Former gender-transition manager: Pediatric transition "morally and medically appalling"

AP Photo/Rick Bowmer

Has modern medicine deliberately decided to abandon its pledge to “first do no harm” when it comes to children and gender transitions? According to this self-described “queer woman” and Bernie Sanders supporter, the answer is yes. And Jamie Reed should know; she worked as a case manager for a pediatric gender clinic for “almost four years,” handling intake and care decisions for children confused about their bodies and identity.


She started out as a believer in gender transitions for minors. Now Reed declares in The Free Press that it’s time to bring it to a halt immediately, and end the deliberate damage that the medical industry is doing to this generation of children before it’s too late:

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.

Today I am speaking out. I am doing so knowing how toxic the public conversation is around this highly contentious issue—and the ways that my testimony might be misused. I am doing so knowing that I am putting myself at serious personal and professional risk.

Almost everyone in my life advised me to keep my head down. 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.


What the medical industry is doing is making these children into permanent clients. The harm inflicted on these children is not just significant in one moment of time; it requires a lifetime of medical support as well. The use of puberty blockers transitions to a chronic requirement for hormone therapy; the surgeries to create artificial genitalia likewise are anything but turnkey. And when a significant number of these children decide later to detransition as adults, those surgeries and therapies will also require a lifetime of medical support.

It’s not difficult to see the incentive structure inherent in abandoning the Hippocratic oath, even without Reed’s whistle-blowing. And the irony of the same political wing that normally hyperventilates over “Big Pharma” — the Bernie Sanders wing, if you will — championing and defending this practice is both as potent and bitter as it gets.

It’s important to read all of the Free Press essay written by the former intake manager of a pediatric gender clinic. To attempt to excerpt this beyond her statement of principles would be to essentially reprint the entire testimony. However, we can highlight some critical revelations within it as a roadmap to its importance:

  • Reed started with the assumption that this was a medically sound practice backed by research, which turned out to be false
  • Anyone who raised questions ran the risk of being branded a “transphobe”
  • Patients frequently self-reported problems they didn’t have, including Tourette’s and multiple-personality illnesses, which clinic doctors recognized as the effects of “social contagion”
  • When Reed raised that as an issue for gender dysphoria as well, the same doctors rejected it
  • The clinic “downplayed” the clear and unavoidable side effects of transition therapy

This set of revelations doesn’t sound like science at all. It sounds like a cult, a fad for-profit diet program, or perhaps both. Reed quotes the clinic’s website to demonstrate the denial involved regarding both physical and psychological side effects:

“Left untreated, gender dysphoria has any number of consequences, from self-harm to suicide. But when you take away the gender dysphoria by allowing a child to be who he or she is, we’re noticing that goes away. The studies we have show these kids often wind up functioning psychosocially as well as or better than their peers.”

“We’re noticing”? Does that sound scientific at all, or merely a vague reference to anecdotal incidents that likely are impacted by selection bias? As Reed notes, there is no scientific basis for the claims made here, and “we’re noticing” is a big reveal in that regard. This is not science, in other words, but a belief system — and it operates on that basis, complete with excommunication of heretics and apostates. Reed in fact predicts that she will get that very treatment for her whistleblowing today, and she’s probably right, but she won’t be alone — which we’ll see in a moment.

There is more, however, and even more disturbing. A significant portion of the clinic’s clientele came from an inpatient psychiatric facility. These children and teens suffered from a range of mental illnesses and various degrees of those, but like the proverbial craftsman with only a hammer, every child looked like a gender-transition nail to the clinic doctors.


What about detransitioners? How did Reed’s clinic handle those cases, when their patients change their minds? They couldn’t be bothered, not even to track cases to refine the medical standards of their clearly innovative care. Reed and one colleague tracked them anyway, which is what led to her efforts to raise ethical questions at the clinic. I’ll provide one brief excerpt (as long as you promise to click through and read the whole thing), because Reed describes best what happened next:

In all my years at the Washington University School of Medicine, I had received solidly positive performance reviews. But in 2021, that changed. I got a below-average mark for my “Judgment” and “Working Relationships/Cooperative Spirit.” Although I was described as “responsible, conscientious, hard-working and productive” the evaluation also noted: “At times Jamie responds poorly to direction from management with defensiveness and hostility.”

Things came to a head at a half-day retreat in summer of 2022. In front of the team, the doctors said that my colleague and I had to stop questioning the “medicine and the science” as well as their authority. Then an administrator told us we had to “get on board, or get out.”

This isn’t science, and it’s not even a virtuous model for business in general. Even describing this as a belief system may be assigning too much virtue to it, although it still fits. Reed got treated as a heretic verging on apostasy, complete with a warning about excommunication. But if you don’t like that analogy, how about this: in a more secular sense, this looks like a con game on the verge of becoming a syndicate, complete with a demand of omertà.


Either way, this isn’t medicine or “care” in any normal sense of the word. It’s an exploitation for politics and profit. And this process butchers children for life, robbing them of their procreative possibilities and all sorts of future choices as adults, on the basis of belief (at best) rather than science.

It is an outrage. And it is a must-read for anyone who truly cares about truth and the care of children, as well as the future of this country in the next generation.

Update: The clinic is located in the St. Louis area. Missouri senator Josh Hawley announced that his office would open an investigation into its practices:

Hawley can open his own investigation, but senators have no individual prosecutorial or subpoena power. Since Republicans are in the minority in the Senate, Hawley probably won’t be able to get a committee or subcommittee to issue subpoenas or probe the clinic operations, either. This still can raise the public profile of the story, as well as signal to Hawley’s House Republican allies to open their own probe.

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