The STRIVE for Kids Program (Supportive Team approach to ReproductIVE variations) at Children's Hospital of Philadelphia (CHOP) is one of the busiest programs in the country working with children with differences in sex development (DSD), variations of sex characteristics, differences of the gonads or genitalia at birth, and other conditions that can affect genitourinary (GU) or reproductive function.

Our interdisciplinary team includes experts from Endocrinology, the Adrenal and Puberty Center, Urology, Psychology, the Roberts Individualized Medical Genetics Center (IMGC) and other specialties, such as radiology, gynecology, reproductive medicine, oncology and ethics.

This program delivers diagnostic, management and treatment services to individuals with DSD and other variations in sex characteristics (VSC) throughout childhood and adolescence while also providing support and addressing the individual needs of each patient and their families.

About differences of sex development

Differences of sex development (DSD) is an umbrella term that describes a group of conditions that occur early in pregnancy and result in the development of sex organs that are different than typical.

There are many types of DSD. They can present as differences in the external genitalia that are noticed at birth or in differences to internal reproductive body parts or sex hormones that are noticed later in childhood, in adolescence or even in adulthood. These alterations can present as differences in pubertal development, hormone differences or infertility. Some people with differences in sex development have other health issues, while many individuals are otherwise healthy.

The causes of these differences vary. Many types of DSD have a genetic or hormonal (i.e., endocrine) basis. A change or alteration of a gene or part of a gene can lead to different instructions for the body during development. Genetic and hormone testing can help us determine a specific DSD diagnosis, determine if there are additional health concerns, alter medical management and provide appropriate counseling.

Expertise in DSD evaluation, treatment and follow-up care

Though differences in sex development are rare, our STRIVE for Kids Program has evaluated and actively follows more than 250 patients and families. Our dedicated staff and faculty provide comprehensive, interdisciplinary evaluations with genetics, endocrinology, urology, psychology and social work.

We follow patients on an ongoing basis, from birth to young adult life. We also provide prenatal counseling to those who are at risk of having a baby with DSD or other GU or reproduction concerns.

The STRIVE program is dedicated to helping families navigate the medical, genetic, surgical and psychosocial care needed for their child through childhood and adolescence.