Information

Related Research Units

Gynecology Research

Research Overview

Dr. Grimstad engages in research surrounding transgender and differences of sex development/ intersex traits (dsd/I) reproductive health. Her interests center around optimizing reproductive health outcomes for both populations including hormonal and menstrual management, sexual health, surgical care, and family planning.

Research Background

Frances Grimstad (she/her) is a Pediatric and Adolescent Gynecologist at Boston Children’s Hospital and an Assistant Professor of Obstetrics, Gynecology and Reproductive Biology at Harvard Medical School.

She engages in clinical and research work surrounding transgender and differences of sex development/ intersex traits (dsd/I) reproductive health. She has been involved in trans health advocacy since her own adolescence, when she decided to pursue medicine to address disparities in care faced by these communities. Dr. Grimstad believes in using research and advocacy to dismantle clinical bias and bring more evidence-based care to gender- and sex-diverse patients.

At Boston Children’s she is the founder of the Transgender Reproductive Health Service and also the gynecologist in the Center for Gender Surgery and the BEING-U clinic (the program for patients with dsd/I). She believes reproductive health and the decisions that surround it are deeply personal and as unique as each individual. She prioritizes individualized reproductive, sexual and fertility goals for her transgender, gender diverse, and dsd/I patients.

Education

Undergraduate School

Sarah Lawrence College
2008 Bronxville NY

Medical School

University of Southern California, Keck School of Medicine
2013 Los Angeles NY

Residency

University of Kansas Medical Center
2017 Kansas City MO

Fellowship

Children's Mercy Hospital
2019 Kansas City MO

Graduate School

University of Missouri Kansas City
2019 Kansas City MO

Fellowship

Gender Affirming Surgery Cleveland Clinic
2022 Cleveland OH

Publications

  1. Survey of Urogynecology Fellows on the Care of Patients with Differences in Sex Development/Intersex Traits. Int Urogynecol J. 2025 Jan 09. View Abstract
  2. Qualitative assessment of provider approaches to dilation following vaginoplasty. J Pediatr Adolesc Gynecol. 2024 Dec 05. View Abstract
  3. National Trends of Common Gynecologic Procedures Among Pediatric Hospitals: A National Surgical Quality Improvement Program Pediatric (NSQIP-P) Database Analysis. J Pediatr Surg. 2025 Feb; 60(2):162068. View Abstract
  4. Use of Continuous Oral Drospirenone for Menstrual Suppression in Adolescents. J Adolesc Health. 2025 Jan; 76(1):148-153. View Abstract
  5. Medical and Surgical Reproductive Care of Transgender and Gender Diverse Patients. Obstet Gynecol Clin North Am. 2024 Dec; 51(4):621-633. View Abstract
  6. Use of Vaginoscopy after Vaginoplasty in Individuals with Congenital Adrenal Hyperplasia. J Pediatr Adolesc Gynecol. 2024 Dec; 37(6):602-607. View Abstract
  7. Approach to the Patient: Navigating Body Mass Index Requirements for Gender-Affirming Surgery. J Clin Endocrinol Metab. 2024 Aug 13; 109(9):2389-2399. View Abstract
  8. NASPAG Clinical Opinion: The Care of Transgender and Gender Nonbinary Adolescents and Young Adults. J Pediatr Adolesc Gynecol. 2024 Dec; 37(6):533-541. View Abstract
  9. Adult endocrinologists' perspectives on transitioning adolescent patients with congenital adrenal hyperplasia. J Pediatr Endocrinol Metab. 2024 Aug 27; 37(8):722-729. View Abstract
