An internal investigation at Washington University in St. Louis has found that allegations of inappropriate care at the pediatric and adolescent transgender clinic at the St. Louis Children’s Hospital are unsubstantiated. The investigation was launched in response to allegations made by a former employee, Jamie Reed, who claimed that the clinic routinely prescribed puberty blockers and hormone therapy to minors without proper assessment. Reed also alleged that the clinic’s providers referred minors for gender transition surgery, which the providers had testified was not an option for anyone under 18.
Though the attorney general’s investigation into the Transgender Center at the St. Louis Children’s Hospital is ongoing, Washington University physicians and staff at the center follow appropriate policies and procedures and treat patients according to the currently accepted standard of care, as recommended by the American Academy of Pediatrics and other nationally recognized organizations. In the summary of its findings, the university stated that Reed’s allegations are unsubstantiated but that it will be changing some of its practices going forward.
The Transgender Center will now require written consent from parents before prescribing gender-affirming medications, such as puberty blockers and hormone therapy, rather than obtaining verbal consent as was previously done. The center will also require a family to provide custody agreements before an initial visit at the center if the patient is a minor. The university also stated that physicians will no longer perform gender-affirming operations on minors, and that it adopted a policy prohibiting such referrals since late 2018.
The university’s investigation found that a total of six operations were performed on minors by university physicians since 2018, and that all six were chest operations for adolescents transitioning to male. The university noted that chest masculinization surgery for minors is within the standard of care recommended by the World Professional Association for Transgender Health, or WPATH, a nonprofit association dedicated to transgender medical care.
The allegations made by Reed have been met with criticism from some former employees of the center, who claim that the clinic follows the standard of care recommended by WPATH. Though the investigation did not substantiate Reed’s allegations, it has prompted the center to change some of its practices. Amid a legislative landscape in Missouri that has seen a bill passed to ban gender-affirming care for minors, the importance of ethical, client-centered care at the center cannot be overstated.