St. Louis Children’s Hospital Gender-Affirming Care Department Passes Internal Review

An internal Washington University in St. Louis investigation released last Friday found that a former employee’s allegations that a Missouri gender-affirming clinic in its purview neglected to assess minors were unfounded.

Jamie Reed, a case worker at the facility between 2018 and late 2022, had alleged in a lengthy affidavit that children were often given puberty blockers or hormones without acquiring “appropriate or accurate mental health assessments” during her time.

According to Reed, the center’s providers “regularly refer minors for gender transition surgery,” even though they have consistently told the state Legislature that minors are not candidates for the procedure.

Reed published her accusations in an op-ed by The Free Press, a news site launched by former New York Times op-ed writer Bari Weiss.

Weiss and the website have a history of anti-transgender bias. For example, the site was recently criticized for publishing a story about a young transgender teen. According to the child, the story misrepresented everything about the minor’s situation.

As part of his investigation of St. Louis Children’s Hospital’s Transgender Center, Republican attorney general Andrew Bailey initiated an ongoing investigation in February.

The Children’s Hospital’s parent organization, Washington University in St. Louis, said it was “alarmed” by Reed’s allegations and would examine them thoroughly.

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After an internal investigation that lasted two months, officials have found the allegations unsubstantiated, but some center practices will be modified.

“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,” according to the summary of conclusions in the internal review document.

One of Reed’s claims was that kids were often prescribed drugs “without informed parental consent” and that officials failed to review custody agreements of divorced couples to secure all legal parties’ consent.

Previously, only verbal consent was required for medication prescriptions — much like any other time one gets a drug from one’s doctor — and only “before medical intervention in cases where decision-making authority was in question” did officials seek written custody agreements previously. Regardless, according to the summary, these details were consistently documented in patient medical records.

As of late 2018, the university prohibited surgical referrals to patients under 18.

According to the university, families were given names of surgeons (including Washington University physicians) who performed such surgeries, and the center’s providers offered summaries of their care to patients who needed surgery.

The hospital said its surgeons had performed only six top surgeries for teens transitioning to male since 2018. It was either outside physicians or the patients themselves who referred these cases.

Chest masculinization surgery for minors is within acceptable care standards, according to the World Professional Association for Transgender Health. For adolescents to be eligible for surgery, WPATH’s latest guidelines, updated last year, state that they must meet many requirements.

The university reported that nearly half of the patients treated at the center received no medication prescriptions as part of their care.