Vulnerable populations
I am a 42-year-old St. Louis native, a queer woman, and politically to the left of Bernie Sanders. My worldview has deeply shaped my career. I have spent my professional life providing counseling to vulnerable populations: children in foster care, sexual minorities, the poor.
Jamie Reed worked for several years at The Washington University School of Medicine Division of Infectious Diseases with teenagers and young adults who were HIV positive.
Many of them were trans or otherwise gender nonconforming, and I could relate: Through childhood and adolescence, I did a lot of gender questioning myself. I’m now married to a transman, and together we are raising my two biological children from a previous marriage and three foster children we hope to adopt.
Makes it a bit tricky to label her a “transphobe” I should think.
All that led me to a job in 2018 as a case manager at The Washington University Transgender Center at St. Louis Children’s Hospital, which had been established a year earlier.
The center’s working assumption was that the earlier you treat kids with gender dysphoria, the more anguish you can prevent later on. This premise was shared by the center’s doctors and therapists. Given their expertise, I assumed that abundant evidence backed this consensus.
Does off the charts social contagion count as abundant evidence? As it turns out, no.
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.
So she is blowing the whistle.
Frequently, our patients declared they had disorders that no one believed they had. We had patients who said they had Tourette syndrome (but they didn’t); that they had tic disorders (but they didn’t); that they had multiple personalities (but they didn’t).
The doctors privately recognized these false self-diagnoses as a manifestation of social contagion. They even acknowledged that suicide has an element of social contagion. But when I said the clusters of girls streaming into our service looked as if their gender issues might be a manifestation of social contagion, the doctors said gender identity reflected something innate.
Ok hang on. How could they know that? How could they possibly tell? When the putative condition itself is entirely in the mind? There are no physical symptoms of being trans, so how can doctors possibly be confident that thinking you are the other sex is not social and mental rather than physical?
Many encounters with patients emphasized to me how little these young people understood the profound impacts changing gender would have on their bodies and minds. But the center downplayed the negative consequences, and emphasized the need for transition. As the center’s website said, “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.”
There are no reliable studies showing this. Indeed, the experiences of many of the center’s patients prove how false these assertions are.
Well the center didn’t specify reliable studies, it just said “the studies we have.” So that’s ok then!
Reed and a colleague had concerns about a boy who didn’t really grasp what the off-label medication was going to do to him.
Bicalutamide is a medication used to treat metastatic prostate cancer, and one of its side effects is that it feminizes the bodies of men who take it, including the appearance of breasts. The center prescribed this cancer drug as a puberty blocker and feminizing agent for boys. As with most cancer drugs, bicalutamide has a long list of side effects, and this patient experienced one of them: liver toxicity. He was sent to another unit of the hospital for evaluation and immediately taken off the drug. Afterward, his mother sent an electronic message to the Transgender Center saying that we were lucky her family was not the type to sue.
They should have sued.
I don’t understand. I was assured that Reed and Jesse Singal were going to be locked up in HIPPA Prison by now!
I remember she was quite heavily excoriated when she first started blowing this whistle. In the time since this article, the revelations of the lack of scientific rigor have been confirmed by reviews of WPATH and the final Cass Review.
I had to read this part a couple of times, though:
because to me, being “who they are” reads as allowing them to develop as adolescents without medical interventions. Anyone who has studied adolescence and developmental psychology should be able to recognize that this is a period that is fraught with vagaries. The idea that any sort of medical intervention that would have permanent consequences would, in an honest practice of psychology, be laughed at derisively if the suggestion were to prescribe drugs of surgery. But, no, we have the intermediate choice of “pausing” puberty until kids figure out their gender. If we let kids figure it out for themselves, they tend to give up on the idea that their gender is wrong for their body. That’s what I was reading, and had to go back to the sentence before I realized what the Center claims.
Even if stopping adolescent development were safe, a proposition that should give pause to anyone who’s familiar with all the physical and mental development that goes on in those horrible years, a reasonable inquiry would include the question of how a child can figure out gender in its absence. It’s a crucial developmental phase, in which boys and girls realize how gender affects them, both positively and negatively, in relationship to their newly maturing sexual organs. Stopping puberty is something that would benefit the Raelians, but they were a very weird cult.
Mike there’s something missing in this sentence:
“The idea that any sort of medical intervention that would have permanent consequences would, in an honest practice of psychology, be laughed at derisively if the suggestion were to prescribe drugs of surgery.”
Mike, that line leapt out at me, too. It’s such a clear own goal. Letting people be who they are is nice, I suppose, but it’s even more important to let them be whom they will be–in other words, to let them grow and develop.
No, that doesn’t really say what I intended, does it?
Ugh.
The idea that Intervention surgery or medical treatment to permanently alter a child who thinks he or she is the other sex should be dismissed rather than indulged. Adolescents are not experts in gender and need guidance on how to be themselves without being injected nor dissected.
Heh, it’s not an ugh thing, just that there was a word or phrase missing. Sometimes it’s obvious what the word or phrase is and I just fix it, but sometimes it isn’t. Anyway it’s still missing! But if we change the third word, “that,” to “of” then the sentence works. Or else insert “is a good idea” or similar after “the other sex”.
If I ever write my book, I want Ophelia to be my editor!
It’s my one talent!