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Families dispute whistleblower’s allegations against Missouri transgender health care center

Casey Pick, Director of Law and Policy at The Trevor Project, speaks at a rally on the steps of the Missouri Capitol on Feb. 2, after testifying in two hearings.
Annelise Hanshaw
/
Missouri Independent
Casey Pick, Director of Law and Policy at The Trevor Project, speaks at a rally on the steps of the Missouri Capitol on Feb. 2, after testifying in two hearings.

The Missouri Attorney General’s office and state health offices are investigating allegations of misconduct at the Washington University Transgender Center. Former patients say that treatments were only undertaken after long consultations with doctors and mental health professionals.

The picture painted by whistleblower Jamie Reed of how patients were treated at the Washington University Transgender Center at St. Louis Children’s Hospital doesn’t match Jess Jones’ experience.

Jones worked alongside Reed for two years as the center’s educational coordinator before resigning in 2020. The allegations of misconduct laid out by Reed — both on a national news website called The Free Press and in an affidavit with the Missouri attorney general’s office — simply don’t match the reality during the time they worked together, Jones said.

“I feel like I could go line by line to her affidavit,” Jones said, “and debunk it all.”

And Jones is not alone.

The Independent spoke with numerous former patients of the Transgender Center, as well as parents of former patients. Some were eager to share their story, inspired by the onslaught of attention the center has received since Reed’s affidavit caused three state agencies to launch an investigation into its practices.

Others asked not to be named out of fear of retribution and concern about laws pending in the Missouri legislature that would criminalize gender-affirming care for minors.

Each person interviewed described a far different experience than Reed about how the Transgender Center operates and how minors seeking care are treated. And they want the state’s investigation to hear their experiences.

Reed, who lives in St. Louis County, has alleged minors were rushed into medical procedures without taking into account mental health, and that side effects of treatments were hidden from parents.

Those who received treatment from the center say that’s not the case, and any treatments were only undertaken after long consultations with doctors and mental health professionals. Often, patients were told they needed to wait for years.

Several of those interviewed by The Independent also recounted their experiences with Reed — both good and bad.

“There were parents of trans kids who also raised some red flags around Jamie. So I really wish the center had listened to trans people,” Jones said. “We said: ‘This is a person who isn’t safe for us.’”

Reed’s attorney, Vernadette Broyles, said Wednesday that it is not surprising that the only patients speaking up are those who have had good experiences.

Broyles said those unhappy with their transition often feel pressure to stay quiet. She said she’s heard from many former patients nationwide who have come to regret their treatment.

“It does not surprise me that you would find someone in that honeymoon phase,” she said.

Jamie Reed

Chris Hyman, who has a transgender son, remembered Reed’s magnetic energy at the center. She felt like an ally.

After Reed’s story became public, Hyman tuned into The Free Press webinar and saw a change in Reed and was stunned at some of the answers she gave to a Free Press editor.

“When [lawmakers] do their job, what happens to the transgender center you used to work at?” Free Press journalist Emily Yoffe asked.

“I do not believe it can continue to function,” said Reed, who is married to a transgender man.

“You want it closed down,” Yoffe inquired.

“I believe it’s the only way to stop hurting more kids,” Reed said.

Susan Halla, who is the mother of a transgender young adult, also thought of Reed as an advocate. Halla is the president of TransParent, a group that supports the caregivers of transgender people. Hyman is the organization’s at-large chapter chair.

“We were just apoplectic where this all came from,” Halla said.

Broyles, who serves as president of public interest law firm Child & Parental Rights Campaign, said during the webinar that Reed had tried to institute change at the Transgender Center.

“After trying to make changes happen internally, [the center directors] were just not going to honor her concerns. She appropriately made a complaint to the right governing official, and under Missouri law that’s the attorney general,” Broyles said.

She said Reed sought sanctuary under the state’s Whistleblower’s Protection Act, which states workplaces can’t fire an employee that reports an “unlawful act” committed by the employer.

Another one of Broyles’ cases was a key anecdote as Florida considered a law that bans the discussion of gender identity or sexual identity in grades K-3. Broyles is representing a family that alleges their child’s school helped the student socially transition without the parents’ knowledge.

Reed’s other attorney is Ernie Trakas, a Republican member of the St. Louis County Council who is involved with the Child & Parental Rights Campaign.

Currently, the Missouri Attorney General’s office, the Department of Social Services and the Division of Professional Registration are investigating Reed’s allegations. U.S. Sen. Josh Hawley has requested records from the center. Some state lawmakers expressed interest in launching an investigation, but no substantial action has been taken on their proposal.

