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Positive Reevaluation of Urogenital Differences (PROUD) Clinic

Contact number | 202-476-5631

The Children’s National Positive Reevaluation of Urogenital Differences (PROUD) Clinic, formerly known as the Differences (or Disorders) of Sexual Development Clinic, provides specialized diagnostic, evaluation and treatment services for children with a variety of rare and complex diseases. The team provides individualized care for patients, ranging from prenatal diagnoses to adolescence.

Differences in Sex Development

Differences in sex development (DSD) include a large and varied number of conditions. They consist of conditions in which the chromosomes, the gonads (testes or ovaries), or internal or external sexual organs are considered atypical. These differences are not as rare as many think and may happen in 0.2% to 1.7% of births. These conditions may be identified in the following ways:

  • Before birth, when genetic testing or ultrasound reveal atypical findings
  • When a baby is born with ambiguous genitalia
  • During evaluation for a hernia in childhood
  • When a teen has abnormal puberty
  • During evaluation for infertility

When the gonads, internal reproductive structures or external genitalia do not grow normally, the child has a difference in sex development. It is important to avoid guessing the sex or making any assumptions until your child's healthcare provider can determine more information about the underlying cause. 

PROUD Clinic Services

The PROUD Clinic is led by Veronica Gomez-Lobo, M.D., who works closely with specialists in pediatric endocrinologyurology, gynecology, genetics and psychiatry to create an individual care plan for every patient and family.

Conditions treated in the PROUD Clinic include:
  • Congenital adrenal hyperplasia 
  • 5 alpha reductase deficiency
  • Complete or partial gonadal dysgenesis
  • XX Testicular DSD
  • Ovotesticular DSD
  • Persistent Mullerian duct syndrome
  • Sex-chromosome mosaicism
  • Testosterone synthesis defects
  • Androgen insensitivity syndrome (complete and partial)

Our services include genetic counseling, genetic testing, hormonal therapy and psychological and psychosocial support.

Children’s National is part of the Disorders of Sex Development Translational Research Network (DSD-TRN), a NIH-supported group of medical centers working to improve knowledge about and care for patients with DSD.

Children's National is also a member of the Accord Alliance. Accord Alliance promotes comprehensive and integrated approaches to care that enhance the health and well-being of people and families affected by DSD.

A Clinic to Meet the Needs of Families

Every month, Children’s National brings together the Proud Clinic's team of experts to meet with patients and their families. The team specializes in treating differences of sexual development, and provides families with resources and expertise in a compassionate environment. The clinic is held on the fourth Tuesday of every month at the Washington Nationals Diabetes Care Complex at Children’s National Hospital in Washington, D.C. 

For more information about the PROUD Clinic, please contact our Endocrinology team at 202-476-5631 or Tammy Middleton-Walker, RN, at 202-476-4187.

Positive Reevaluation of Urogenital Differences (PROUD) Clinic Team

  • Kim Shimy

    Kim Shimy

  • Eyby Leon Janampa

    Eyby Leon Janampa
    Medical Geneticist

  • Louise Pyle

    Louise Pyle
    Medical Geneticist

  • Veronica Gomez-Lobo

    Veronica Gomez-Lobo
    Division Chief, Gynecology
    Director, Positive Reevaluation of Urogenital Differences (PROUD) Clinic
    Director, Pediatric and Adolescent Gynecology
    Pediatric and Adolescent Gynecologist

  • Jacqueline Maher

    Jacqueline Maher

  • David Call

    David Call
    Medical Director, Gender Development Program

  • Daniel Casella

    Daniel Casella
    Director, Urology Fellowship
    Medical Director, Informatics for Surgery

  • Emmanuele Delot

    Emmanuele Delot
    Research Coordinator

  • Children's National Hospital

    Tammy Middleton-Walker
    Registered Nurse