I Thought I Was Saving Trans Kids. Now I’m Blowing the Whistle.
S E E D E D C O N T E N T
I am a 42-year-old St. Louis native, a queer woman, and politically to the left of Bernie Sanders. My worldview has deeply shaped my career. I have spent my professional life providing counseling to vulnerable populations: children in foster care, sexual minorities, the poor.
For almost four years, I worked at The Washington University School of Medicine Division of Infectious Diseases with teens and young adults who were HIV positive. Many of them were trans or otherwise gender nonconforming, and I could relate: Through childhood and adolescence, I did a lot of gender questioning myself. I’m now married to a trans man, and together we are raising my two biological children from a previous marriage and three foster children we hope to adopt.
All that led me to a job in 2018 as a case manager at The Washington University Transgender Center at St. Louis Children's Hospital , which had been established a year earlier.
The center’s working assumption was that the earlier you treat kids with gender dysphoria, the more anguish you can prevent later on. This premise was shared by the center’s doctors and therapists. Given their expertise, I assumed that abundant evidence backed this consensus.
During the four years I worked at the clinic as a case manager—I was responsible for patient intake and oversight—around a thousand distressed young people came through our doors. The majority of them received hormone prescriptions that can have life-altering consequences—including sterility.
I left the clinic in November of last year because I could no longer participate in what was happening there. 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.” Instead, we are permanently harming the vulnerable patients in our care.
Today I am speaking out. I am doing so knowing how toxic the public conversation is around this highly contentious issue—and the ways that my testimony might be misused. I am doing so knowing that I am putting myself at serious personal and professional risk.
Almost everyone in my life advised me to keep my head down. But I cannot in good conscience do so. Because what is happening to scores of children is far more important than my comfort. And what is happening to them is morally and medically appalling.
Soon after my arrival at the Transgender Center, I was struck by the lack of formal protocols for treatment. The center’s physician co-directors were essentially the sole authority.
At first, the patient population was tipped toward what used to be the “traditional” instance of a child with gender dysphoria: a boy, often quite young, who wanted to present as—who wanted to be—a girl.
Until 2015 or so, a very small number of these boys comprised the population of pediatric gender dysphoria cases. Then, across the Western world, there began to be a dramatic increase in a new population: Teenage girls, many with no previous history of gender distress, suddenly declared they were transgender and demanded immediate treatment with testosterone.
I certainly saw this at the center. One of my jobs was to do intake for new patients and their families. When I started there were probably 10 such calls a month. When I left there were 50, and about 70 percent of the new patients were girls. Sometimes clusters of girls arrived from the same high school.
This concerned me, but I didn’t feel I was in the position to sound the alarm back then. There was a team of about eight of us, and only one other person brought up the kinds of questions I had. Anyone who raised doubts ran the risk of being called a transphobe.
The girls who came to us had many comorbidities: depression, anxiety, ADHD, eating disorders, obesity. Many were diagnosed with autism, or had autism-like symptoms. A report last year on a British pediatric transgender center found that about one-third of the patients referred there were on the autism spectrum.
Frequently, our patients declared they had disorders that no one believed they had. We had patients who said they had Tourette syndrome (but they didn’t); that they had tic disorders (but they didn’t); that they had multiple personalities (but they didn’t).
The doctors privately recognized these false self-diagnoses as a manifestation of social contagion. They even acknowledged that suicide has an element of social contagion. But when I said the clusters of girls streaming into our service looked as if their gender issues might be a manifestation of social contagion, the doctors said gender identity reflected something innate.
To begin transitioning, the girls needed a letter of support from a therapist—usually one we recommended—who they had to see only once or twice for the green light. To make it more efficient for the therapists, we offered them a template for how to write a letter in support of transition. The next stop was a single visit to the endocrinologist for a testosterone prescription.
That’s all it took.
When a female takes testosterone, the profound and permanent effects of the hormone can be seen in a matter of months. Voices drop, beards sprout, body fat is redistributed. Sexual interest explodes, aggression increases, and mood can be unpredictable. Our patients were told about some side effects, including sterility. But after working at the center, I came to believe that teenagers are simply not capable of fully grasping what it means to make the decision to become infertile while still a minor. ...
Besides teenage girls, another new group was referred to us: young people from the inpatient psychiatric unit, or the emergency department, of St. Louis Children’s Hospital. The mental health of these kids was deeply concerning—there were diagnoses like schizophrenia, PTSD, bipolar disorder, and more. Often they were already on a fistful of pharmaceuticals.
This was tragic, but unsurprising given the profound trauma some had been through. Yet no matter how much suffering or pain a child had endured, or how little treatment and love they had received, our doctors viewed gender transition—even with all the expense and hardship it entailed—as the solution.
Some weeks it felt as though almost our entire caseload was nothing but disturbed young people.
For example, one teenager came to us in the summer of 2022 when he was 17 years old and living in a lockdown facility because he had been sexually abusing dogs. He’d had an awful childhood: His mother was a drug addict, his father was imprisoned, and he grew up in foster care. Whatever treatment he may have been getting, it wasn’t working.
During our intake I learned from another caseworker that when he got out, he planned to reoffend because he believed the dogs had willingly submitted.
