A former case manager at a Missouri pediatric transgender clinic is blowing the whistle on the “morally and medically appalling” treatment resulting in “permanent harm” done to children.
Jamie Reed, a self-described “queer” leftist woman married to a transgender man, worked as a case manager handling intake of patients at the Pediatric Transgender Center at Washington University School of Medicine at St. Louis Children’s Hospital for more than four years. In an exposé for The Free Press, Reed confirmed all of the fears that have been raised in recent years about the fast-tracking of children into irreversible medical treatments.
“I left the clinic in November of last year because I could no longer participate in what was happening there,” penned Reed. “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.”
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.”
In a letter prepared for Missouri’s attorney general, Reed outlined the rapid medicalization of children, poor assessments of mental health prior to gender-altering treatment, lack of informed consent from parents and youth, and actual harm caused by the medical treatment. The letter also contained allegations of abuse and intimidation of parents who don’t fully support medicalization and misleading testimony before the Missouri Legislature.
“Given the secrecy and lack of rigorous standards that characterize youth gender transition across the country, I believe that to ensure the safety of American children, we need a moratorium on the hormonal and surgical treatment of young people with gender dysphoria,” Reed concluded.