Washington University in St. Louis said allegations by a former employee that its pediatric and adolescent transgender clinic failed to adequately screen minors before providing care are unsubstantiated, according to findings from an internal investigation released on friday.
In February, Missouri Attorney General Andrew Bailey launched an investigation into the Transgender Center at Children’s Hospital of St. Louis after Jamie Reed, who was a caseworker at the center from 2018 to November 2022, alleged in a 23 page affidavit that children were routinely prescribed puberty blockers or hormone therapy without «appropriate or accurate» mental health evaluations. Bailey’s investigation is ongoing.
Reed also alleged that the center’s providers «regularly refer minors for gender transition surgery,» even though the providers have testified in the state legislature that surgeries are not an option for children under 18 years of age.
The same day the attorney general’s office announced its investigation, Reed went public with his allegations in a opinion piece published in The Free Press, a news website started by Bari Weiss, a former op-ed writer and editor at The New York Times. Reed, who has a master’s degree in clinical research management, concluded his op-ed by calling for a «moratorium on hormonal and surgical treatment of gender dysphoric youth.»
Washington University in St. Louis, the parent institution of Children’s Hospital, said in a statement that it was «alarmed by the allegations» and would investigate Reed’s claims.
After an eight-week internal investigation, the university said in a summary of its findings that its allegations are unsubstantiated but that it would change some of its practices.
“University of Washington physicians and staff at the Center follow appropriate policies and procedures and treat patients in accordance with the currently accepted standard of care, as recommended by the American Academy of Pediatrics and other globally recognized organizations. national,” the university said in the summary.
Reed’s attorney did not immediately respond to a request for comment.
In his affidavit, Reed alleged that patients were routinely provided medication «without informed parental consent.» He also alleged that the center failed to obtain custody agreements from the divorced parents to ensure that all parties consented to treatment.
Although the university does not mention these allegations in the investigation summary, it said that, in the future, the Transgender Center will require written parental consent before prescribing gender-affirming drugs, such as puberty blockers and hormone therapy. Previously, providers obtained verbal parental consent for treatment and documented it in the patient’s chart, according to the abstract.
The center will also require a family to provide custody agreements prior to an initial visit to the center if the patient is a minor, according to the summary. Previously, providers requested custody arrangements «prior to medical intervention in cases where decision-making authority was in question.»
Regarding Reed’s allegations about surgical referrals, the university said the center has not provided such referrals to patients under the age of 18 since late 2018, when it adopted a policy prohibiting them.
“Upon request, some families were provided with the names of the surgeons (including University of Washington physicians) who performed such surgeries, and providers at the Center provided summaries of care to patients desiring surgeries,” he said. the university in the research summary.
The university said doctors will no longer perform gender-affirming surgeries on minors. The University of Washington declined to say when it adopted this policy.
The university said that university doctors have performed a total of six surgeries on minors since 2018, and that all six were chest surgeries for teens transitioning to men. All referrals were from other medical providers outside the center or were patient-initiated self-referrals, the university said.
He noted that chest masculinization surgery for minors falls within the standard of care recommended by the World Professional Association for Transgender Health, or WPATH, a nonprofit association dedicated to transgender healthcare. The WPATH standards, which were recently updated last year, recommend that minors meet a list of criteria before they may be eligible for surgery.
Two former employees of the center said it follows the standard of care recommended by WPATH.
Jess Jones, who uses they/them pronouns and was the educational liaison at the center from 2018 to 2020, shared a variety of documents about the center’s protocols, including documents they said were provided to all families on their first visit, a screening endocrine. roadmap” that outlined the steps patients needed to complete to initiate gender-affirming treatment, and internal documents with patient scenarios that the center used for teaching.
Christine Hyman, whose son has been a patient at the center since 2018, shared emails she received from Reed after her son’s appointments. The email includes one of the same documents Jones shared on masculinizing hormones. It details when a patient should freeze her eggs if she is interested in doing so and a chart on the various effects of testosterone and whether they are reversible, partially reversible or irreversible.
“They’re just a lot of information,” Hyman said of the clinic’s doctors. “They’ve been fabulous all along, especially with a parent who came in and I was like, ‘Help.’”
Jones said the center sometimes «controlled» access to care, «which is why Jamie’s account was so terrible.»
“She made it sound like we were just delivering hormones to children,” Jones said, when in fact Jones said minors had to meet a number of criteria before they could access care.
The center declined to comment.
Cate Hensley, who uses the pronouns «they» and «she» and worked at the center from August 2020 to May 2021 as part of her master’s degree in social work at the University of Washington, said she reported directly to Reed. They said Reed «frequently interpreted the children’s experiences as exaggerated or not telling the truth,» which worried Hensley, who said it was «antithetical» to her mental health clinical training.
They said what stood out to them most in Reed’s affidavit and op-ed was how she violated the trust of patients who did not consent to their private health information being shared publicly. They said they could identify some of the cases Reed described in her affidavit, but that Reed misunderstood or misinterpreted them.
For example, Hensley said they remember the medical team discussing a situation Reed describes in his affidavit in which a patient experienced vaginal lacerations after intercourse while taking testosterone, which can cause thinning of the vaginal tissue, but Hensley didn’t want to. talk about it. in detail because it is private patient information. They said Reed also described a boy he said he identified as an «attack helicopter,» which Hensley said was a joke and is a reference to an internet meme and a science fiction story.
Hensley said the legislative landscape in Missouri, where the Republican Party House passed a bill last week that would ban gender-affirming care for minors makes Reed’s accusations «more insidious.»
“It is more important than ever that the center be able to continue to function and provide ethical client-centered care, and what Jamie has done is not based on any evidence, it is absolutely fueling transphobia and hate here in the state, and will directly harm to the kids. Hensley said.