Almost six months ago in our pages, therapist Tamara Pietzke blew the whistle on how her former employer, MultiCare Health System—one of the largest health providers in Washington State—instructed staffers to approve all teen gender transitions, regardless of patients’ other health concerns. 

Pietzke refused to rush vulnerable young people with multiple mental health difficulties into a life-altering gender transition. In her essay, she wrote that she quit her job and spoke out “because nothing will change unless people like me—who know the risks of medicalizing troubled young people—blow the whistle. I am desperate to help my patients. And I believe, if I don’t speak out, I will have betrayed them.”

She added that she was villainized for her decision by her colleagues, who made her feel like she “had gone insane.”

Now, in a dramatic turn, MultiCare has issued a memo to its board members announcing what the hospital is calling its new “holistic approach” to gender care. In September, the hospital’s gender clinic will begin implementing new standards for providing “gender-affirming health care for adolescents,” ensuring that they are “backed by the most up-to-date science.” The memo, first reported by the site [un]Divided, was sent to board members from the hospital’s CEO on July 17.