Amid at least two official investigations into a children’s transgender clinic run by Washington University in St. Louis, the clinic says it will not impose a moratorium on the prescription of puberty blockers or cross-sex hormones to any new patients. 

This comes despite a whistleblower’s sworn statement that she witnessed doctors at the Washington University Transgender Center at St. Louis Children’s Hospital prescribing puberty-blocking drugs to minors without parental consent. 

“The Washington University Transgender Center at St. Louis Children’s Hospital is the only place in the entire state of Missouri where transgender youth can access the care they need to ensure their mental and physical well-being,” the Feb. 14 statement reads. 

“Therefore, we cannot institute a moratorium that would deny critical, standards-based care to current and new patients. Out of an abundance of caution, however, we are establishing additional oversight at the Transgender Center, and we will continue our internal review of practices at the center to ensure that our patients and families are receiving the appropriate guidance and care for their individual medical needs.”

In a Feb. 9 blog post, a former case worker at the clinic, Jamie Reed, said she left in November 2022 because the hospital was, in her view, “permanently harming the vulnerable patients in our care.” 

In addition to putting numerous minors on puberty blockers and other drugs, Reed claimed her former clinic “regularly refers minors for gender transition surgery” and performed at least one double mastectomy on a minor at St. Louis Children’s Hospital. In a two-year period from 2020 to 2022, the clinic “initiated medical transition for more than 600 children. About 74% of these children were assigned female at birth,” Reed wrote in a sworn statement published by the Missouri Attorney General’s Office. She said she observed numerous young people being pushed toward transgender surgery amid serious comorbidities such as mental illness and depression. 

“During my time at the center, I personally witnessed center health care providers lie to the public and to parents of patients about the treatment, or lack of treatment, and the effects of treatment provided to children at the center,” Reed wrote in her affidavit. 

“I witnessed staff at the center provide puberty blockers and cross-sex hormones to children without complete informed parental consent and without an appropriate or accurate assessment of the needs of the child. I witnessed children experience shocking injuries from the medication the center prescribed. And I saw the center make no attempt or effort to track adverse outcomes of patients after they left the center.”

In her blog post at the website thefp.com, Reed said over the four years she was at the clinic she observed a notable increase in the number of teenage girls wishing to “transition” and become boys. 

After Reed went public with her allegations, Washington University said in a statement that it was “alarmed” by what was alleged. 

“We are taking this matter very seriously and have already begun the process of looking into the situation to ascertain the facts,” that statement read. 

Missouri Attorney General Andrew Bailey had on Feb. 10 directed a letter to Trish Lollo, president of St. Louis Children’s Hospital, and Andrew Martin, chancellor of Washington University in St. Louis, urging the institutions to halt prescribing puberty blockers or cross-sex hormones to new patients at the Transgender Center at St. Louis Children’s Hospital until the completion of the investigations. 

The attorney general’s office investigation into the hospital’s practices based on Reed’s allegations began in January, Bailey said in an announcement. 

“As attorney general, I want Missouri to be the safest state in the nation for children,” Bailey said in the February announcement, noting that his office was waiting for Reed to go public before they announced the investigation. U.S. Sen. Josh Hawley, R-Missouri, said his office is also launching an investigation.

The Feb. 14 statement from Washington University said that the university is “committed to providing lifesaving, evidence-based care that aligns with the standards set by the American Academy of Pediatrics [AAP].”

AAP’s standards, as well as those of the U.S.-based Endocrine Society and the World Professional Association for Transgender Health, have come under scrutiny recently for failing to cite compelling evidence for their claims. A recent article from The British Medical Journal criticized AAP’s guidance on pediatric gender dysphoria, which was drafted primarily by a single doctor, Jason Rafferty, and released in 2018. The document, which recommends against pediatric transgender surgery except on a “case-by-case basis,” has been described by its author as a “policy statement … not meant to be a protocol or guidelines in and of themselves.” The AAP told The British Medical Journal that all its policy statements are reviewed after five years and so a “revision is under way,” based on its experts’ own “robust evidence review.”

Several other countries, such as Britain, Finland, Sweden and the Netherlands, have begun in recent years to restrict the use of puberty blockers for minors, citing insufficient evidence of their efficacy outweighed by evidence of harm. In addition, Finland and Sweden reserve transgender surgery for adults.