Emergency Room Staff Near St. Louis Gender Clinic Worry ‘No One Is Ever Told No’: Report

ER workers saw an influx of trans-identifying children in crisis.
A person walks past a Transgender flag during The TransFest 2023 in the Queens borough of New York City on July 29, 2023. (Photo by Leonardo Munoz / AFP) (Photo by LEONARDO MUNOZ/AFP via Getty Images)

Emergency room workers at a St. Louis children’s hospital that houses a popular gender clinic said they worry that the young trans-identifying patients showing up at the ER in crisis are never “told no” when it comes to hormone treatments.

In February, Jamie Reed, a former case manager at the Transgender Center at St. Louis Children’s Hospital went public with explosive whistleblower allegations that the gender clinic had hastily put children with significant psychiatric issues on gender hormone treatments. Reed also alleged that the clinic did not make sure children and their families were fully aware of the side effects, some of which are serious.

At the same time, emergency room staff at the hospital started seeing a spike in trans-identifying children showing up every day in psychiatric crisis, The New York Times reported on Wednesday.

The children were taking hormones but not receiving the therapy they needed, emergency room doctors warned.

The clinic’s nurse, wrote in an email obtained by the Times that emergency room staffers “aren’t sure why patients aren’t required to continue in counseling if they are continuing hormones” and were concerned that “no one is ever told no.”

In recent years, the clinic saw a huge spike in trans-identifying children asking for services. By 2021, four or five new patients were calling the clinic every day, up from 2018 when the clinic would only see four or five new patients a month. About 73% of those new patients were girls, according to internal documents reported by the Times.

As the clinic became overwhelmed, it started relying on outside therapists, some of whom did not have much experience in gender issues, to determine whether children were psychologically fit for puberty blockers or cross-sex hormones.

Some children with red flags in their medical histories were put on gender hormone regimens, the Times reported. Some of those patients later stopped identifying as transgender and did not receive any support from the clinic afterwards.

Reed and the clinic’s nurse together kept a private “red flag list” of 60 patients with complex psychiatric diagnoses, a changing sense of gender, or complicated family situations. One patient on testosterone stopped taking their schizophrenia medication, one was known to hallucinate, and one had been in a psychiatric unit for five months.

They also kept track of 16 patients who had detransitioned, meaning they changed their gender identity again or stopped taking hormones, the Times said.

One apparently female patient emailed the clinic to say she had detransitioned and asked for a voice coach for her masculinized voice as well as an autism screening. Another patient ended up regretting her mastectomy and asked for a breast reconstruction, but she had not received a reply, according to emails between clinic staff. Another patient posted a warning about the clinic on Reddit after she was put on testosterone around the same time she was being treated for bipolar disorder and anxiety. She told the Times that “overall, there was a major lack of care and consideration for me” at the clinic.

After the original whistleblower allegations from Reed, the former case manager, Missouri’s Republican attorney general opened an investigation into the clinic. That investigation remains ongoing.

Senator Josh Hawley (R-MO) also launched an investigation into the clinic that is ongoing.

An internal investigation by Washington University, which is affiliated with St. Louis Children’s Hospital, found Reed’s claims were “unsubstantiated.”

Over the last few years, critics have sounded the alarm about the permanent effects of both gender hormone treatments and surgical procedures, especially on children.

Both puberty blockers and cross-sex hormones come with serious health risks. Puberty blockers can affect bone growth and density and cause sexual dysfunction, voice damage, and infertility, among other issues. Cross-sex hormones can cause infertility, deadly blood clots, heart attacks, increased cancer risks of the breasts and ovaries, liver dysfunction, worsening psychological illness, and other serious conditions.

The number of gender surgeries nearly tripled in the U.S. from 2016 to 2019, according to an analysis published Wednesday in JAMA Network Open. In 2016, there were about 4,550 procedures, and that number spiked to around 13,000 in 2019.

Hundreds of teen girls in the U.S., some as young as 12, have gotten elective, gender-related double mastectomies to remove their healthy breasts over the last few years.

Meanwhile, it is more popular than ever for youth to adopt new gender identities. An estimated 300,000 minors aged 13 to 17 identified as transgender as of last year.

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