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Gender-Clinic Whistleblower Jamie Reed Has Provided A Detailed Account Of Her Most Controversial Claim, Including The Names Of Those Involved
But it’ll still take some time for anyone to be able to verify it independently
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This probably goes without saying, but if you have any information about the gender clinic under discussion here, whether positive or negative, please send me an email. Anonymity is guaranteed unless and until we come to a mutual decision otherwise.
After Jamie Reed, a former case manager at The Washington University Transgender Center at St. Louis Children’s Hospital, came forward as a whistleblower accusing her former employer of widespread negligent practice, it was inevitable she would face harsh criticism. After all, by going public with her concerns, she has inserted herself into the white-hot national debate over youth gender medicine — a debate that has only become more contentious in the wake of the seemingly ever-increasing number of Republican attempts to ban youth gender medicine at the state level, turn state agencies against parents who help their children transition, or both.
There were a couple paragraphs in her affidavit that stood out, because they suggested the Center was fast-tracking truly confused or disturbed kids onto medical treatments:
One patient came to the Center identifying as a “communist, attack helicopter, human, female, maybe non binary.” The child was in very poor mental health and early on reported that they had no idea their gender identity. Rather than treat the child for their serious mental health problems, the Center put the child on cross-sex hormones and ignored the child’s obvious mental health problems. The child subsequently reported that their mental health actually was worsening once they started the cross-sex hormones.
Children come into the clinic using pronouns of inanimate objects like “mushroom,” “rock,” or “helicopter.” Children come into the clinic saying they want hormones because they do not want to be gay. Children come in changing their identities on a day-to-day basis. Children come in under clear pressure by a parent to identify in a way inconsistent with the child’s actual identity. In all these cases, the doctors decide to issue puberty blockers or cross-sex hormones.
In the eyes of a number of fairly high-profile liberal journalists, the detail about the helicopter turned Reed into an instant punchline — not just a liar, but a hackish one. “I sexually identify as an attack helicopter,” after all, is a well-worn internet meme, often used as an attack against transgender people. (It also inspired a very good science fiction short story that in turn sparked a brutal online controversy which led to its unpublishing.)
“[W]ow who could have predicted that the front-desk staffer who claimed children were being given hormones for identifying as mushrooms and helicopters would have some credibility problems,” said the popular podcaster Michael Hobbes, misconstruing Reed’s role at the clinic and linking to a St. Louis Post-Dispatch story that, well, misconstrued Reed’s role at the clinic (and which had other problems as well).
“Definitely building a stronger and stronger case that the helicopter lady is stable and reliable,” said Tom Scocca, a blogger and former Gawker Media staffer.
“[P]ersonally when someone claims to be the left of Bernie Sanders and tells an *outlandish* gender story that just happens to line up with right-wing agitprop, I know what to do: believe them,” commented Ryan Cooper, executive editor of the liberal American Prospect magazine. “[reading a story about children identifying as helicopters in a publication run by someone who fell for an “Official Antifa” parody account] Michael Hobbes will answer for this.” (No, I do not expect anyone who isn’t far too online to get that reference.)
My former New York magazine colleague Jon Chait came in for a cavalcade of criticism online, simply because he sympathetically cited Reed’s affidavit, helicopter child included, in an article published last month.
At some point, a strange game of internet telephone took hold. Reed’s original claim, that a child who seemed to identify as a number of things, only one of which was a helicopter, had been rushed too hastily onto hormones, morphed into something orders of magnitude stupider. Amanda Marcotte, a senior writer at the liberal online magazine Salon, begged Chait to simply stop and think about how idiotic he was being: “Dude. Dude. Let it go,” she tweeted at him. “You claimed kids were taking hormones to be helicopters. Take a beat. Exercise. Meditate. Ask hard questions with your therapist about why the personal lives of strangers bother you so much.”
(I think the community note now affixed to the tweet is in error, and that Marcotte was addressing Chait, not me.)
Rebecca Watson, who runs the science blog Skepchick, devoted a whole article and video to this made-up claim headlined “Journalist Thinks Trans Kids Are Getting Hormones to Turn into Helicopters.” “[U]nlike New York Magazine writers,” she insisted, “most doctors are not credulous morons, and absolutely no doctor would do anything for a kid like that besides recommend intensive therapy for their unbearable need for attention.”
Obviously, I had to ask Reed about this. She responded with a very detailed account of what happened, naming everyone directly involved other than the patient. She also provided me with new details about how she collected the information she has since turned over to the office of Missouri’s Attorney General, and why she is confident that when all is said and done it will be straightforward for investigators to verify her claims.