  10. Management of breakthrough bleeding in transgender and gender diverse individuals on testosterone. Am J Obstet Gynecol. 2024 Nov; 231(5):534.e1-534.e11. View Abstract
  11. Peri-surgical imaging of intersex and gender diverse youths. Pediatr Radiol. 2024 07; 54(8):1371-1390. View Abstract
  12. Use of the Drospirenone-Only Contraceptive Pill in Adolescents with Endometriosis. J Pediatr Adolesc Gynecol. 2024 Aug; 37(4):402-406. View Abstract
  13. Overview of gender-affirming surgery. Pediatr Radiol. 2024 07; 54(8):1363-1370. View Abstract
  14. Incidence of breakthrough bleeding in transgender and gender-diverse individuals on long-term testosterone. Am J Obstet Gynecol. 2024 04; 230(4):434.e1-434.e10. View Abstract
  15. Danazol's use for menstrual suppression in transgender individuals: A retrospective multi-site cohort study. Womens Health (Lond). 2024 Jan-Dec; 20:17455057241265081. View Abstract
  16. How Do Prescribing Clinicians Obtain Consent to Initiate Gender-Affirming Hormones? Transgend Health. 2023 Dec; 8(6):526-533. View Abstract
  17. Prevalence of pelvic pain in transgender individuals on testosterone. J Sex Med. 2023 11 30; 20(12):1459-1465. View Abstract
  18. Preventive Practices and Knowledge of Human Papillomavirus in Mayer-Rokitansky-Küster-Hauser Syndrome Individuals. Sex Transm Dis. 2024 Feb 01; 51(2):128-131. View Abstract
  19. A randomized trial comparing perioperative pelvic FLOor physical therapy to current standard of care in transgender Women undergoing vaginoplasty for gendER affirmation: the FLOWER Trial. Int Urogynecol J. 2023 Dec; 34(12):2985-2993. View Abstract
  20. How Should Clinicians Navigate Decision Making About Genital Reconstructive Surgeries Among Intersex and Transgender Populations? AMA J Ethics. 2023 06 01; 25(6):E437-445. View Abstract
  21. Success in Accessing Fertility Preservation Appointments for Egg-Producing Transgender and Gender-Diverse Patients: A Mystery Caller Study. LGBT Health. 2023 Aug-Sep; 10(6):439-446. View Abstract
  22. Retrospective review of changes in testosterone dosing and physiologic parameters in transgender and gender-diverse individuals following hysterectomy with and without oophorectomy. J Sex Med. 2023 04 27; 20(5):690-698. View Abstract
  23. Desire for genetically related children among transgender and gender-diverse patients seeking gender-affirming hormones. F S Rep. 2023 Jun; 4(2):224-230. View Abstract
  24. Assessing and Addressing the Risk of Venous Thromboembolism Across the Spectrum of Gender Affirming Care: A Review. Endocr Pract. 2023 Apr; 29(4):272-278. View Abstract
  25. Retrospective Review of Sexual and Reproductive Health Conversations During Initial Visits of Adolescents Seeking Gender-Affirming Testosterone. J Pediatr Adolesc Gynecol. 2023 Feb; 36(1):25-32. View Abstract
  26. Postoperative Vaginal Bleeding Concerns after Gender-Affirming Hysterectomy in Transgender Adolescents and Young Adults on Testosterone. J Pediatr Adolesc Gynecol. 2023 Feb; 36(1):33-38. View Abstract
  27. Young Adult Patients with Testosterone Management Concerns after Gender-Affirming Hysterectomy and Bilateral Oophorectomy: A Case Series. J Pediatr Adolesc Gynecol. 2023 Feb; 36(1):89-91. View Abstract
  28. Family Building Perspectives of Assigned Female at Birth Transgender and Gender Diverse Adolescents Seeking Testosterone Gender-Affirming Hormone Therapy. LGBT Health. 2022 Oct; 9(7):463-470. View Abstract
  29. Prevalence of Chronic Pelvic Pain by Sexual Orientation in a Large Cohort of Young Women in the United States. J Sex Med. 2022 06 01; 19(6):1012-1023. View Abstract
