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Gender clinic for kids confirms some whistleblower claims, pledges vague changes amid probes

Study that found breast removal improves "chest dysphoria" in young women inexplicably hides its findings on gender dysphoria.

Published: May 2, 2023 11:19pm

Updated: September 15, 2023 3:20pm

The shroud is coming off the practices associated with so-called gender affirming care for minors and the research that purportedly favors giving children puberty blockers and cross-sex hormones and surgically removing healthy breasts and genitals.

The Washington University Transgender Center at St. Louis Children's Hospital tacitly confirmed some claims by a whistleblower while pledging vague changes amid investigations by Missouri Attorney General Andrew Bailey and Sen. Josh Hawley (R-Mo.), even as it exonerated itself of "substandard care causing adverse outcomes for patients."

A study that concluded breast removal improves "chest dysphoria" in young women who identify as men or nonbinary, published last fall in the Journal of the American Medical Association Pediatrics, inexplicably hid its results pertaining to gender dysphoria, suggesting they didn't align with the researchers' hypothesis.

An accompanying editorial proclaimed that so-called top surgery in adolescents and young adults is "effective and medically necessary."

Restrictions on life-altering and sometimes irreversible treatments for children too young to understand the consequences are ramping up in red states, largely in line with restrictions in Europe.

Oklahoma Gov. Kevin Stitt (R) signed the latest bill (SB 613) into law Monday, joining at least 15 other states with similar bans pertaining to minors, the Associated Press reported.

The law provides for "felony charges, license revocation and civil actions which can be filed by a parent or guardian," Stitt's office said. Once they reach adulthood, children subject to the procedures could also sue providers until age 45.

A small majority of parents in a new Archives of Sexual Behavior study on rapid-onset gender dysphoria (ROGD) said they felt pressured by a "gender clinic or specialist" to transition their child socially or medically. They took a survey at a website for parents of suspected ROGD kids.

Former case manager Jamie Reed alleged the Washington University gender clinic lacked "formal protocols for treatment," ignored telltale signs of "social contagion," promoted gender transition as "the solution" for serious psychiatric issues and "downplayed the negative consequences," citing specific incidents without names.

In a four-page "summary of conclusions" from its eight-week internal investigation, the university declared that its physicians and staff treat patients in line with the World Professional Association for Transgender Health (WPATH) "standard of care," also used by the American Academy of Pediatrics, whose gender transition research has been challenged by its own allies.

But it quietly confirmed Reed's affidavit claims that the clinic didn't require "written consent" from parents before starting treatment or seek "custody agreements" that specify "who among divorced parents must consent to medical procedures" by default.

Other parts of the statement are vague. It says "some" of the 531 patients receiving cross-sex hormones had started on puberty blockers from the clinic or unrelated providers, but not how many for either. The university is now undertaking "additional efforts to reaffirm its policy prohibiting gender-affirming surgery to the Departments of Pediatrics and Surgery."

Reed's lawyers crowed at the university's admissions while faulting its reliance on standards by WPATH, "an advocacy organization that relies very little on sound, proven evidence" and its refusal to interview Reed for the investigation. 

They also questioned the clinic's official tally of 1,165 patients over 55 months. Reed's own "detailed data sets," which include intake calls that resulted in medical charts but not clinic visits, count more patients despite covering only half the period, the statement says. 

The St. Louis Post-Dispatch said Reed declined to provide "evidence of her data sets." One of her lawyers, Vernadette Broyles, told Just the News the newspaper "did not request the data set" and left out the "detailed description of the concerns for the data discrepancies" from her press release.

"The St Louis Post Dispatch also did not report if they asked Washington University to explain their methodology to explain the numbers that they provided," Broyles wrote in an email. "The data sets in question have been provided to the proper authorities as part of the ongoing investigation."

Bailey claimed the university's assertions "don’t line up with" with his findings to date, without specifying.

Science journalist Jesse Singal, known for his reporting on gender identity, identified additional red flags in the university's summary of conclusions, including its silence on how the investigation was structured.

The university also denied finding any "adverse physical reactions caused by medications prescribed by Center providers," which is complicated by a former clinic staffer who told NBC News she recognized a case mentioned in Reed's affidavit, Singal said.

"Children who take testosterone as a cross-sex hormone experience severe atrophy of vaginal tissue," Reed had said, and such a female patient "experienced vaginal lacerations so severe" from sexual intercourse she had to go to the St. Louis Children's emergency room. Reed's affidavit isn't clear on who prescribed the testosterone, however.

The university's statement cryptically cites "an opportunity to be more intentional about public engagement on the topics of gender dysphoria and transgender care ... particularly as it pertains to guidance provided to local school administrators and educators."

Singal said Reed told him she believes this refers to a school counselor's request for guidance from the clinic when female students started passing out while wearing chest binders, which can make breathing difficult. The clinic said educators even then don't have to tell parents their daughters were wearing binders.

Broyles confirmed this was Reed's belief and added another incident it could refer to. Emails obtained by the Daily Mail showed a teacher had asked the clinic how to handle a group of fifth graders who all adopted transgender identities after their friend came out as trans.

The clinic responded that the "contagion" explanation was "invalid" but admitted that kids sometimes "latch onto a new concept" such as "fad diets" or ADHD when someone they know does it first or gets a diagnosis. "However, it may still be a valid experience, and for some, it may be genuine exploration of gender," the response said.

The university didn't answer Just the News queries to flesh out the omissions and possible inconsistencies in its statement.

The JAMA Pediatrics study on chest dysphoria in 13-25 year-old women started with a broader question than it publicly answered. "The investigators hypothesize that masculinizing top surgery ... leads to an improvement in self-report[ed] chest dysphoria, gender dysphoria, and gender congruence," the listing says.

Singal obtained "some of the consent forms" through a public records request to the University of Illinois Chicago, whose institutional review board signed off on the research because it involved a UIC plastic surgeon. 

Participants were informed they would fill out questionnaires including the Utrecht Gender Dysphoria Scale, which Singal called "an established, validated scale" that is "miles ahead" of the Olson Chest Dysphoria Scale used in a different questionnaire. Yet the published paper doesn't mention gender dysphoria at all, even to explain its absence. 

"I suspect that the researchers simply disappeared the variable because it didn’t move in the direction they wanted," Singal said, claiming none responded to his requests for clarification and that UIC declined to provide the research protocol, citing the Illinois Medical Studies Act. 

Neither Northwestern University plastic surgeon Sumanas Jordan, the corresponding author, nor UIC responded to Just the News queries.

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