Seven months after former pediatric gender clinician Jamie Reed blew the whistle on unquestioning “affirming” care at Washington University Transgender Center at St. Louis Children’s Hospital, the New York Times has confirmed core elements of her story.
Speaking with patients, employees, local health-care providers, and parents, the Times investigation corroborated many of Reed’s central allegations, most notably that a substantial number of adolescent patients were prescribed testosterone treatments before their underlying mental-health issues were addressed. Moreover, the St. Louis clinic exhibited a categoric lack of record-keeping and patient tracking.
As “demand rose, more patients arrived with complex mental health issues. The clinic’s staff often grappled with how best to help, documents show, bringing into sharp relief a tension in the field over whether some children’s gender distress is the root cause of their mental health problems, or possibly a transient consequence of them,” the Times noted.
“With its psychologists overbooked, the clinic relied on external therapists, some with little experience in gender issues, to evaluate the young patients’ readiness for hormonal medications. Doctors prescribed hormones to patients who had obtained such approvals, even adolescents whose medical histories raised red flags. Some of these patients later stopped identifying as transgender, and received little to no support from the clinic after doing so.”
In February, Reed went public with her concerns, writing in the Free Press about the pitfalls of a medical system that had blindly embraced “gender-affirming” care without implementing robust safeguards to identify children who were dealing with underlying mental-health issues that may have been contributing to to their dysphoria but would not be addressed with hormone treatments, which often have lasting consequences. “I left the clinic in November of last year because I could no longer participate in what was happening there. 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 wrote.
“Today I am speaking out. I am doing so knowing how toxic the public conversation is around this highly contentious issue — and the ways that my testimony might be misused. I am doing so knowing that I am putting myself at serious personal and professional risk,” Reed continued. “Almost everyone in my life advised me to keep my head down. 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.”
Reed’s story was an instant bombshell and triggered Missouri’s attorney general to open an investigation into the clinic shortly after.
According to the Times, after leading six training sessions with emergency room staff in August and September 2022, Reed’s colleague reported back to her colleagues that doctors and nurses had expressed concern about the rise of transgender teens coming to the ER in crisis, but her warnings fell on deaf ears. “At the trainings, E.R. staff shared concerns about their own experiences with their young transgender patients, which Ms. Hamon [Reed’s coworker] later relayed to her team and university administrators,” Times reporter Azeen Ghorayshi writes. “The E.R. staff, she wrote in an email, had been seeing more transgender adolescents experiencing mental health crises, ‘to the point where they said they at least have one TG [transgender] patient per shift.'”
“‘They aren’t sure why patients aren’t required to continue in counseling if they are continuing hormones,'” Reed’s associate, Hamon, wrote. “No one is ever told no.”
After becoming concerned about the clinic’s failure to record patient outcomes, Reed and Hammond began keeping a “red flag list,” an excel spreadsheet where they eventually compiled case notes on 60 individuals who were permitted to pursue transition despite complex underlying mental-health issues.
Reed provided the spreadsheet to the Times:
The list eventually included 60 adolescents with complex psychiatric diagnoses, a shifting sense of gender or complicated family situations. One patient on testosterone stopped taking schizophrenia medication without consulting a doctor. Another patient had visual and olfactory hallucinations. Another had been in an inpatient psychiatric unit for five months.”
On a different tab, they tallied 16 patients who they knew had detransitioned, meaning they had changed their gender identity or stopped hormone treatments.
The Times article comes several months after the outlet found itself in the crosshairs of nearly 200 employees and contributors who criticized the paper for its handling of transgender issues. The “Times has in recent years treated gender diversity with an eerily familiar mix of pseudoscience and euphemistic, charged language, while publishing reporting on trans children that omits relevant information about its sources,” the open letter reads.
“As thinkers, we are disappointed to see the New York Times follow the lead of far-right hate groups in presenting gender diversity as a new controversy warranting new, punitive legislation. Puberty blockers, hormone replacement therapy, and gender-affirming surgeries have been standard forms of care for cis and trans people alike for decades.”
The list of co-signers featured prominent writers and personalities, including Roxane Gay, Ed Yong, and Lena Dunham.
The Times also found that “at least one” of Reed’s claims “included factual inaccuracies,” stemming from a story she included about a transgender youth whose prescription for testosterone blockers led to liver damage. However, according to the Times, Reed erroneously cited the treatment rather than the child’s underlying health problems. The child’s mother insisted to the Times: “We don’t regret any decision.”
“My daughter’s situation was exploited,” the concerned parent added.