Reed claims not to be very online, but when I first mentioned the helicopter kid on Monday night, it seemed like she had caught wind of some of the criticism and was exasperated by it. “I know exactly all about this!” she said. “This is driving me batty!” She quickly explained that the helicopter claim had come from a letter of support from a clinician referring a child to the Center for hormones.
The Transgender Center has multiple locations. On Tuesdays, Reed explained, she would work out of the West County, Missouri clinic, which according to this online press release opened in April 2022, and which is formerly known as the St. Louis Children’s Hospital Specialty Care Center - West County. The incident in question occurred between April and July of last year, she estimated, but she couldn’t narrow down the date further.
Reed explained that on the day in question she was sitting in “the pod,” the room where the medical staff worked, with Karen Hamon, a nurse. Casey Lofquest, a nurse practitioner, came out of one of the exam rooms looking concerned. She walked over to Reed and Hamon and explained that the patient she was seeing was having a rough time. This patient, who was a natal male and who Reed believes used they/them pronouns, was attending their second appointment at the clinic. During their first, which had occurred three months prior, they had been prescribed hormones by one of the Center’s endocrinologists.
Lofquest explained that the patient was reporting that their mental health had worsened since starting hormones. The patient also couldn’t clearly define their gender identity. That prompted Reed to pull up their chart on her computer to try to figure out what was going on. The clinic uses Epic, a popular program for keeping track of patient records. Included in this patient’s Epic chart, in the “Media” tab where additional information can be added, was the letter of support from an outside therapist that had apparently been used to justify the decision to immediately start them on hormones upon their arrival at the clinic.
The patient was quoted in the letter as saying they identified as a “communist, attack helicopter, human, female, maybe non binary.” The therapist also wrote that the patient reported that they “hope for the transition to feel better in my body and no longer just in a flesh box.” Despite these major red flags — or at least what Reed saw as red flags, reading the letter months later — the referring provider nonetheless finished the letter by saying the young person was ready for hormones.
Reed was sufficiently concerned by the letter to get Hamon’s attention and ask her to read it. Hamon read it and agreed with Reed that something was off. The next time the endocrinologist came into the pod, Hamon asked him about the letter. According to Reed, the endocrinologist reported that he did not have any recollection of a patient identifying in the strange manner described in the letter, which suggested to Reed that he hadn’t read the letter, or hadn’t read it closely.
(On Wednesday I emailed both of my press contacts at Washington University in St. Louis, as well as the three individuals Reed named to me, providing them with the full account of the helicopter incident I’m publishing in this article and offering them a chance to highlight any factual inaccuracies. I didn’t get a response, which is neither surprising nor necessarily damning given the intense scrutiny the Transgender Center, which Reed wants shut down, is under. I’m leaving the endocrinologist’s name out of this story because he is the only individual who Reed directly criticized, and because it may well be the case that he is not, at present, in a position to muster any defense without running afoul of his employer.)
By the time she came across this patient, Reed said, she had already developed deep and growing concerns about how the Center was functioning, and the possibility that it was hurting the kids it was charged with caring for, many of whom had very complicated mental health situations. In fact, she said, she’d already confronted the endocrinologist and outright accused him of having harmed his patients. That he didn’t appear to have read this letter closely before starting this troubled kid on hormones “just continued to prove some of my deep-seated concerns,” she said.
Reed had, by then, begun keeping a running Notes file on her iPhone with “Thoughts” at the top, both to keep track of ongoing issues she had at the clinic and to brainstorm, to herself, how to best act on those concerns without jeopardizing her employment situation. She pulled the file up on her phone and typed in the two most alarming sentences from the referring letter, verbatim.
When I asked Reed if I could see this file she immediately emailed it to me, on the condition I not share any of the other information in it. There, about halfway through various other notes and reflections on her situation, were the phrases in question:
“Communist, attack helicopter, human, female, maybe non binary”
“Hope for the transition to feel better in my body and no longer just in a flesh box”
Reed also shared a Google Document titled “Bullet points for Center Specific Concerns” that seemed to serve a similar purpose as the Notes file, albeit in more fully-baked form. It hadn’t been edited since January 5, which Reed told me was the point at which she had finalized it and decided to talk to lawyers about what she had seen at the clinic.
