'No one is ever told no': NY Times does a deep dive on St. Louis gender clinic (Update)

You may remember back in February the Free Press published an explosive report about a pediatric gender clinic in St. Louis. A former clinic worker named Jamie Reed had decided to come forward as a whistleblower. Reed had become concerned that children coming to the clinic were being given drugs without sufficient screening and mental health treatment.

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During the four years I worked at the clinic as a case manager—I was responsible for patient intake and oversight—around a thousand distressed young people came through our doors. The majority of them received hormone prescriptions that can have life-altering consequences—including sterility.

I left the clinic in November of last year because I could no longer participate in what was happening there. 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’s claims stirred up people on both sides of the debate. A few weeks later the St. Louis Post-Dispatch published a story that read like a rebuttal of the original report. And there was a reason for that. One of the parents heavily featured in the report turned out to be the founder of a group called TransParent that advocates for medical access for trans kids. Somehow the Post-Dispatch forgot to mention it. Instead it opened its story this way:

Explosive allegations made public last month about a St. Louis clinic that treats transgender children have flung parents into a vortex of emotions: shock, confusion, anger, fear.

Kim Hutton, among those confused by the reports, views the treatment her son, now 19, received from Washington University’s Transgender Center at St. Louis Children’s Hospital as vital to making him the outgoing college freshman he is today.

“The idea that nobody got information, that everybody was pushed toward treatment, is just not true. It’s devastating,” Hutton said. “I’m baffled by it.”

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As Jesse Singal pointed out, not only was Hutton an activist, she also had ties to the gender clinic in question:

…not only is Hutton the cofounder of TransParent, but she actually helped create the very gender center being scrutinized. A savvy tipster, who wanted to remain anonymous, pointed this out to me in an email. TransParent’s History page details close links between Hutton and St. Louis Children’s Hospital going back more than a decade. In a 2018 article in the Ladue News informing readers of 2018’s “Women of Achievement,” the author writes that among her other accomplishments, Hutton “successfully lobbied for the Washington University Transgender Center of Excellence, which opened in 2017.”

In any case, today the NY Times has published its own deep dive on the story and the paper concludes some of Reed’s claims were corroborate while others couldn’t be confirmed.

The reality was more complex than what was portrayed by either side of the political battle, according to interviews with dozens of patients, parents, former employees and local health providers, as well as more than 300 pages of documents shared by Ms. Reed.

Some of Ms. Reed’s claims could not be confirmed, and at least one included factual inaccuracies. But others were corroborated, offering a rare glimpse into one of the 100 or so clinics in the United States that have been at the center of an intensifying fight over transgender rights.

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I’m fine with adding nuance but it sounds to me like the primary claim Reed made about the clinic—that it was not screening kids sufficiently for other mental problems—was accurate. [emphasis added]

…as demand rose, more patients arrived with complex mental health issues. The clinic’s staff often grappled with how best to help, documents show, bringing into sharp relief a tension in the field over whether some children’s gender distress is the root cause of their mental health problems, or possibly a transient consequence of them.

With its psychologists overbooked, the clinic relied on external therapists, some with little experience in gender issues, to evaluate the young patients’ readiness for hormonal medications. Doctors prescribed hormones to patients who had obtained such approvals, even adolescents whose medical histories raised red flags. Some of these patients later stopped identifying as transgender, and received little to no support from the clinic after doing so.

This background of increased demand for services is addressed in a companion article also published today by the Times.

The number of gender-affirming surgeries, intended to align patients’ physical appearance with their gender identity, nearly tripled in the United States between 2016 and 2019, according to a new analysis published in JAMA Network Open on Wednesday.

The number of procedures rose from about 4,550 in 2016 to about 13,000 in 2019, and then dipped slightly in 2020, according to the study’s estimates. Because of various data limitations, the researchers behind the study believe the true figures are higher.

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Kim Hutton gets more coverage in today’s story saying she and her son have no regrets but at least the Times identifies her. On the other hand, Jamie Reed kept a spreadsheet of information on patients including 16 who had detransitioned and some who regretted permanent changes made to their bodies.

One patient emailed the clinic, in January 2020, to say they had detransitioned and were seeking a voice coach for their masculinized voice…

In another email thread, the center’s staff discussed a patient who regretted a recent mastectomy. The patient had messaged their surgeon at Washington University twice about wanting a breast reconstruction, but had not received a reply.

The Times also independently located a former patient named Alex who detransitioned after three years on testosterone prescribed by the clinic. Alex told the Times, “overall, there was a major lack of care and consideration for me.”

Perhaps the most telling paragraph in the story involves the influx of new patients. By 2021 the clinic was getting calls from 4-5 new patients per day. And trans patients were also showing up in the ER so frequently that Jamie Reed and the gender clinic’s nurse held a training session for the ER nurses. The nurse, Ms. Hamon, later relayed concerns expressed by the ER staff to the clinic and university administrators.

“They aren’t sure why patients aren’t required to continue in counseling if they are continuing hormones,” Ms. Hamon added. And they were concerned that “no one is ever told no.”

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Overall, this piece is far more favorable to Jamie Reed’s claims than it is to her detractors. I suspect we’ll be hearing a lot of gnashing of teeth about the NY Times in general and this article in particular over the coming weeks. We’ll have to wait and see if the rest of the media decides to pile on as they’ve done in the past or take the claims of critics with a bit more skepticism.

Update: This is nice to see. Chris Hayes was casting doubt on the Free Press story back in May. Yesterday Bari Weiss reminded him of that. Is Chris going to tweet about this story again?

And as expected, the activists are jumping all over the NY Times for reporting the truth.

BTW, the “anti-trans extremist” in this case is Jamie Reed. Just a reminder of Reed’s progressive bona fides:

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