Mick Hartley

Back in February Jamie Reed, a former case manager at The Washington University Transgender Center at St. Louis Children's Hospital, wrote a powerful indictment of the treatment there. She had to resign, she said, because she'd realised that, rather than helping the kids they were treating, they were permanently damaging them.

Now, finally, the message seems to have got through – though it's the potential legal challenges rather than medical ethics that seems to have caused the shift. Eliza Mondegreen at UnHerd:

Yesterday, the Washington University Transgender Center at St. Louis Children’s Hospital announced that doctors there will no longer prescribe puberty blockers or cross-sex hormones to children and adolescents. This decision follows months of controversy and comes in the wake of a new law that just went into effect in Missouri, which limits hormonal and surgical interventions for gender transition to patients over the age of 18.

Under a “grandfather clause” in the new law, the Transgender Center could have continued to prescribe puberty blockers and cross-sex hormones to current patients. However, it decided to back away from these interventions altogether:

We are disheartened to have to take this step. However, Missouri’s newly enacted law regarding transgender care has created a new legal claim for patients who received these medications as minors. This legal claim creates unsustainable liability for health-care professionals and makes it untenable for us to continue to provide comprehensive transgender care for minor patients without subjecting the university and our providers to an unacceptable level of liability. – WASHINGTON UNIVERSITY TRANSGENDER CENTER

The Transgender Center rejected Reed’s accusations, declaring her allegations “unsubstantiated”. So, no admission that they were mutilating vulnerable children in the name of a ridiculous social contagion. It's the legal threat – unsustainable liability – that's got them worried.

But the case for youth gender transition has been unravelling this year, under pressure from state officials and legislators and increased scrutiny from the media. At the end of August, St. Louis Circuit Court Judge Steven Ohmer allowed Missouri’s ban on hormonal and surgical interventions for youth to go into effect, writing that the evidence for youth transition “raises more questions than answers”.

Hence the “unsustainable liability” Washington University cited in its decision to pull back from this area of healthcare. That’s because Missouri’s new law also extended the period of time former patients have to sue for damages to 15 years. Perhaps, when the Washington University investigated themselves, they found more merit to Reed’s allegations than they were willing to acknowledge publicly. They fear being made to pay for it.

Medical scandals tend to end quietly: the “chemical lobotomy” phased out the lobotomy-lobotomy. The Satanic Panic choked not on its own absurdities but in courtrooms and insurance offices. Public reckonings are few and far between. “Unsustainable liability” may be the beginning of the end for youth gender transition.

Not with a bang of outrage at what was being done to troubled teens, more with a whimper of discretion in the face of legal threats.