  30. Prevalence of Chronic Pelvic Pain by Sexual Orientation in a Large Cohort of Young Women in the United States. J Sex Med. 2022 06; 19(6):1012-1023. View Abstract
  31. A 13-Year-Old Girl with Primary Amenorrhea. NEJM Evid. 2022 04; 1(4):EVIDmr2200001. View Abstract
  32. Vaginectomy in Transmasculine Patients: A Review of Techniques in an Emerging Field. Female Pelvic Med Reconstr Surg. 2022 06 01; 28(6):e222-e230. View Abstract
  33. Puberty and growth in patients with pediatric intestinal failure. J Pediatr Surg. 2022 Jun; 57(6):1045-1049. View Abstract
  34. Evaluating Provider Self-Disclosure in Adolescent Contraception Counseling. J Pediatr Adolesc Gynecol. 2022 Aug; 35(4):457-461. View Abstract
  35. A Body-Neutral and Gender-Neutral Modified Ferriman-Gallwey Diagram. J Pediatr Adolesc Gynecol. 2022 Jun; 35(3):375-378. View Abstract
  36. Unintended and teen pregnancy experiences of trans masculine people living in the United States. Int J Transgend Health. 2021; 22(1-2):65-76. View Abstract
  37. The Use of Telemedicine in Pediatric and Adolescent Gynecology. J Pediatr Adolesc Gynecol. 2022 Apr; 35(2):133-137. View Abstract
  38. Clinician Advocacy and Intersex Health: A History of Intersex Health Care and the Role of the Clinician Advocate Past, Present, and Future. Pediatr Ann. 2021 Sep; 50(9):e359-e365. View Abstract
  39. The Health Care of Adults with Differences in Sex Development or Intersex Traits Is Changing: Time to Prepare Clinicians and Health Systems. LGBT Health. 2021 10; 8(7):439-443. View Abstract
  40. Vulvovaginal Involvement in Pediatric Stevens-Johnson Syndrome: A Case Series. J Pediatr Adolesc Gynecol. 2021 Oct; 34(5):745-748. View Abstract
  41. Breakthrough Bleeding in Transgender and Gender Diverse Adolescents and Young Adults on Long-Term Testosterone. J Pediatr Adolesc Gynecol. 2021 Oct; 34(5):706-716. View Abstract
  42. The role of androgens in clitorophallus development and possible applications to transgender patients. Andrology. 2021 11; 9(6):1719-1728. View Abstract
  43. Gender-Affirming Surgeries in Transgender and Gender Diverse Adolescent and Young Adults: A Pediatric and Adolescent Gynecology Primer. J Pediatr Adolesc Gynecol. 2021 Aug; 34(4):442-448. View Abstract
  44. Oxandrolone Use in Trans-Masculine Youth Appears to Increase Adult Height: Preliminary Evidence. LGBT Health. 2021 May-Jun; 8(4):300-306. View Abstract
  45. Multidisciplinary approach to imaging for gender-affirming surgery: engaging surgeons, radiologists, and patients to ensure a positive imaging experience. Ann Transl Med. 2021 Apr; 9(7):610. View Abstract
  46. A Response to Jue et al, "Kidney Transplantation in Transgender Patients". Curr Urol Rep. 2021 03 29; 22(5):28. View Abstract
  47. Routine Screening for Transgender and Gender Diverse Adults Taking Gender-Affirming Hormone Therapy: a Narrative Review. J Gen Intern Med. 2021 05; 36(5):1380-1389. View Abstract
  48. Spontaneous Cervicovaginal Fistula in Obstructed Hemivagina and Ipsilateral Renal Anomaly Syndrome: A Case Report. J Pediatr Adolesc Gynecol. 2021 Apr; 34(2):220-222. View Abstract
  49. The gynecologic examination of the transfeminine person after penile inversion vaginoplasty. Am J Obstet Gynecol. 2021 03; 224(3):266-273. View Abstract
  50. Survey of Experiences of Transgender and Gender Nonbinary Patients During Imaging Encounters and Opportunities for Improvement. AJR Am J Roentgenol. 2020 11; 215(5):1136-1142. View Abstract