It also contained the helicopter excerpt:
Reed said that because she doesn’t spend much time online, she didn’t realize the helicopter reference was from the internet. “I had no idea,” she told me. She found out about it from Julia Mason, a pediatrician who has coauthored academic articles criticizing some of the research that underpins it, and who is also listed as one of the “Clinical and Academic Advisors” at the Society for Evidence-Based Gender Medicine,which bills itself as “an international group of over 100 clinicians and researchers concerned about the lack of quality evidence for the use of hormonal and surgical interventions as first-line treatment for young people with gender dysphoria.”
Mason happened to be in St. Louis in December, and Reed told her about the helicopter kid over coffee. Mason replied that it was a preexisting concept from the internet (Mason confirmed this to me). “It did not make it any less disconcerting” to find out the patient appeared to be referencing a meme, said Reed. “But I think it framed it within the context of a young person pulling something from what they found online.” She continued: “I don’t understand why the therapist did not flesh this out at the time, but to me, when you see that type of — it’s not that they’re stealing it from online — that type of online influence, I think it should make someone pause and question the patient’s internalized feelings versus external influence.”
While members of the online commentariat viewed certain aspects of Reed’s affidavit as instantly disqualifying, I didn’t get the sense that anyone who has closely followed the controversy over youth gender medicine felt that way. For a long time, there’s been a steady trickle of anecdotes about subpar care in this relatively new, under-evidenced area of medicine,particularly in the form of shoddy assessments that might fail to pick up red flags suggesting a kid shouldn’t go on blockers or hormones, at least not without a lot more assessment.
There are some illustrative examples of this in BBC Newsnight investigations producer Hannah Barnes’ recently released book, Time to Think: The Inside Story of the Collapse of the Tavistock’s Gender Service for Children, which I just interviewed her about on Blocked and Reported (paywalled for now, but free starting Monday morning). Tavistock’s Gender Identity Development Service (GIDS), long the National Health Service’s only provider of youth gender medicine, is being shut down and replaced with regional clinics in part because of concerns about the quality of the care it delivered that were reported by clinicians at least as far back as 2005.
Barnes’ book contains quotes from longtime GIDS clinicians who said that kids frequently arrived at the clinic very confused, very traumatized, or both, but that they were sometimes ushered along toward medical transition nonetheless, with little regard given for their mental health comorbidities. Barnes’ reporting suggests that giant red flags were ignored with some frequency. Clinicians even “feared they may be seeing fabricated or induced illness (FII), a presentation previously referred to as ‘Munchausen’s by proxy’ ”:
Anastassis Spiliadis recalls a case where he believes this was “very clear.” “The young person said that ‘my mum wants this for me,’ or ‘my mum wants the blocker more than I do.’ I mean, that was very solid evidence that something needs to happen.” The family situation was incredibly complicated. There was sexual abuse and domestic violence in the background, and the family were reluctant for others to be involved. Spiliadis and his colleague agreed that they would not be putting the young person forward for puberty blockers, given how much was going on, and “because there was so much more to explore.”
He says that despite their significant clinical concerns, [GIDS director] Polly Carmichael suggested they refer the young person for puberty blockers.*
The asterisk points to a note from Barnes explaining that Spiliadis repeated this accusation under oath, and that after Barnes and her team broadcast it and other, similar claims on Newsnight, GIDS issued a statement refuting the allegations in a general way, but without providing any details.
In claims and testimony that sound quite similar to Reed’s, GIDS clinicians said kids would arrive at their clinic with extremely strange ideas about their identity. That, too, sometimes wasn’t seen as a good reason to slow down the process of medicalization:
There were even young people presenting at GIDS who didn’t just identify as another gender, but as another ethnicity too. “There were several cases in the service where a young person identified as a different nationality, usually East Asian, Japanese, Korean, that sort of thing,” [Matt] Bristow says. Anna Hutchinson confirms this was the case. They would have “quite specific ideas about transitioning and then taking on this East Asian identity as well as a different gender identity,” Bristow recalls. It’s hard to imagine quite what must be going on for some of these young people. The fact that they also viewed themselves as a different race was sometimes pretty much parked, and they were assessed for their gender identity difficulties as if the other identity issues were not important, or an indication that perhaps this young person might be struggling more generally.
Despite the obvious complexity of all these cases — sexual abuse, trauma, potential FII — “the answer was always the same,” says Bristow. “That the young people eventually get put on the blocker unless they themselves say they don’t want it.”