Speed of treatment

Missouri Attorney General Andrew Bailey speaks to the Missouri chapter of the Federalist Society on the Missouri House of Representatives floor on Jan. 20. He is currently overseeing an investigation into the Washington University Transgender Center at St. Louis Children’s Hospital
Annelise Hanshaw
/
Missouri Independent
Missouri Attorney General Andrew Bailey speaks to the Missouri chapter of the Federalist Society on the Missouri House of Representatives floor on Jan. 20. He is currently overseeing an investigation into the Washington University Transgender Center at St. Louis Children’s Hospital

Reed’s affidavit to Attorney General Andrew Bailey alleges the Transgender Center quickly gave children hormones. The center “gave children puberty blockers and cross-sex hormones after just two one-hour visits (one with a therapist and one with a doctor at the Center),” she wrote in the affidavit.

Parents and former patients told The Independent it took months and multiple appointments before their transgender children received a puberty blocker or hormone treatment.

Rene and Kyle Freels called the Transgender Center in June of 2021 for their daughter. Reed answered the phone.

“What do you want from us?” Kyle Freels recalls Reed asking.

“I thought she had some sort of an agenda. Like the first time we called, she answered the phone. She was the opposite of helpful,” he said.

They didn’t know what treatment was recommended, and they were expecting more help on the other end of the line.

“For us, she was the ultimate gatekeeper. She was the ultimate person that kept our kid from getting an appointment and kept other kids from getting appointments at the center,” Rene Freels said.

They hung up confused and irritated but nonetheless determined to get medical care for their daughter. By August of 2021, their daughter had her first visit with a pediatric endocrinologist, a doctor specializing in hormones, at the center.

The doctor did not prescribe any hormones or puberty blockers and said he wanted their daughter to transition socially, meaning take on her new name and pronouns, prior to taking estrogen, the Freels said.

Their daughter did not have mental health conditions, like anxiety or depression, but attended therapy sessions and received a recommendation to receive hormone treatment.

The Freels returned for a second appointment with the endocrinologist a year later, and their daughter opted to get a puberty-blocking implant in November of 2022 — 17 months after coming out to her pediatrician.

Kyle Freels described the appointment as “so thorough.”

“There’s a lot of information,” Kyle Freels said. “He tells you the pros and cons of this method or that method.”

Lisa is the mother of a trans child who asked that her last name be withheld. She waited longer than the Freels family for her pre-teen son to receive a puberty blocker.

Her son had his first appointment at the Transgender Center in August 2019 but was too young for a puberty blocker. He had to wait three years.

He has had 21 visits with a psychologist and nine visits with an endocrinologist since the summer of 2019.

Joey, who also asked that his last name be withheld, started taking testosterone days before his seventeenth birthday and after nearly a year of therapy.

“Everything took a really really long time to get going,” he said.

The Transgender Center’s endocrinologist didn’t think he was ready for hormones after his first appointment because he wasn’t “out” yet at school, he said.

“Everything was so slow,” he said, later adding:. “Everything is so restricted and difficult for any kind of trans health care, particularly if you’re a minor.”

He opted to get “top surgery,” which removes breast tissue, a few weeks after he turned 18.

Reed alleges in her affidavit that the Transgender Center gives referrals for surgery to minors, but Jones said the center only provided patients with the names of surgeons that could provide the procedure.

“We did give out the information of surgeons,” Jones said, “but we never referred for surgery.”

Hyman’s son wanted top surgery but was immediately told “put that out of your mind until you’re 18,” she said.

Alison Maclean’s son was five or six months into his transition when she called the Transgender Center. Maclean was met with questions about her son’s social transition, like if his peers called him his name.

“I think they really gauge like where I think the clinic attempts to gauge where you’re at, kind of in your, in your journey with your child,” Maclean said.

Her son, now 12, does not receive any puberty blockers or hormones. He discusses with his Transgender Center doctor what may happen if he eventually takes testosterone, but Maclean said she and her son don’t feel pushed toward hormones.

The doctor told him he wouldn’t be old enough “for many years,” she said.

Mental Health

Jones said the center had one in-house psychiatrist but referred patients to other providers in the area and within St. Louis Children’s Hospital.

“It is true that many patients came in anxious and depressed, whether that was a diagnosis or just symptoms, but from my experience, that was alleviated with the start of gender affirming hormones,” Jones said.

Jones said Reed had a particular concern with patients’ ability to consent, alleging Reed wanted to make patients take an IQ test prior to accessing puberty blockers or cross-sex hormones.

Reed, speaking through her attorney to The Independent, didn’t directly address the IQ test accusation.

“She was always in favor of a full assessment being done and that full assessments should be done on every patient in accordance with the WPATH guidelines. So whatever was needed for any given patient, that was what she favored, as a general proposition,” Broyles said. “And that’s really as much as she feels comfortable saying at this point.”

The World Professional Association for Transgender Health sets standards of care for gender transition. In her affidavit, Reed said WPATH is considered an “activist organization.”

Danielle, who did not wish to share her last name, said her son walked into the center with depression at first. But that evaporated when he was able to be a boy.

“When [my child] came out as transgender, it was immediate, just the social transition results. Like he was not depressed anymore,” she said.

Maclean noticed her son becoming less like himself as the family moved and COVID-19 interrupted routines — and he also began puberty.

