the physical exam, please let the GENECIS doctor know at the beginning of the appointment.
  • At this visit and all subsequent medical visits, you will also meet with a GENECIS social worker. 
  • Same-day appointments with a GENECIS psychiatrist or psychologist are available sometimes. These check-ins do not replace the counseling provided by your child’s regular therapist.

Will my child be started on medication at the first medical appointment?

This depends on your child’s treatment plan as well as the type of medication prescribed.

If your child might be started on Lupron injections or testosterone at the initial visit, and you have commercial insurance, we will instruct you to have labs drawn at your insurance’s preferred lab (usually LapCorp or Quest) before the clinic appointment.

  • Puberty Blockers (also know as puberty suppression)
    • Lupron injections - Requires insurance coverage verification; might be started at the first visit.
    • Supprelin Implant - Requires insurance coverage verification and a separate outpatient appointment to place the implant. In total, this process takes an average of 2-8 weeks.
    • Vantas implant - Cash pay only; requires a separate outpatient appointment to place the implant. In total, this process takes an average of 2-4 weeks.
  • Hormone Therapy (also know as cross-sex hormones)
    • Testosterone - The first dose can typically be given at the first visit.
    • Spironolactone, Estradiol - The first dose can typically be started immediately after the first visit.

Will my insurance cover these appointments?

  • Mental health services will be billed to your insurance. Coverage varies depending on your insurance plan and deductible.
  • Medical visits, blood work, and imaging studies will be billed to your insurance and are usually covered but the degree of coverage varies depending on the insurance plan. You may need to complete blood work at a location other than Children’s for this to be covered by your insurance.
  • We cannot guarantee medication coverage by your insurance company. We will work with your insurance company to attempt coverage and appeal if needed. We cannot provide information about medication coverage before the first medical visit.
  • There are no charges for social work services.
  • If your child does not have insurance or our hospital or provider(s) are out of network with your insurance plan, we will put you in contact with our Financial Services Department for help with billing. You may qualify for a program that provides discounted rates.

Who can I contact with questions?

Request Appointment