ST. LOUIS — The whistleblower who accused a transgender clinic of harming its young patients is standing firm in her claims of medical negligence after an internal review by Washington University found them to be unsubstantiated.
In a pair of statements on April 22, ex-employee Jamie Reed’s legal team called the oversight committee’s , released the day before, “little more than the expected self-serving finding.â€
Reed, a former case manager, put the Washington University Transgender Center at ºüÀêÊÓƵ Children’s Hospital in the hot seat in early February with a , an online publication.
In it, she claimed that families were rushed to treatment, mental health issues were ignored and side effects of hormone therapy glossed over. Reed expanded on the allegations in a provided to Missouri Attorney General Andrew Bailey, who began an investigation. Sen. Josh Hawley also launched an inquiry. Washington University said it has provided documents to both politicians.
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The statements from Reed’s lawyers, , cast doubt on the university’s accounting of how many people have sought treatment at the clinic. The university noted that, since June 2018, medical records have been started for 1,165 patients.
Reed’s lawyers say she has kept data that shows that more patient charts — 1,315 — were created in a time period about half as long as the one WU reported. Reed declined to provide evidence of her data sets to the Post-Dispatch and has refused multiple interview requests since her Free Press piece was published.
But in interviews with podcasts and other outlets, she has reiterated her allegations against the center — “a fly by the seat of the pants operation,†she calls it on one program — and posited theories as to why the number of children being seen there has accelerated since it opened in 2017.
The rise in patients seeking gender-affirming care is a phenomenon across the United States and in many European countries. Research on the increase is lacking; speculation is abundant. Many LGBTQ advocates say that broader visibility, stronger networks and better access to information have emboldened transgender people to articulate their needs.
Reed, on a London-based YouTube program last month called , ascribed some of the spike to homophobia.
“Part of the trans epidemic is that kids did not feel and do not feel like it’s OK to be gay,†Reed told the hosts. “They tell us it’s almost better to be trans.â€
‘It’s quite simple’
That is a misunderstanding of sexual orientation and gender identity, said Cathy Renna of the , a social justice nonprofit based in Washington. Transgender people can be gay. They can be straight. Or they can be bisexual.
“It’s quite simple,†Renna said. “Sexual orientation is who you are attracted to. Gender identity is who you are.â€
Public attitudes toward homosexuality, according to opinion polls, have undergone a dramatic shift in the last couple decades, a time period in which gay people earned the right to marry. According to a , 72% of Americans believe homosexuality is acceptable. A found that 38% of Americans believe a person can be transgender, a decline from five years ago.
At a outside the transgender center to protest the medical treatment of adolescents there, activists with a new organization called the held signs reading “LGB drop the TQ†and “stop transing gay kids.†A couple of parents said their teenage children, who identify as transgender, were not trans but most likely gay.
On the YouTube show, Reed said that the support she found when she was a young gay person is less available today.
“There was a gay coffeehouse. There were gay bars. There was a gay culture,†she said.
National and local gay advocacy organizations have expanded their purpose in recent years to include transgender people and have devoted more resources to their legal battles. Language around gender and sexuality have changed, with younger people, especially, embracing the word queer as a kind of catchall term.
One subset is not pitted against the other in the push for civil liberties and societal inclusion, said Laurel Powell, a spokeswoman for the , a lobbyist and advocacy group. Gender-diverse folks are not new to the movement.
“Trans people have been part of this since the beginning,†Powell said. “The idea that homophobia is somehow pushing people to be trans is outrageous.â€
Transgender people are more likely to be victims of violence and more likely to lose their jobs because of their identity, studies show, than gay men and lesbians, and they are in the crosshairs of legislative efforts to regulate their lives.
So far this year, at least a dozen states, , have passed bills to ban or limit gender-affirming care for minors. Even in places where treatments are available, it is expensive and often not covered by insurance.
Lack of data
In the TRIGGERnometry interview, Reed offers theories in addition to homophobia to explain the influx of adolescents asking for transgender care: that schools, peers and social media are influencing clusters of kids to come out as trans, called the “social contagion†hypothesis; that the dominant culture has taken away doctors’ autonomy to say no to a patient who wants to be medicalized; and that being trans in a white, liberal family means “you’re in the group that’s no longer the oppressor, you’re in the oppressed group.â€
Six years ago, 1.4 million Americans identified as transgender, according to an analysis by the , a public policy research group at UCLA. Four years later, the total had expanded by 200,000. The surge is even bigger among those 25 and younger.
That’s still a tiny sliver of the population — less than 1%. Most people will never question their gender.
“But there are people for whom gender is more fluid,†said Dr. Jack Drescher, a psychiatrist who specializes in human sexuality and gender identity and teaches at Columbia University in New York. “We don’t know why numbers are growing.â€
Research is sparse to nonexistent, he said. And in the absence of data, the vacuum has been filled by “an irrationality of responses†— anecdotal reports, debunked studies and the oversimplification of a complex topic — from people looking for answers.
“The question of what to do should be left to experts on the subject, not a casual bystander, not a legislature,†he said. “The solution is more research and more funding.â€
Care and caution are warranted, he said, but “to decide to stop treatment altogether has more to do with prejudices against transgender people than it has to do with medical science and research.â€
Drescher is a distinguished fellow of the American Psychiatric Association, one of more than two dozen major medical organizations that endorse gender-affirming care as a best practice.
Washington University said in the summary of its internal review that it follows guidelines set forth by the World Professional Association for Transgender Health, an international agency of physicians and researchers that has established standards of care since 1979.
The statement released by Reed’s lawyers said that WPATH’s standards of care ignore emerging evidence and rely on “the idea that trans health care is about the right to embodiment of cosmetic goals on demand.â€
Reed was not interviewed by the university’s oversight committee, the statement said.
On Wednesday, a Washington University spokeswoman said, “Our summary speaks for itself. We stand by our conclusions.â€