Missouri AG Andrew Bailey Launches Investigation Into Pediatric Transgender Center at St. Louis Children’s Hospital

AP Photo/David A. Lieb
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On Thursday, a blockbuster story broke regarding a whistleblower who came forward to shed light on troubling practices at the Pediatric Transgender Clinic at St. Louis Children’s Hospital.

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Jamie Reed, a former employee of the clinic, charges that over 600 kids were harmed, an allegation serious enough that Missouri Attorney General Andrew Bailey is launching a formal investigation. Bailey says he is concerned by “individuals who may be more concerned with a radical social agenda than the health of children.”

Following the story’s publication, Missouri Attorney General Andrew Bailey announced that his office had already launched an investigation into the clinic, including a sworn affidavit from Reed and supporting documentation.

In a lengthy Twitter thread, Bailey detailed some of the horrific abuses detailed in Reed’s affidavit. A full statement from Bailey’s office, as well as the affidavit, can be found on the AG’s website. Missouri’s Department of Social Services and Division of Professional Registration are also assisting in the investigation.

The statement sets forth a detailed and highly disturbing list of allegations, describing a singular devotion to pushing cross-sex hormones and puberty blockers, disregard for parental consent and notification, disregard for worsening mental health in patients, and misleading statements to the public and prospective patients regarding the nature of the treatment provided at the center:

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Specific allegations include:

  • “On several occasions, the doctors have continued prescribing medical transition even when a parent stated that they were revoking consent.”
  • “The Center does not require children to continue with mental health care after they prescribe cross-sex hormones or puberty blockers and even continues those medications when the patients directly report worsening mental health after initiating those medications “
  • “I have seen puberty blockers worsen the mental health outcomes of children. Children who have not contemplated suicide before being put on puberty blockers have attempted suicide after.”
  • “It is my belief that the Center does not track these outcomes because they do not want to have to report them to new patients and because they do not want to discontinue cross-sex hormone prescriptions. The Center never discontinues cross-sex hormones, no matter the outcome.”
  • “During my time at the Center, I personally witnessed Center healthcare 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.”
  • “Doctors at the Center also have publicly claimed that they do not do any gender transition surgeries on minors. … This was a lie. The Center regularly refers minors for gender transition surgery. The Center routinely gives out the names and contact information of surgeons to those under the age of 18. At least one gender transition surgery was performed by Dr. Allison Snyder-Warwick at St. Louis Children’s Hospital in the last few years.”
  • “The Center tells the public and parents of patients that the point of puberty blockers is to give children time to figure out their gender identity. But the Center does not use puberty blockers for this purpose. Instead, the Center uses puberty blockers just until children are old enough to be put on cross-sex hormones. Doctors at the Center always prescribe cross-sex hormones for children who have been taking puberty blockers.”
  • “The Center tells the public and parents that it makes individualized decisions. That is not true. Doctors at the Center believe that every child who meets four basic criteria—age or puberty stage, therapist letter, parental consent, and a one-hour visit with a doctor—is a good candidate for irreversible medical intervention. When a child meets these four simple criteria, the doctors always decide to move forward with puberty blockers or cross-sex hormones. There were no objective medical test or criteria or individualized assessments.”
  • “One doctor at the Center, Dr. Chris Lewis, is giving patients a drug called Bicalutamide. The drug has a legitimate use for treating pancreatic cancer, but it has a side effect of causing breasts to grow, and it can poison the liver. There are no clinical studies for using this drug for gender transitions, and there are no established standards of care for using this drug.”
  • “I know of at least one patient at the Center who was advised by the renal department to stop taking Bicalutamide because the child was experiencing liver damage. The child’s parent reported this to the Center through the patient’s online self-reporting medical chart (MyChart). The parent said they were not the type to sue, but ‘this could be a huge PR problem for you.’”
  • “Children come into the clinic using pronouns of inanimate objects like ‘mushroom,’ ‘rock,’ or ‘helicopter.’ Children come into the clinic saying they want hormones because they do not want to be gay. Children come in changing their identities on a day-to-day basis. Children come in under clear pressure by a parent to identify in a way inconsistent with the child’s actual identity. In all these cases, the doctors decide to issue puberty blockers or cross-sex hormones.”
  • “In one case where a girl was placed on cross-sex hormones, I found out later that the girl desired cross-sex hormones only because she wanted to avoid becoming pregnant. There was no need for this girl to be prescribed cross-sex hormones. What she needed was basic sex education and maybe contraception. An adequate assessment before prescribing hormones would have revealed this fact. But because the doctors automatically prescribe cross-sex hormones or puberty blockers for children meeting the bare minimum criteria, this girl was unnecessarily placed on drugs that cause irreversible change to the body.”
  • “On another occasion, a patient had their breasts removed. This surgery was performed at St. Louis Children’s Hospital. Three months later, the patient contacted the surgeon and asked for their breasts to be ‘put back on.’ Had a requisite and adequate assessment been performed before the procedure, the doctors could have prevented this patient from undergoing irreversible surgical change.”
  • “It is my belief that the Center does not track these outcomes because they do not want to have to report them to new patients and because they do not want to discontinue cross-sex hormone prescriptions. The Center never discontinues cross-sex hormones, no matter the outcome.”
  • “In just a two-year period from 2020 to 2022, the Center initiated medical transition for more than 600 children. About 74% of these children were assigned female at birth. These procedures were paid for mostly by private insurance, but during this time, it is my understanding that the Center also billed the cost for these procedures to state and federal publicly funded insurance programs.”
  • “I have personally witnessed staff say they were uncomfortable with how the Center has told them they have to code bills sent to publicly funded insurance programs. I have witnessed staff directly ask the providers for clarification on billing questions and have providers dismiss the concerns and work to have the patients have this care covered as the priority.”
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Bailey’s office isn’t the only Missouri official investigating the Center. U.S. Senator Josh Hawley (who served as Missouri’s AG prior to Bailey’s immediate predecessor, Eric Schmitt) announced, on Thursday, that his office was also launching an investigation into the matter.

