ST. LOUIS 鈥 Missouri鈥檚 senior senator and the state鈥檚 new attorney general both announced investigations Thursday after publication of allegations that a transgender clinic in 最新杏吧原创 was providing substandard care to children and teens.
The allegations, published , were made by Jamie Reed, a 42-year-old native 最新杏吧原创an, who said she worked at the as a case manager between 2018 and 2022.
鈥淚 left the clinic in November of last year because I could no longer participate in what was happening there,鈥 Reed wrote. 鈥淏y the time I departed, I was certain the way the American medical system is treating these patients is the opposite of the promise we make to 鈥榙o no harm.鈥 Instead, we are permanently harming the vulnerable patients in our care.鈥
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Among Reed鈥檚 allegations: Instead of providing mental health treatment to children who needed it, the center gave them puberty blockers or cross-sex hormones. She also alleged the center regularly referred minors for gender-transition surgery, contrary to public assurances by its doctors.听
In response, U.S. Sen. Josh Hawley on Thursday said his office was launching an investigation.
鈥淭his is a sickening account of forced sterilization and child abuse. Happening in Missouri at an institution that receives federal taxpayer funds,鈥 Hawley, a Republican, wrote on Twitter. 鈥淢issouri children deserve to be protected.鈥
Missouri Attorney General Andrew Bailey also announced Thursday afternoon that his office opened an investigation two weeks ago after hearing from the whistleblower. Bailey, a Republican who took office last month, said he waited to disclose the probe until Reed went public.
Washington University, , said it was alarmed by Reed鈥檚 allegations, and it was also investigating.
鈥淲e are taking this matter very seriously and have already begun the process of looking into the situation to ascertain the facts,鈥 the statement read.
Hawley said late Thursday he spoke with Washington University Chancellor Andrew D. Martin, and received the university鈥檚 assurance that it will 鈥渇ully cooperate鈥 with his investigation. Hawley said he also was assured that the whistleblower will be fully protected from retaliation. In a letter to Washington University and 最新杏吧原创 Children鈥檚 Hospital, Hawley directed both institutions to preserve all records 鈥渞egarding gender-related treatments performed on minors.鈥
The transgender center opened in 2017, with one arm serving adults older than 18, and . The center provides gender-affirming care to those who identify as transgender, gender non-conforming, non-binary or genderqueer.
鈥淕ender affirming care isn鈥檛 meant to influence people in any particular direction. We don鈥檛 鈥榯reat鈥 anyone鈥檚 identity or tell anyone what they should or shouldn鈥檛 do,鈥 the website states. 鈥淲e鈥檙e here to educate you about your options and help you decide which path is best.鈥
Treatment options include adjustments in gender expression (such as use of pronouns, makeup, hair, voice, clothing or behavior), puberty blockers, hormone therapy and referrals to psychologists and therapists.
pause the physical changes of growing up. With , transgender girls receive estrogen and transgender boys, testosterone.
Hormone therapy helps transgender girls develop breasts and wider hips; transgender boys, facial hair and a deeper voice. Some, but not all, of the changes are reversible if the patient goes off hormones.
鈥楲ack of protocols and treatment鈥
Reed, who describes herself as a progressive queer woman married to a trans man, said staff at the center too freely prescribed medications and did not properly explain the side effects. 鈥淚 was struck by the lack of protocols and treatment,鈥 she wrote.
During the four years she worked there, around a thousand young people came through the doors and a majority received hormone prescriptions.
To begin transition, Reed wrote, all children needed a letter of support from a therapist, who was often one recommended by the center.
Reed said her encounters with patients left her feeling like they did not know about the side effects of hormone therapy. For example, transgender males taking testosterone, which thins vaginal tissues, suffered vaginal lacerations during sex; and a transgender female taking experienced liver toxicity.
Reed began seeing many kids with diagnoses such as schizophrenia, PTSD and bipolar disorder referred to the center from 最新杏吧原创 Children鈥檚 Hospital.
鈥淵et no matter how much suffering or pain a child had endured, or how little treatment and love they had received, our doctors viewed gender transition 鈥 even with all the expense and hardship it entailed 鈥 as the solution,鈥 she wrote.
She was also disturbed by cases where parents did not agree on their child鈥檚 need for gender-affirming care. 鈥淚t seemed the center always took the side of the affirming parent,鈥 she wrote. In Missouri, only one parent鈥檚 consent is needed for treatment.
Reed said she advocated for tracking desistance and detransition among patients, but the idea was turned down. 鈥淒esisters鈥 end up choosing not to go through with transition, and 鈥渄etransitioners鈥 decide to return to their birth gender after transitioning.
She and a colleague tracked the cases anyway, she said, calling it the 鈥淩ed Flag List.鈥
, Washington University stressed its commitment to 鈥減roviding compassionate, family-centered care鈥 to all patients, and holding is medical providers 鈥渢o the highest professional and ethical standards.鈥
Bailey said his office has already taken sworn testimony from Reed, 鈥渟o that parents are fully aware of the nature of these allegations.鈥
The Missouri Department of Social Services will also look into allegations of abuse of the state鈥檚 Medicaid program, and the Division of Professional Registration will determine if action needs to be taken against the providers鈥 licenses.
鈥淲e 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,鈥 Bailey stated.
Growth in transgender care
The number of gender clinics treating children in the U.S. has gone from zero to more than 100 in the past 15 years, according to a recent story by Reuters, yet the long-term impacts of puberty blockers and sex hormones on brain development and fertility are not well understood.
Major medical organizations, such as the American Academy of Pediatrics and the Endocrine Society, endorse puberty blockers and hormone treatments as . They say the mental health ramifications of not addressing the needs of such patients put them in peril.
More than half of transgender teens have considered suicide, , an LGBTQ crisis-intervention nonprofit. A study released a year ago found that receiving gender-affirming care lowers the risk of depression and suicide for transgender teens.
, a Washington University pediatric endocrinologist who co-founded the Transgender Center at 最新杏吧原创 Children鈥檚 Hospital, told the Post-Dispatch in a story that published in May 2022 about a transgender youth that doctors there see 250 new patients a year.
Some of that increase is due to a greater understanding of transgender care, he said, and broader insurance coverage.
Last year, Lewis traveled to Jefferson City to testify against a bill that would have prohibited transitioning treatment for transgender youths.
鈥淲e are taking away the autonomy and dignity of these patients and families 鈥,鈥 he told lawmakers. 鈥淚t will limit access to care that we know benefits them. It鈥檚 only going to harm them.鈥
Misconceptions about treatment can color people鈥檚 opinions, Lewis told the Post-Dispatch. No one younger than 18 undergoes gender-affirming surgery 鈥 and many transgender adults never have surgery. Patients are monitored regularly by a team of specialists who keep a close eye on hormone levels and potential side effects, such as blood clots and bone-density loss.
The incidence of regret is small, he said, and is almost always attributed to social consequences: lack of family acceptance, job loss or victimization.听听
Includes reporting by Colleen Schrappen of the Post-Dispatch.
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'This is a sickening account of forced sterilization and child abuse. Happening in Missouri at an institution that receives federal taxpayer funds. Missouri children deserve to be protected.'
Sen. Josh Hawley, R-Mo., on Twitter