Gender Clinic Case Manager Admits They’ve Done Permanent Harm to Children

The whistle blows on the former Missouri transgender case manager who was a part of the Missouri Pediatric Transgender Clinic’s case management. “morally and medically appalling” Treatment that results in “permanent harm” Children are not allowed to do this. 

Jamie Reed, a self-described “queer” leftist woman married to a transgender man, worked as a case manager handling intake of patients at the Pediatric Transgender Center at Washington University School of Medicine at St. Louis Children’s Hospital for more than four years. An exposé Reed, speaking for The Free Press, confirmed all the concerns that have been expressed in recent years regarding the rapid-tracking of children to irreversible medical treatment.

“I left the clinic in November of last year because I could no longer participate in what was happening there,” Reed. “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.”

Reed, a St. Louis native, describes herself as “politically to the Left of Bernie Sanders,” In the summer 2018, she took up a position at the Transgender Center, where she was a case manager and responsible for patient intake. 

“Soon after my arrival at the Transgender Center, I was struck by the lack of formal protocols for treatment,” Reed. “The center’s physician co-directors were essentially the sole authority.”

Reed noted that during her four years working at the Transgender Center, she observed a significant increase of teenage girls looking to transition to males with comorbidities, such as anxiety, ADHD, eating disorders or autism-like symptoms.

“Until 2015 or so, a very small number of these boys comprised the population of pediatric gender dysphoria cases,” Reed. “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.” 

Reed and her colleagues recognized that the rapid increase in patients seeking transition could be a manifestation of social contagion — especially when clusters of girls arrived from the same high school — but their concerns were allegedly dismissed by the physicians. 

“Anyone who raised doubts ran the risk of being called a transphobe,” Reed.

After one to two visits, a letter from a therapist can be used to start medical transition. Reed stated that the Transgender Center made it easy by recommending gender-affirming therapists, and provided a template letter of support. The prescription for testosterone was given in one visit to an endocrinologist. Reed discovered that infertility and the long-term effects that testosterone can have on minors is not well understood. The current treatment system was failing to protect them.

“Our patients were told about some side effects, including sterility,” Reed. “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.” 

Reed provided examples of adverse psychological and physical effects patients can experience, such as liver toxicity, vaginal bleeding, and clitoral enhancement. She also warned of the danger of long-term health problems that hormonal treatment, such blood pressure, sleep apnea, or diabetes, could cause.

“But clinics like the one where I worked are creating a whole cohort of kids with atypical genitals—and most of these teens haven’t even had sex yet,” Reed. “They had no idea who they were going to be as adults. Yet all it took for them to permanently transform themselves was one or two short conversations with a therapist.”

Reed was also aware that there were an increasing number detransitioners, minors who regret their medical transitions in 2019. Reed and her colleague tried to raise the issue and track data, but doctors resisted their attempts. The author and her colleague nevertheless created the document. “Red Flag” Register to keep track of these patients 

“We thought the doctors would want to collect and understand this data in order to figure out what they had missed,” Reed. “We were wrong.”

Reed spoke of the sad case of a teenage girl who was detransitioned from a family that had a history drug abuse and had had a double mastectomy to remove both breasts. She regretted her decision after only three months. 

“Three months later she called the surgeon’s office to say she was going back to her birth name And that her pronouns were ‘she’ and ‘her,’” said Reed. “Heartbreakingly, she told the nurse, ‘I want my breasts back.’”

When Reed and her colleague checked on the young girl, they found out she was pregnant. “Of course, she’ll never be able to breastfeed her child,” Reed lamented.

Reed felt morally obliged to voice growing concerns in spring 2020. She began communicating her concerns through email and in-office. She began receiving negative reviews of her performance for the first-time, noting that she was being underrated. “defensiveness and hostility” When she was given direction by management. 

“Things came to a head at a half-day retreat in [the] summer of 2022,” Reed. “In front of the team, the doctors said that my colleague and I had to stop questioning the ‘medicine and the science’ in addition to their authority. An administrator then told us that we needed to ‘get on board, or get out.’”

Reed finally left the Transgender Center in November 2022 and decided to come forward after she felt “stunned and sickened” by comments made by Dr. Rachel Levine, the transgender Assistant Secretary for Health at the federal Department of Health and Human Services, who said that “clinics are proceeding carefully and that no American children are receiving drugs or hormones for gender dysphoria who shouldn’t.”

“Almost everyone in my life advised me to keep my head down,” Reed. “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.”

In a Letter prepared for Missouri’s attorney general, Reed outlined the rapid medicalization of children, poor assessments of mental health prior to gender-altering treatment, lack of informed consent from parents and youth, and actual harm caused by the medical treatment. The letter also contained allegations of abuse and intimidation of parents who don’t fully support medicalization and misleading testimony before the Missouri Legislature.

“Given the secrecy and lack of rigorous standards that characterize youth gender transition across the country, I believe that to ensure the safety of American children, we need a moratorium on the hormonal and surgical treatment of young people with gender dysphoria,” Reed concluded.

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