Pediatric patients with a gender identity that is discordant from their biologic sex have become more common over the last decade. There are different options in approaching such patients with distinctly different outcomes. It is important for pediatricians to understand how to establish the diagnosis for such patients and then to guide them on a path that brings maximum benefit for both short and long term outcomes based on solid, reproduceable scientific studies. The premise, above all, is to first do no harm.

Quentin L. Van Meter received his MD degree from the Medical College of Virginia and trained in pediatrics at the UCSF/Oakland Naval program. He completed his pediatric endocrine fellowship at Johns Hopkins Hospital and served in the US Naval Medical Corps for 20 years. He has been in private practice as a board-certified pediatric endocrinologist for 48 years.