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Transgender Clinic Under Investigation for Using Experimental Drugs on Kids, Medicaid Fraud

February 10, 2023

A pediatric gender clinic is under criminal investigation after a whistleblower charged the center with potentially defrauding Medicaid and private insurance to prescribe transgender hormones to children as young as 11. The sworn affidavit states the St. Louis facility administered cross-sex hormones to mentally ill children, sometimes against their parents’ wishes, and ignored children’s worsening physical and mental health conditions — including at least one suicidal teenager.

Missouri Attorney General Andrew Bailey (R) announced Thursday night that his office and two other agencies had opened an investigation into The Washington University Transgender Center at St. Louis Children’s Hospital. “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,” said Bailey, citing an affidavit from a former employee, who switched to another area of the hospital after becoming convinced the center is permanently hurting the people it swears to help.

The whistleblower, Jamie Reed, describes herself as “a 42-year-old St. Louis native, a queer woman, and politically to the left of Bernie Sanders.” She says she is married to a woman who identifies as a male and affirms, “I support trans rights.” Reed details in her affidavit and in an article at Bari Weiss’ website, The Free Press, that she began working as an idealistic case manager at the center in 2018. By the time she left last November, she left convinced the center’s actions are “morally and medically appalling” — and is likely a systemic problem in the nation’s 100 pediatric gender clinics. “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,’” she wrote.

“I was struck by the lack of formal protocols for treatment,” said Reed. Yet she kept her concerns private for months, because “anyone who raised doubts ran the risk of being called a transphobe.”

Reed states the center provides outside psychiatrists with a “template” form letter attesting that a child identifies as transgender. If the analyst will not sign it, the center uses in-house psychiatrists, Dr. Dr. Alex Maixner and Dr. Sarah Girresch-Ward, to confirm a child’s “gender dysphoria” after a one-to-two-hour consultation, rather than a full 10-12 hour assessment. They then begin children on a pipeline that results in lifelong hormones and potentially permanently disfiguring surgery before the age of 18.

She exposed potential perjury, as surgeons at the center testified before the Missouri legislature that transgender surgeries for minors are not “on the table” at their center. “This was a lie,” said Reed in the affidavit. She said the center claimed it provided minors with referrals to surgeons who are willing to remove teenagers’ healthy breasts and genitals “for educational purposes,” but they “were in fact referrals.” And Dr. Allison Snyder-Warwick performed at least one gender transition surgery in the hospital, apparently contradicting the doctors’ testimony.

Doctors at the center prescribed teenagers the prostate cancer medication Bicalutamide, which she says caused liver toxicity in a 15-year-old boy. (His mother agreed not to sue the center but warned her son’s condition “could be a huge PR problem.”) She related horrifying tales of physical and mental harm, including a graphic description of intense vaginal bleeding caused by the side effects of “gender-affirming care.”

Reed paints the picture of a center ignoring the real needs of its patients, and the real harms inflicted by the transgender regimen, in order to maximize its profits.

“[N]early all children who came to the Center here presented with very serious mental health problems,” including autism, ADHD, depression, anxiety, PTSD, trauma histories, OCD, and serious eating disorders, she said. Some erroneously identified as suffering from other psychosomatic maladies, such as Tourette Syndrome or blindness. “Privately,” the doctors recognized their other psychosomatic illnesses reflected “social contagion” … but not their gender dysphoria, even when groups came from the same high school. Others used pronouns identifying as a “mushroom” or a “rock”; one patient told employees she identified as a “communist, attack helicopter, human, female, maybe non-binary.” Despite these serious issues, the center “would not treat these mental health issues. Instead, children were automatically given puberty blockers or cross-sex hormones.”

The center also ignored indications of parental coercion of physical abuse, Reed said. In one case, a parent was “forcing” a boy to dress as a female, but the center administered cross-sex hormones, as well. In another, a 17-year-old boy brought to the center by an unrelated male and given hormones upon turning 18. His mental health deteriorated, yet staffers continued administering hormones — even after it turned out the man who brought him to the facility “had been sexually and physically abusing” him.

The experimental nature of many of these drugs set children up for a lifetime of infertility, early menopause, bone thinning, and — contrary to their advertisements — worsened mental health. “I witnessed the Center cause permanent harm to many of the patients,” said Reed. “I doubt that any parent who’s ever consented to give their kid testosterone (a lifelong treatment) knows that they’re also possibly signing their kid up for blood pressure medication, cholesterol medication, and perhaps sleep apnea and diabetes.” She added “clinics like the one where I worked are creating a whole cohort of kids with atypical genitals.”

When parents or doctors would describe worsening mental health outcomes, the center ignored them and continued the hormones, she said. One mother, in a letter revoking consent for her son to receive hormone blockers, said her child “is a shell of his former self riddled with anxiety.”

The center even ignored pleas that their actions might contribute to a potential suicide. In one case, “a psychiatrist called the Center’s endocrinologist and explained that a child, who had already tried to commit suicide by threatening to jump off a roof, should not be given cross-sex hormones because the child was struggling with serious mental health issues,” Reed attested. “I witnessed the endocrinologist yell at the psychiatrist on the phone and speak down to this provider.”

“The Center never discontinues cross-sex hormones, no matter the outcome,” she said.

The center’s actions often lead to lifelong regret, Reed noted. A black teenager from a troubled family began receiving hormones at the facility at age 16 and had a double mastectomy at age 18. Three months later, she told the surgeon she would return to her birth gender, adding, “I want my breasts back” and asked a surgeon to have them “put back on.” Reed wrote, “The last I heard, she was pregnant. Of course, she’ll never be able to breastfeed her child.”

These are the same concerns that motivated Chloe Cole, the teenage detransitioner who now embraces her biological identity, as nearly nine out of 10 children with dysphoria eventually do. “I don’t know if I’ll be able to fully carry a child,” she told Florida legislators last July. “And because I do not have my breasts … I am not able to breastfeed whatever future children I have. That realization actually was one of the biggest things that lead to me realizing that this was not the path that I should have taken.” She’s now suing the Permanente Medical Group and the Kaiser Foundation Health Plan for breaching appropriate standards of care.

Even removing parental consent was not enough to stop the ideologically motivated doctors at the center according to Reed, who testified, “On several occasions, the doctors have continued prescribing medical transition even when a parent stated that they were revoking consent.”

The center also fudged the billing codes for many of these prescriptions, Reed said, sending erroneous invoices to private insurance and sometimes state or federal programs. Employees falsely claimed that one child who received puberty blockers was experiencing precocious puberty, Reed wrote.

The whistleblower’s comments have triggered a statewide investigation from the Missouri attorney general, the Missouri Department of Social Services, and the Division of Professional Registration. Sheila Solon, the director of the Division of Professional Registration, promised her agency will “take any necessary action against the licenses” of Missouri doctors involved in the center’s work that violates the “health, safety, and welfare of the citizens of Missouri.”

Ben Johnson is senior reporter and editor at The Washington Stand.