On his Senate website, Hawley outlined the planned investigation:

Following the announcement by U.S. Senator Josh Hawley (R-Mo.) today that he is launching an investigation into potential malpractice regarding minors at The Washington University Transgender Center at St. Louis Children’s Hospital, Senator Hawley has sent a new letter tonight to the university chancellor, hospital president, and the center’s co-directors.

“Starting immediately, your institutions must take steps to preserve all records, written and electronic, regarding gender-related treatments performed on minors since the opening of the Center,” the Senator wrote. “Additional oversight inquiries and outreach will follow.”

His letter went on to reference additional reporting about the Center’s practices, saying today’s report “builds on recent revelations that the Center counseled educational authorities to conceal information from parents regarding their children’s cross-gender identification. […] Encouraging teachers to lie to children’s parents is unconscionable. If even a fraction of the whistleblower’s new allegations is corroborated, the Center should be immediately shut down.”

Senator Hawley spoke with Chancellor Andrew D. Martin of Washington University in St. Louis today, and confirmed they will fully cooperate with the investigation. The Senator was also assured that the whistleblower will be fully protected from retaliation.

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Obviously, with the investigations just being opened, there are numerous questions demanding answers. Hopefully, those will be forthcoming. But if even a portion of the allegations in Reed’s affidavit are substantiated, the harm that has been done to these patients and their families is immeasurable. As Joe Cunningham rightly noted in his OpEd on this story:

We have a broken society and a medical care system that is thinking so much about how to not offend that they are actively ignoring the dangers of what they do. It’s absolutely insane what hormone treatments can do to young, developing bodies – ranging from weakening the vaginal walls to causing emotional disorders to causing deformation of the genitalia. These aren’t normal, and kids certainly don’t grasp what all they are doing to their bodies when they start these treatments.

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