“He kind of withdrew and, like the light left him. He wasn’t depressed or suicidal or anything; he just was not himself,” she said.

The families noticed a positive difference after their child received gender-affirming care.

“We thought our kid was happy before, but after she came out and is living her true self, she’s so much happier,” Kyle Freels said. “You could tell the weight of the world was off her shoulders.”

“I would say I’ve only gotten benefits [from gender-affirming care],” Joey said. “It’s been awesome. And I wouldn’t trade it for the world.”

Side effects

Parents said they felt like they had the Transgender Center’s doctors’ full attention to ask questions and review possible side effects of treatments. When they left, they had multiple handouts — some provided to The Independent that had been emailed from Reed herself.

“Not only do they give you a paper handout, they give you a whole slew of materials to look at,” Lisa said.

Maclean has been given handouts with testosterone side effects listed and warnings about things Reed alleges goes unaddressed by the Transgender Center, like vaginal atrophy.

“I think these little bits have been cherry picked from people who maybe didn’t pay attention,” Maclean said.

“We were not rushed into it,” Danielle said. “We were not uninformed. Everything that I’ve read in the affidavit, the opposite is true for us.”

 A Transgender Center handout sent to The Independent by a parent and a former employee discloses possible side effects of testosterone.
A Transgender Center handout sent to The Independent by a parent and a former employee discloses possible side effects of testosterone.

Parents, patients and Jones told The Independent the center would send children on hormone or puberty-blocking medication to get lab work before every visit.

At first, patients review their hormone levels and look for side effects, like cholesterol levels, every three months. Then, they reduce frequency to every six months.

Lisa’s son gets regular labs run to test his hormone levels and check his health, and doctors check his bone scans to check his calcium and bone density.

All the families interviewed said they were advised to consider fertility options, like storing eggs or sperm, if treatment would inhibit future plans to have children.

An April 2020 study by the Mayo Clinic notes that there is little research on fertility outcomes for transgender people but that fertility preservation is an option even after beginning hormones.

Parental consent

Reed alleges the center bullied parents into agreeing to their kids’ medical treatment.

“A common tactic was for doctors to tell the parent of a child assigned female at birth, ‘You can either have a living son or a dead daughter,’” she wrote in her affidavit.

The evening the affidavit became public, she told The Free Press subscribers it was only one doctor that said that, a doctor that no longer works at the center.

Jones said the center did not coerce consent.

“We were very adamant in my time working there that all guardians had to consent, and they needed to be present and receive informed consent around treatment,” Jones said.

Jones said physicians presented research that showed a lower rate of suicide with gender-affirming care as they explained the benefits and side-effects of hormones.

Divorced parents told The Independent the center contacted both parents prior to proceeding with treatment, including meeting via video chat for an out-of-state ex-husband.

“They made it very clear that until, until the other parent was in full agreement, they could not move forward if and when one of the parents wanted to move forward,” Lisa said.

Families addressed other sections of the affidavit, sharing concern for the investigation ahead of state agencies.

Approximately 50 people wait to testify outside of a packed hearing room as State Sen. Mike Moon, R-Ash Grove, presents a bill that seeks to prevent the instruction of “gender identity and sexual orientation” in schools Feb. 7, 2023.
Annelise Hanshaw
/
Missouri Independent
Approximately 50 people wait to testify outside of a packed hearing room as State Sen. Mike Moon, R-Ash Grove, presents a bill that seeks to prevent the instruction of “gender identity and sexual orientation” in schools Feb. 7, 2023.

“If you go to a cardiologist and they give you bad drugs or whatever and you have a heart attack, you don’t shut down the office; there’s a medical malpractice suit,” Kyle Freels said. “These politicians are like, ‘Hey, one, two or three clients had adverse effects, just like any other doctor would have,’ but they want to shut down the transgender unit immediately without even an investigation.”

The attention the center has gotten since Reed’s allegations surfaced has given momentum to a spate of bills seeking to criminalize gender-affirming care.

Families of transgender children say fear of what’s to come has them looking at leaving the state.

“[My family is] from all over. We don’t have to stay here,” said Maclean. “We thought we were here for the long haul, but we don’t have to be.”

Her family is not the only one thinking about leaving the state.

“There’s already one family that’s moved, and there’s another family that’s about to move,” Halla said. “But not every family can do that.”

The Transgender Center did not comment on the allegations; its phone number dedicated to the media has given a busy signal during numerous attempts.

This story was originally published by the Missouri Independent, part of States Newsroom, a network of news outlets supported by grants and a coalition of donors as a 501c(3) public charity. Missouri Independent maintains editorial independence.

Copyright 2023 St. Louis Public Radio. To see more, visit St. Louis Public Radio.

Annelise Hanshaw covers education for the Missouri Independent — a beat she has held on both the East and West Coast prior to joining the Missouri Independent staff. A born-and-raised Missourian, she is proud to be back in her home state.
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