Pediatric Gender Clinic Under Multi-Agency Investigation

Feb 10, 2023

ST. LOUIS, MO – Missouri Attorney General Andrew Bailey announced that his office has launched a multi-agency investigation into the Washington University Pediatric Transgender Center at St. Louis Children’s Hospital after a former employee went public and accused the hospital of lying to parents and harming hundreds of children with puberty blockers and mutilating surgeries.

The Attorney General’s office has a sworn affidavit from the whistleblower, Jamie Reed, and documents that support her allegations. The Missouri Department of Social Services and Division of Professional Registration are assisting the investigation. 

“As Attorney General, I want Missouri to be the safest state in the nation for children,” said Attorney General Andrew Bailey. “We have received disturbing allegations that individuals at the Transgender Center at St. Louis Children’s Hospital have been harming hundreds of children each year, including by using experimental drugs on them. We take this evidence seriously and are thoroughly investigating to make sure children are not harmed by individuals who may be more concerned with a radical social agenda than the health of children,” said Bailey. 

Reed worked at the Washington University Transgender Center and was responsible for patient intake between 2018 and November 2022. She said she took the job with the intention of “saving” gender-confused children, but now she believes what is happening amounts to “permanent harm” on young, vulnerable children. 

Reed said, “During the four years I worked at the clinic as a case manager—I was responsible for patient intake and oversight—around a thousand distressed young people came through our doors. The majority of them received hormone prescriptions that can have life-altering consequences—including sterility. I left the clinic in November of last year because I could no longer participate in what was happening there. By the time I departed, I was certain that the way the American medical system is treating these patients is the opposite of the promise we make to ‘do no harm.’ Instead, we are permanently harming the vulnerable patients in our care.” 

“Almost everyone in my life advised me to keep my head down. But I cannot in good conscience do so. Because what is happening to scores of children is far more important than my comfort. And what is happening to them is morally and medically appalling,” said Reed.

Soon after her arrival at the Transgender Center, Reed was shocked by the lack of formal protocols for treatment and the physician co-directors were essentially the sole authorities. Reed stated that the doctors she worked with at the Center often said regarding the patients: “We are building the plane while we are flying it.” Yet after four years, Reed realized that no one should be a passenger on that kind of aircraft.

In 2019, Reed started noticing a growing number of patients deciding not to go through with “transition,” or deciding to embrace their biological gender. She and her colleague started collating information about those patients with the assumption that the doctors would want to know about their change of heart. But the doctors did not. 

She noted that the girls who came to the Center had many comorbidities such as depression, anxiety, ADHD, eating disorders, and obesity. Many were diagnosed with autism or had autism-like symptoms. Frequently, patients declared they had disorders that no one believed they had. The doctors privately recognized these false self-diagnoses as a manifestation of social contagion. They even acknowledged that suicide has an element of social contagion. But when clusters of girls streaming into the Center looked as if their gender issues might be a manifestation of social contagion, the doctors said gender identity reflected something innate. 

Reed also acknowledged that all that was required for a child to “transition” was a letter of support from a therapist, typically one recommended by the staff, and who the patient had to see only once or twice for the green light. To make it more efficient for the therapists, the Center offered them a template for how to write a letter in support of “transition.” The next stop was then a single visit to the endocrinologist for a testosterone prescription. 

In her sworn affidavit for the Missouri Attorney General’s office, Reed asserts that individuals at the Center are using experimental drugs on children, distributing puberty blockers and cross-sex hormones without individualized assessment, and even without parental consent. Bicalutamide is a medication used to treat metastatic prostate cancer, and one of its side effects is that it feminizes the bodies of men who take it, including the appearance of breasts. The Center prescribed this cancer drug as a puberty blocker and feminizing agent for boys. As with most cancer drugs, bicalutamide has a long list of side effects including liver toxicity. There also are no clinical studies for using this drug for gender confusion, and there are no established standards of care for using this drug. 

In addition, these “transitioning” methods have led children to attempt suicide and the Center never discontinues prescribing cross-sex hormones, no matter how much those drugs are harming the child. Reed also has provided evidence that the Center has been unlawfully billing state taxpayers to fund these actions.