Some worried clinicians told Barnes that even in cases where they were successful in applying the brakes, they were met with intense pressure from their colleagues to adopt a less questioning stance toward medical interventions for gender dysphoria:
There were other instances that raised “red flags,” says Matt Bristow, recalling one case where a young person was being sent gifts by an adult trans woman living abroad, and the young person had told Bristow and his co-worker that they were planning to go and live with this person. The teenager also had an “unusual kind of profile” he says, in terms of what they wanted to change about their body. The GIDS pair took the case to a team meeting, explaining they did not feel the young person should be referred to [University College London Hospitals] for puberty blockers yet. There was too much going on. He says the response they received from the Executive was “fairly robust, vicious” even.*
They were told that it was their clinical judgement not to refer, and that was accepted, he says, “But it was clear that they felt very differently and felt we should be referring.”
The asterisk notes that this claim, too, was repeated under oath.
There are important structural differences between GIDS and American gender clinics, many of them stemming from the fact that GIDS was part of a nationalized healthcare system and clinics like The Washington University Transgender Center are not, meaning they operate in a very different manner, bureaucratically speaking. But in terms of how clinics here versus there practice gender medicine, there’s simply no good, prima facie reason to think that the problems that arose at GIDS are unlikely to pop up in the states, too.
In fact, there’s some reason to suspect the opposite: that American gender clinics might be more likely to engage in slipshod practices. Barnes notes in Time to Think that Polly Carmichael, the longtime director of GIDS, believed the American system to be less conservative about its approach to youth gender medicine than her clinic was. When I asked Barnes if she felt this was the more general belief of British clinicians, she said it was, and she pointed out that the NHS has binding age restrictions for some aspects of youth gender medicine that the US does not, such as surgery and cross-sex hormones. After we were done recording, I mentioned the most controversial parts of Reed’s affidavit and asked Barnes if she found the document surprising. She answered that while she had not personally encountered examples of young people identifying as inanimate objects in her reporting, and did find that extreme, she generally did not find the document surprising. Echoing what I noticed after reading both the affidavit and her book, Barnes also said that many other parts of Reed’s testimony were strikingly similar to what she had been told by numerous GIDS staffers.
I also asked Erica Anderson about the affidavit. Anderson is a trans woman and longtime psychologist who is now in private practice, but who previously worked at the Child & Adolescent Gender Center at UCSF Benioff Children’s Hospital in Oakland, which is one of the more famous youth gender clinics in the United States. In recent years she has grown increasingly worried about slipping standards in her field, and in 2021 she coauthored a Washington Post column with Laura Edwards-Leeper, a psychologist with similar concerns, raising concerns about the lack of mental health support trans kids considering medical intervention often receive. (I have quoted both Anderson and Edwards-Leeper previously, and also interviewed Anderson on my podcast. Anderson will also serve as an expert witness for Reed’s attorney, Vernadette Broyles, who is president and general counsel of the conservative Child and Parental Rights Campaign, in some upcoming cases.)
I had no doubt Anderson would be broadly sympathetic to Reed, but I wasn’t sure what she would say about kids identifying as inanimate objects. “I believe her,” said Anderson. “I’m told about such kids also. The wackiest one I’ve heard myself is a kid saying that they are raccoon gender.” She said that when she asked this patient follow-up questions, it was clear they were joking. “We ended up talking about creativity, fantasy, and reality,” Anderson explained. “They made it up and knew it was ridiculous. Definitely threw their parents for a loop.” Anderson said that “Secondhand I’ve heard ‘space gender’ and other equally preposterous assertions.”
What a kid means when they say they are “space gender” or “raccoon gender” might differ greatly from child to child. Sometimes it could be a joke, and sometimes it could be a sign of genuine confusion, or a particular fixation, that is in need of exploration. Go online and you’ll find kids engaging in a veritable rainbow of identity exploration (here’s the flag for raccogender, if you’re curious), so it shouldn’t surprise anyone that some of this finds its way into youth gender clinics. The point isn’t necessarily that a kid who expresses these sentiments really feels, deep down, they are a raccoon or space (or a helicopter), but simply that if they aren’t able to communicate a consistent, coherent gender identity, a competent clinician will do a lot more work before feeling comfortable referring them for serious medical treatments. “Exploring gender issues is critical” in these cases, said Anderson.
Anderson had this to say about the alleged helicopter child: “That sounds wacky and the reference should have been a red flag to the clinic. Lack of continuity in identity is a nonstarter as far as medications are concerned. Consistency. . . . Absent.”
