'No one is ever told no': NYT investigates whistleblower's claims against St. Louis gender clinic

St. Louis Children's Hospital in St. Louis, Missouri.
St. Louis Children's Hospital in St. Louis, Missouri. | Screenshot: Google Maps

A Missouri-based gender clinic that's faced government scrutiny this year was the subject of a recent New York Times article looking into a whistleblower's claims that providers were too quick to administer hormone drugs to minor patients amid rising demand in recent years. 

The clinic made headlines in February after former case manager Jamie Reed at the Washington University Transgender Center at St. Louis Children's Hospital claimed in a whistleblower affidavit to the state attorney general's office that her former employer pushed puberty-blocking drugs and cross-sex hormones on minors, some of which were reportedly not receiving forced to continue counseling. 

Reed claimed that the clinic, which opened in 2017, relied heavily on promoting gender transition for children despite the risks of "permanently harming the vulnerable patients." After an investigation, the university deemed the claims "unsubstantiated."

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In a statement to The Christian Post, a spokesperson for Washington University said that an appropriate mental health assessment is required for patient prescriptions, and these assessments are performed by licensed mental health professionals, including at community facilities. Due to patient privacy concerns, the spokesperson could not provide details about specific cases or patients. 

"Prescribing decisions reflect individualized assessment, appropriate documentation of consent, discussion of risks such as known side effects and means to avoid those, and an evaluation of the views of mental health professionals familiar with the patient," the spokesperson stated. "Washington University provided the resources needed to support the care delivered to patients at the Center. As always, caring for our patients and their families is our highest priority."

The St. Louis Children's Hospital did not immediately respond to The Christian Post's request for comment.

Reed's concerns drew national attention as critics across the country pointed to her claims in their advocacy for bans on such medical interventions on gender-confused children, which over 20 states, including Missouri, have passed. 

Earlier this year, the Missouri state legislature passed a law that bans health care providers from performing gender transition procedures or administering puberty-blocking drugs or cross-sex hormones to people under 18. A judge allowed that law to go into effect on Monday. 

According to a Wednesday report from The New York Times, Reed's doubts about the clinic's practices arose in 2019 after hearing the account of a detransitioner who regretted altering their body. In 2020, the former case manager witnessed a spike in patients at the clinic, many of whom were struggling with various psychological issues related to the pandemic. 

Emails obtained by the outlet showed that, by the end of 2021, the clinic began receiving calls from four or five new patients daily, far more than in 2018. A 2021 internal presentation also showed around 73% of the new patients were girls. 

As the number of people coming to the clinic increased, the center began relying on outside therapists to determine a child's eligibility for puberty blockers or cross-sex hormones, according to the outlet. 

During training sessions with the emergency department in August and September 2022, the staff expressed concerns to Reed and the clinic's nurse, Karen Hamon, about the growing number of patients who identified as trans and suffered from mental health issues. Hamon informed university administrators and her team about these concerns, The Times reported. 

"They aren't sure why patients aren't required to continue in counseling if they are continuing hormones," Hamon wrote in an email, noting that many were concerned that "no one is ever told no." 

Reed and Hamon put together a "red flag list" to track patient outcomes, as the clinic did not have a system for tracking patient outcomes. 

The list eventually included 60 adolescent patients with complex psychiatric diagnoses, a changing sense of gender or complicated family situations. Another section of the list counted at least 16 patients who detransitioned. 

One female patient who detransitioned emailed the clinic in January 2020, writing that they were looking for a voice coach due to their masculinized voice and a request for an autism screening. The patient noted that she had mentioned this at appointments and over email before, but "it did not seem to go anywhere." 

Another email obtained by the newspaper discussed a female patient who regretted surgery to remove her breasts and had twice messaged the surgeon at Washington University about possibly undergoing breast reconstruction. The patient did not receive a reply. 

Alex, another patient highlighted in the report, said that the clinic prescribed her testosterone in 2017 after one appointment after she was referred by a therapist. At the time, she was also in therapy for her bipolar disorder and anxiety. 

The detransitioner is now 21, and has stopped taking her testosterone injection. While she told The Times she does not "regret" taking hormones, she said about her experience at the clinic: "Overall, there was a major lack of care and consideration for me." 

As CP reported earlier this year, following Reed's allegations about the clinic, Missouri Attorney General Andrew Bailey called for a moratorium on St. Louis' gender clinic prescribing puberty blockers or cross-sex hormones to children. A statement from the attorney general's office later confirmed that it had launched an investigation into the clinic.

In Europe, some governments are starting to take a more precautious approach to how medical professionals handle the influx of minors reporting to gender clinics. 

Amid concerns about the long-term side effects cross-sex hormones and puberty blockers may have on children, England's National Health Service took steps in June to restrict the use of puberty-blocking drugs for gender transition outside of clinical trials. 

The NHS released a 25-page document outlining the approach, calling for an integrated multi-disciplinary team to determine the best "clinical pathway" for a child that fully involves their family. Children who have already received cross-sex hormones or puberty blockers will be treated on a case-by-case basis, according to the NHS. 

In previous guidelines released in October, the NHS warned doctors against advising children to socially transition during what may be a "transient phase."

Samantha Kamman is a reporter for The Christian Post. She can be reached at: Follow her on Twitter: @Samantha_Kamman

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