Other specific allegations in Reed’s affidavit include: 

  • “On several occasions, the doctors have continued prescribing medical transition even when a parent stated that they were revoking consent.
  • The Center does not require children to continue with mental health care after they prescribe cross-sex hormones or puberty blockers and even continues those medications when the patients directly report worsening mental health after initiating those medications.
  • I have seen puberty blockers worsen the mental health outcomes of children. Children who have not contemplated suicide before being put on puberty blockers have attempted suicide after.
  • It is my belief that the Center does not track these outcomes because they do not want to have to report them to new patients and because they do not want to discontinue cross-sex hormone prescriptions. The Center never discontinues cross-sex hormones, no matter the outcome.
  • During my time at the Center, I personally witnessed Center healthcare providers lie to the public and to parents of patients about the treatment, or lack of treatment, and the effects of treatment provided to children at the Center.
  • Doctors at the Center also have publicly claimed that they do not do any gender transition surgeries on minors. … This was a lie. The Center regularly refers minors for gender transition surgery. The Center routinely gives out the names and contact information of surgeons to those under the age of 18. At least one gender transition surgery was performed by Dr. Allison Snyder-Warwick at St. Louis Children’s Hospital in the last few years.
  • The Center tells the public and parents of patients that the point of puberty blockers is to give children time to figure out their gender identity. But the Center does not use puberty blockers for this purpose. Instead, the Center uses puberty blockers just until children are old enough to be put on cross-sex hormones. Doctors at the Center always prescribe cross-sex hormones for children who have been taking puberty blockers.
  • The Center tells the public and parents that it makes individualized decisions. That is not true. Doctors at the Center believe that every child who meets four basic criteria—age or puberty stage, therapist letter, parental consent, and a one-hour visit with a doctor—is a good candidate for irreversible medical intervention. When a child meets these four simple criteria, the doctors always decide to move forward with puberty blockers or cross-sex hormones. There were no objective medical test or criteria or individualized assessments.
  • I know of at least one patient at the Center who was advised by the renal department to stop taking Bicalutamide because the child was experiencing liver damage. The child’s parent reported this to the Center through the patient’s online self-reporting medical chart (MyChart). The parent said they were not the type to sue, but ‘this could be a huge PR problem for you.’
  • Children come into the clinic using pronouns of inanimate objects like ‘mushroom,’ ‘rock,’ or ‘helicopter.’ Children come into the clinic saying they want hormones because they do not want to be gay. Children come in changing their identities on a day-to-day basis. Children come in under clear pressure by a parent to identify in a way inconsistent with the child’s actual identity. In all these cases, the doctors decide to issue puberty blockers or cross-sex hormones.
  • On another occasion, a patient had their breasts removed. This surgery was performed at St. Louis Children’s Hospital. Three months later, the patient contacted the surgeon and asked for their breasts to be ‘put back on.’ Had a requisite and adequate assessment been performed before the procedure, the doctors could have prevented this patient from undergoing irreversible surgical change.
  • In just a two-year period from 2020 to 2022, the Center initiated medical transition for more than 600 children. About 74% of these children were assigned female at birth. These procedures were paid for mostly by private insurance, but during this time, it is my understanding that the Center also billed the cost for these procedures to state and federal publicly funded insurance programs.
  • I have personally witnessed staff say they were uncomfortable with how the Center has told them they have to code bills sent to publicly funded insurance programs. I have witnessed staff directly ask the providers for clarification on billing questions and have providers dismiss the concerns and work to have the patients have this care covered as the priority.”

According to Komodo Health Inc., in 2021, about 42,000 children and teens across the United States received a diagnosis of gender dysphoria, nearly triple the number in 2017. The analysis found that at least 121,882 children ages 6 to 17 were diagnosed with gender dysphoria from 2017 through 2021. 

In fact, the number of gender clinics treating children in the United States has grown from zero to more than 100 in the past 15 years. At these clinics, doctors are giving testosterone to gender-confused girls as young as eight years old and teen girls as young as 13 are having their breasts removed via mastectomy procedures. Boys the age of 17 can have penises the developmental age of a nine-year-old’s or lose sexual sensation all together due to hormone blockers. 

Liberty Counsel represents licensed counselors who provide life-saving counseling to minors who desperately desire to conform their attractions, behaviors, and gender identities to their sincerely held religious beliefs. Liberty Counsel won two cases at the federal court of appeals striking down these laws under the First Amendment. 

Liberty Counsel Founder and Chairman Mat Staver said, “What is happening to children in these so-called gender clinics is criminal. States must protect minors from irreversible and unnecessary medications and mutilating surgeries. Our children are not guinea pigs to pad the pockets of others.” 

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