Somewhere along the way, he expressed a desire to become female, so he ended up being seen at our center. From there, he went to a psychologist at the hospital who was known to approve virtually everyone seeking transition. Then our doctor recommended feminizing hormones. At the time, I wondered if this was being done as a form of chemical castration.
That same thought came up again with another case. This one was in spring of 2022 and concerned a young man who had intense obsessive-compulsive disorder that manifested as a desire to cut off his penis after he masturbated. This patient expressed no gender dysphoria, but he got hormones, too. I asked the doctor what protocol he was following, but I never got a straight answer.
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It's a long article (full text available at the linked seed) but worth a read.
Scary to see what's being casually done to kids, often with severe mental issues. It's similar to a fast food restaurant. They just put kids on a one size fits all conveyer belt with the minimum of actual attention to the individual.
No minor should be given physiology altering drugs/hormones or have gender altering surgical procedures. Psychotherapy as needed until the age of majority. JMO.
Most kids grow out of it, according to expert.
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When a female takes testosterone, the profound and permanent effects of the hormone can be seen in a matter of months. Voices drop, beards sprout, body fat is redistributed. Sexual interest explodes, aggression increases, and mood can be unpredictable.
I can attest to this, since I witnessed my step child transition to a man. However, I can also attest to exactly the opposite of what this article is pushing. My step daughter went from always being moody as hell, unhappy, and reclusive to now being almost annoyingly cheerful, helpful, and upbeat as a bearded man with a new low voice and muscular physique. He has a serious girlfriend and they are happier than most couples I know. He got his masters in education and is a huge hit among his students and teaching colleagues. It has literally made a world of difference.
Do you agree with what's been going on lately?
Biological males unfairly competing with biological females.
Foolish adults who know better attempting to transition grade school kids?
My personal feeling is that the choice to transition should come with the surrender of competitive athletic ambitions. I’m not a sports fan so I don’t have much of a dog in that fight, but I’m not on board with unnatural anatomical enhancements being used as an edge. However, I have only positive things to say about the change in my stepson’s physique. He went from being a big-boobed flabby female to a dude I wouldn’t want to be in a physical altercation with.
I’m also somewhat horrified by extreme liberal attitudes that allow for young children to present however they feel like. I know of an extended family of an in-law of mine who let their son go to school in a dress once because they didn’t want to deal with arguing with him to put on boy clothes. That would never happen under my roof.
This is the whole thing, these days. You can't talk about it. I consider myself to be pretty liberal, and very supportive of LGBT people. But one of the problems the Left has is that the loudest voices will not tolerate anyone who disagrees with even the most absurd idea. No new idea is too crazy.
Statistically, most young people going through some kind of gender questioning phase will grow out of it. And it really shouldn't surprise us. Society holds a lot of traditional ideas about gender roles and behavior. When a kid doesn't feel naturally comfortable with those roles and behavior, they make the leap to "maybe I'm the wrong sex." If a boy isn't into sports, maybe he should become female. If a girl doesn't want to wear dresses and learn how to cook, maybe she should become male.
And there are plenty of adults around now, who are happy to encourage that line of thinking. But that's a radical response to a common issue.
The truth is there are an infinite number of ways to live life as a male or a female. A boy who likes show tunes isn't automatically gay or secretly female. I find it ironic that the political trend on the left simultaneously condemns traditional gender roles when it suits them (like females as homemakers) while also preaching that if you don't conform to established roles, you must physically be something other than what you appear to be.
What should be a personal, serious, deliberate psychological and medical examination has turned to into a public political debate - but with no dissent allowed. It appears that more and more professionals are afraid to suggest a "wait and see" approach to gender questioning in minors, even though that is likely to be the best response for most people.
But one of the problems the Left has is that the loudest voices will not tolerate anyone who disagrees with even the most absurd idea. No new idea is too crazy.
Who are these “loudest voices” that will not tolerate those standing in the way of their right to marry a ham sandwich or teach in classrooms with 60 lb transgender breast implants? If you find them to be the loudest voices then maybe you should evict them from living inside your head. The vast majority of the “Left” are not supportive of the craziest ideas.
Exactly, Biden exemplifies wild and crazy!
The krazy unpopular ideas are gop ideas...
Ban abortions! Drag queen. Baning books!
Biden is poster boy for staid governance.
The far left is a tiny fringe while krazy MAGAs are mainstream of the gop today!
yeah, saying "trans" rapists don't belong in female prisons is entirely uncontroversial. Just ask JK Rowling.
Anyone with a basic grip on reading comprehension should see that I was not talking about “the vast majority of the Left.”
Anyone with a basic grip on reality knows that the loudest voices are not the ones you are referring to. How convenient of you to not address my question.
Ok, well if you want to live in Fantasyland and imagine that I meant something other than what I said, that’s your problem. But it makes it impossible to have a conversation, so you’ll be talking to yourself, I guess.
So you want to allude to who has the loudest voices but don’t want to identify them. Got it.
So you’re just here to troll. Got it.
I’m not the one spreading false garbage.
And if he is gay, he's not a woman in a man's body. Implanting the idea in kids that they aren't real men or women because they are effeminate or tomboys is going to cause a spectacular amount of trauma.
and there are still many places like that around.
The hospital in the article is simply cashing in on the latest craze.
It's the equivalent of a puppy mill.