  51. Considerations for Providing Pediatric Gender-Affirmative Care During the COVID-19 Pandemic. J Adolesc Health. 2020 11; 67(5):635-637. View Abstract
  52. Ovarian Histopathology in Transmasculine Persons on Testosterone: A Multicenter Case Series. J Sex Med. 2020 09; 17(9):1807-1818. View Abstract
  53. Research is needed to assess breakthrough bleeding rates in transmasculine individuals utilizing hormonal contraception. Am J Obstet Gynecol. 2020 12; 223(6):946. View Abstract
  54. New-Onset Abdominopelvic Pain After Initiation of Testosterone Therapy Among Trans-Masculine Persons: A Community-Based Exploratory Survey. LGBT Health. 2020 07; 7(5):248-253. View Abstract
  55. Dysmenorrhea and Endometriosis in Transgender Adolescents. J Pediatr Adolesc Gynecol. 2020 Oct; 33(5):524-528. View Abstract
  56. Empowering Transmasculine Youth by Enhancing Reproductive Health Counseling in the Primary Care Setting. J Adolesc Health. 2020 06; 66(6):653-655. View Abstract
  57. How Should Decision-Sharing Roles Be Considered in Adolescent Gender Surgeries? AMA J Ethics. 2020 05 01; 22(5):E452-457. View Abstract
  58. Introducing a New Journal Club Feature for JPAG. J Pediatr Adolesc Gynecol. 2020 04; 33(2):101-103. View Abstract
  59. Reply. Am J Obstet Gynecol. 2020 04; 222(4):394. View Abstract
  60. From Suffrage to the Senate: Expanding Inclusion in Women's Rights to Achieve Women's Health Equality. Mo Med. 2019 Nov-Dec; 116(6):472-475. View Abstract
  61. Imaging Findings in Transgender Patients after Gender-affirming Surgery. Radiographics. 2019 Sep-Oct; 39(5):1368-1392. View Abstract
  62. Contraception across the transmasculine spectrum. Am J Obstet Gynecol. 2020 02; 222(2):134-143. View Abstract
  63. Management and Prevention of Postoperative Complications in a Neonate with a Symptomatic Imperforate Hymen. J Pediatr Adolesc Gynecol. 2019 Aug; 32(4):429-431. View Abstract
  64. Creating a Transgender-Inclusive Interventional Radiology Department. J Vasc Interv Radiol. 2019 Jun; 30(6):928-931. View Abstract
  65. Serving the Needs of Transgender and Gender-Diverse Persons in Radiology. J Am Coll Radiol. 2019 04; 16(4 Pt A):533-535. View Abstract
  66. Uterine pathology in transmasculine persons on testosterone: a retrospective multicenter case series. Am J Obstet Gynecol. 2019 03; 220(3):257.e1-257.e7. View Abstract
  67. An Evaluation of Reported Follicle-stimulating Hormone, Luteinizing Hormone, Estradiol, and Prolactin Reference Ranges in the United States. Urology. 2018 Oct; 120:114-119. View Abstract
  68. Histone demethylase KDM4A and KDM4B expression in granulosa cells from women undergoing in vitro fertilization. J Assist Reprod Genet. 2018 Jun; 35(6):993-1003. View Abstract
  69. A Review of the Epigenetic Contributions to Endometriosis. Clin Obstet Gynecol. 2017 09; 60(3):467-476. View Abstract
  70. Use of ICSI in IVF cycles in women with tubal ligation does not improve pregnancy or live birth rates. Hum Reprod. 2016 12; 31(12):2750-2755. View Abstract
  71. Immunogenetic contributions to recurrent pregnancy loss. J Assist Reprod Genet. 2016 Jul; 33(7):833-47. View Abstract
  72. Assessing Residency Program Approaches to the Transgender Health CREOG Objective. Transgend Health. 2016; 1(1):69-74. View Abstract
  73. Periclitoral endometriosis: the dilemma of a chronic disease invading a rare location. J Minim Invasive Gynecol. 2015 May-Jun; 22(4):684-6. View Abstract
  74. Primary amenorrhea: diagnosis and management. Obstet Gynecol Surv. 2014 Oct; 69(10):603-12. View Abstract

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