Abstract

Recently, I was a physician-observer in a clinic for children and adolescents who are struggling with gender identity. Since the clinic opened several years ago, the number of patients seen annually has grown well over six hundred. The staff includes an adolescent-medicine physician, a pediatric endocrinologist, a nurse, and a social worker. I spent twenty-four hours over three clinic days observing the interactions of staff and listening to intake synopses of patients and discussions of treatment plans. My aim was to better understand the working diagnosis of gender dysphoria, the protocols used in treatment, and the ethical concerns. These objectives were not achieved in the way I expected.