It goes almost without saying that none of this proves that Jamie Reed’s claims are true. It could be that she’s an utterly spectacular, utterly self-destructive liar — someone willing to chronically fabricate in extremely specific, easily debunkable ways, in a manner guaranteed to destroy her reputation (not to mention employment prospects) forever. It doesn’t strike me as likely, but is it possible? Sure. There are other possibilities, too. Maybe she misunderstood certain aspects of what she saw at the clinic, or maybe some of her stories will appear far less damning in the light of full context and detail. Either way, it goes without saying that none of the proof she provided with me is close to dispositive — all that Reed has proven is that she is willing to go on the record with many details about what she said occurred at the Center.
Reed claims that it will eventually be quite easy for investigators to fact-check her allegations. She said that sometime in 2020, she and Karen Hamon, the nurse who asked the endocrinologist about the helicopter child, started what they called a “red flag” list — really two lists in one spreadsheet (she referenced this list in the original, viral column she wrote for The Free Press going public with her allegations, though she didn’t name Hamon there). “It had a list of the patients who we knew had detransitioned or desisted — that was one of the spreadsheets — and then it had a list of patients that we had significant concerns about,” said Reed. “We were adding to this list in an Excel spreadsheet as we went, but at a certain point we got in trouble for having that list.”
This occurred in February 2022, after a higher-up administrator was tipped off to the list’s existence. Reed said that “when they found out we were immediately called into a Zoom and told we had to give it to them, which we had a lot of trepidation about doing. So we did not give them the list, but we stopped adding to it for a period of time.” Reed shared emails about the Zoom call in question that appeared to be congruent with what she is describing, although they didn’t contain in-depth details about what was discussed. Reed and Hamon chose not to turn the list over in part because Reed felt the hospital had, in the past, not handled her mounting complaints properly. “I didn’t trust they would look at it through any sort of investigative lens.”
“We never deleted that list, and I sort of hid it in my Excel files,” she said. When the office of Missouri Attorney General Andrew Bailey began an investigation, she said she handed over the spreadsheet, after scrubbing out the personally identifying information that could spark HIPAA problems. She shared a copy of it with me as well — it contains 17 alleged detransitioners or desisters and 60 allegedly worrisome cases. Based on their short descriptions, a number of them were referenced in her affidavit. Reed says that with her help, it will be easy for investigators to trace entries on the spreadsheet she shared with them back to the patients’ Epic charts within the St. Louis Children’s Hospital records system. (Update, 3/12/2023: I’ve added the bolded words to make this sentence clearer. There was online chatter claiming — wrongly, I believe — that this sentence suggested Reed violated HIPAA. I’ll post a fuller update to this post explaining some of the HIPAA details I glossed over in this paragraph when I can.)
(Bailey has publicly called for an immediate moratorium on the clinic’s functions, which hasn’t occurred. For what it’s worth, he’s known as an ardent social conservative and said one of the goals of the investigation is “to make sure children are not harmed by individuals who may be more concerned with a radical social agenda than the health of children.” I emailed his office to see if anyone there could confirm that Reed had handed over a spreadsheet like the one he described. “We are declining to comment at this time, as our investigation is ongoing,” responded a spokeswoman.)
Reed said that the helicopter incident occurred after she and Hamon had been spooked off of maintaining the spreadsheet, so that case isn’t on it. But she said she was confident that if and when investigators do a thorough search of the hospital’s patient records, that case will also emerge, because the referral letter should be sitting right there in the Media tab within the patient’s Epic chart. “If there is enough time and effort,” said Reed, “every single patient who has ever been seen at that clinic will have their medical record and their Media tab pulled, and it will be found verbatim, the entire content of the letter.”
Questions? Comments? The helicopter letter? I’m at email@example.com. I’ll be taking a temporary Twitter break soon, but you can still keep abreast of my latest work on that site by following @jsingalfeed. Image:“Helicopter flight shining spotlight beam in dark sky” via Getty.
Critics sometimes refer to SEGM as anti-trans, or even as a “hate group,” but this is simply false, and part of an unfortunate tendency on the part of some activists and journalists to tar anyone who is skeptical of youth gender medicine in this manner.
Between when I started and finished this article, Norway’s healthcare system became the fourth, after Sweden’s, Finland’s, and the UK’s, to acknowledge publicly that it had found the evidence base for youth gender medicine to be lacking. Norway will likely tighten up youth access to hormones and blockers, just like the other three countries already have to varying extents.