Missouri Attorney General Launches Investigation Into Trans Center For ‘Harming Hundreds Of Children’
Trans pride flags flutter in the wind at a gathering to celebrate International Transgender Day of Visibility, March 31, 2017 at the Edward R. Roybal Federal Building in Los Angeles, California. International Transgender Day of Visibility is dedicated to celebrating transgender people and raising awareness of discrimination faced by transgender people worldwide.
ROBYN BECK/AFP via Getty Images

Missouri’s attorney general announced Thursday that he has launched a multi-agency investigation into the Pediatric Transgender Center at St. Louis Children’s Hospital after a whistleblower alleged that the facility’s practices are seriously harming children.

Missouri Attorney General Andrew Bailey said that his office launched the probe into the “shocking allegations” from whistleblower Jamie Reed, a self-described “queer” leftist woman who worked as a case manager at the facility.

The attorney general’s office said that they received a sworn affidavit from the whistleblower and documents that support her claims.

“As Attorney General, I want Missouri to be the safest state in the nation for children,” said 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.”

Reed said that she left the clinic last November because she could “no longer participate in what was happening there.”

Some of the most explosive claims included 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.”
  • “One doctor at the Center, Dr. Chris Lewis, is giving patients a drug called Bicalutamide. The drug has a legitimate use for treating pancreatic cancer, but it has a side effect of causing breasts to grow, and it can poison the liver. There are no clinical studies for using this drug for gender transitions, and there are no established standards of care for using this drug.”
  • “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.”
  • “In one case where a girl was placed on cross-sex hormones, I found out later that the girl desired cross-sex hormones only because she wanted to avoid becoming pregnant. There was no need for this girl to be prescribed cross-sex hormones. What she needed was basic sex education and maybe contraception. An adequate assessment before prescribing hormones would have revealed this fact. But because the doctors automatically prescribe cross-sex hormones or puberty blockers for children meeting the bare minimum criteria, this girl was unnecessarily placed on drugs that cause irreversible change to the body.”
  • “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.”
  • “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.”
  • “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.”

Reed, a St. Louis native who describes herself as “politically to the Left of Bernie Sanders,” took a job at the Transgender Center in the summer of 2018, where she was a case manager responsible for patient intake and oversight.

“Soon after my arrival at the Transgender Center, I was struck by the lack of formal protocols for treatment,” said Reed. “The center’s physician co-directors were essentially the sole authority.”

During her four years at the Transgender Center, Reed said she noticed a significant increase in teenage girls seeking to transition to male with comorbidities such as depression, anxiety, ADHD, eating disorders, obesity, autism, or autism-like symptoms.

“Until 2015 or so, a very small number of these boys comprised the population of pediatric gender dysphoria cases,” said Reed. “Then, across the Western world, there began to be a dramatic increase in a new population: Teenage girls, many with no previous history of gender distress, suddenly declared they were transgender and demanded immediate treatment with testosterone.”

Reed and her colleagues recognized that the rapid increase in patients seeking transition could be a manifestation of social contagion — especially when clusters of girls arrived from the same high school — but their concerns were allegedly dismissed by the physicians.

“Anyone who raised doubts ran the risk of being called a transphobe,” said Reed.

The process to begin medical transition, like other pediatric gender clinics all over the country, only requires a letter of recommendation from a therapist after one or two visits. Reed said the Transgender Center made this process simple with recommendations of gender-affirming therapists and offered a template letter of support. A single visit to an endocrinologist for a testosterone prescription followed. Reed came to believe that the long-term effects of testosterone, including infertility, are not fully understood by minors and that the current treatment system is failing to do no harm.

“Our patients were told about some side effects, including sterility,” said Reed. “But after working at the center, I came to believe that teenagers are simply not capable of fully grasping what it means to make the decision to become infertile while still a minor.”

Reed detailed examples of negative physical and psychological effects experienced by patients, such as liver toxicity, vaginal laceration, and clitoral enlargement, and warned of the risk for long-term health problems from hormonal treatment like blood pressure issues, sleep apnea, and diabetes.

“But clinics like the one where I worked are creating a whole cohort of kids with atypical genitals—and most of these teens haven’t even had sex yet,” said Reed. “They had no idea who they were going to be as adults. Yet all it took for them to permanently transform themselves was one or two short conversations with a therapist.”

In 2019, Reed also become aware of an increasing number of minors who regretted their medical transition, called detransitioners. She and a colleague tried to bring attention to the issue and track the data but were met with resistance from doctors. Despite this, the author and colleague created the “Red Flag” list to track these patients.

“We thought the doctors would want to collect and understand this data in order to figure out what they had missed,” said Reed. “We were wrong.”

Reed recalled a particularly sad case of a detransitioned teenage girl from an unstable family with a history of drug use who had undergone a double mastectomy to remove her breasts. After only three months, she regretted her decision.

“Three months later she called the surgeon’s office to say she was going back to her birth name and that her pronouns were ‘she’ and ‘her,’” said Reed. “Heartbreakingly, she told the nurse, ‘I want my breasts back.’”

When Reed and her colleague checked on the young girl, they found out she was pregnant. “Of course, she’ll never be able to breastfeed her child,” Reed lamented.

By the spring of 2020, Reed felt morally obligated to voice her growing concerns and began speaking up in the office and through email communications. As a result, she began receiving negative performance reviews for the first time, noting her “defensiveness and hostility” when she received direction from management.

“Things came to a head at a half-day retreat in [the] summer of 2022,” said Reed. “In front of the team, the doctors said that my colleague and I had to stop questioning the ‘medicine and the science’ as well as their authority. Then an administrator told us we had to ‘get on board, or get out.’”

Reed finally left the Transgender Center in November 2022 and decided to come forward after she felt “stunned and sickened” by comments made by Dr. Rachel Levine, the transgender Assistant Secretary for Health at the federal Department of Health and Human Services, who said that “clinics are proceeding carefully and that no American children are receiving drugs or hormones for gender dysphoria who shouldn’t.”

“Almost everyone in my life advised me to keep my head down,” said Reed. “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.”

Christina Buttons contributed to this report. 

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The Daily Wire   >  Read   >  Missouri Attorney General Launches Investigation Into Trans Center For ‘Harming Hundreds Of Children’