Category Archives: Ethics

Profoundly Unethical: UVa Children’s Hospital Hides Child Gender Transition Information from Public Scrutiny

UVa Children’s Hospital courtesy UVa

by James C. Sherlock

I published a series of articles earlier this year that criticized the University of Virginia Children’s Hospital on its approach to gender transition in minors as young as 11.

As a result, the hospital made at least some movement towards change by announcing it was assigning pediatric clinical psychologists to join that program, previously dominated by endocrinologists.

I saw that move as an indication that the minors who came to the clinic would be treated first for anxiety, depression and ongoing emotional issues before being considered for insertion into the hormone-to-surgery pipeline.

That now may be the case, though there is no case flow diagram published. But nothing else has apparently changed except for the elimination of the public information on which I based my criticisms.

There is growing concern among many doctors and other healthcare professionals as to whether medical transition is the best way to proceed for those under aged 18. I have written extensively that several countries have pulled back from medical treatment and instead are emphasizing psychotherapy first.

UVa Children’s is a state hospital. Hiding information from the public to avoid scrutiny cannot be an option.

I call on the Board of Visitors to direct the hospital to improve transparency in the UVa Children’s Hospital web presentations on gender transitions in minors.

Without this, the hospital is guilty of misleading the public.  The removal of previously-available public information shows they are doing this on purpose. Continue reading

Physicians, Hospitals and Gender Dysphoria in Minors- Fundamental Disputes

By James C. Sherlock

What about the doctors in this controversy?  What about hospital and state oversight?  What do laws and regulations require and on what are they silent?

We’ll look.

The dispute among physicians on the treatment of gender dysphoria in minors is primarily an ethical one.  They agree on the diagnosis and some of the medical effects of hormone treatments.  They agree:

  • that gender dysphoria (GD) in childhood describes a psychological condition in which children experience a marked incongruence between their experienced gender and the gender associated with their biological sex;
  • that with the onset of puberty, the emotional turmoil can be significant and needs to be dealt with. (They disagree on how to deal with it);
  • that puberty blockers stop puberty;
  • that puberty blockers cause emotional distress and some increasingly concerning side effects, but achieve the physical results sought;
  • that once a child has puberty blocked, he or she is very likely to proceed to cross-gender hormones;
  • that cross-gender hormones also “work” in a medical sense, meaning they cause the physical changes sought by the physician, and at some level sterilize the patient;
  • that, once transitioned with cross-gender hormones, the minor will be dependent upon them for the rest of his or her life to maintain the gender reassignment; and
  • that there are no scientific clinical studies that have tracked the health of transitioned minors as they have grown into adults.  What little is available are surveys, not clinical follow-ups.

They agree that transitioned persons as a group go on to have very difficult lives. We have the data on that, just not on their health outcomes from the transition treatments.

They also agree that action or inaction and the types of action chosen involve moral judgments. But they disagree on what is moral here.

The progressive view is that these interventions are life-saving and gender-choice-affirming.  Those who oppose the interventions consider them unethical and dangerous experiments on minors unequipped to make such decisions. Some also consider them immoral.

The ethical debates among physicians start early in the process with different interpretations of “first, do no harm.”

In Virginia in 2020, Governor Northam and the General Assembly put a thumb on the scale.

Continue reading

“Puberty Blockers Are Wonderful” – UVa Children’s Hospital

by James C. Sherlock

How do people communicate?

Generally by words and visuals and, in person, with body language. The art and science of marketing and sales is one of the bulwarks of any economy — and any political system.

My article on the hard selling of hormone treatments — puberty blockers and cross-gender use of estrogen and testosterone — by UVa Children’s Hospital Transgender Youth Health Services has drawn a lot of attention.

Two of the most famous lines from the video and its transcript are:

Puberty blockers are wonderful. They provide sort of a break.

Well. What child and parent wouldn’t want a break? Is there ice cream?

That enthusiastic endorsement caused me to check out the FDA warnings on puberty blockers.

Wonderful is not the first word that comes to mind. Continue reading

Hormone Treatment of Transgender Adolescents in Virginia – New Concerns

by James C. Sherlock

We have discussed at length the controversial policies of the American Academy of Pediatrics (AAP).

It is time to consider the impact of Great Britain’s ongoing National Health Service Review of its transgender support to children and young people.

It offers new concerns about clinical challenges in the diagnosis and treatment of gender dysphoria in adolescent patients, especially the safety of puberty blockers.

And it causes us to discuss what has been going on for years at the University of Virginia Children’s Hospital Transgender Youth Health Services.  

It is a state hospital that has treated hundreds of patients from the earliest stages of puberty with both puberty blockers and cross-gender hormones. Continue reading

Progressives in Virginia In Position to Overrule Parental Objections to Invasive Child Gender Dysphoria Treatment

by James C. Sherlock

The Virginian-Pilot, in an editorial, bemoaned Governor Youngkin’s endorsement of a policy that would require schools to tell parents about their kids’ transexual identity expressions at school.

It’s as though the potential consequences of such a policy have never crossed his mind.

The sure consequences of opposing that policy were not discussed.

The Pilot brain trust did not address, and perhaps did not care, that a child in Virginia must have a diagnosis of gender dysphoria as a predicate for mental health treatment. And, of course, for physically invasive treatments.

Most Virginians think parental/guardian consent is required for all of that. It certainly should be. But it won’t be if progressives find the right judge.

Medical ethics should help protect kids, but will not. Progressive medical providers think themselves to be doing the best thing for the child, even with the dangerous, irreversible and ghastly treatments to which some providers subject children diagnosed as gender dysphoric.

Neither will judicial ethics. Read the papers every day for things that progressives think best for all of us. Progressive judges will think themselves to be doing the right thing as well.

Virginia is thick with progressive doctors and judges. It is thicker with parents.

The progressives need to be stopped by changes in Virginia law. This is a very complicated subject.  So the background discussion will be extensive.

Continue reading

Elaine Luria: Facebook Fat Cat

Second congressional district Representative Elaine Luria. Photo credit: Virginian-Pilot

Kerry Dougherty

Memo to Rep. Elaine Luria: When you’ve lost the far-left Daily Beast, you may be in trouble.

In a surprisingly tough May 12 piece headlined “The Dem May Hate Facebook But Her Stock Portfolio Doesn’t,” Daily Beast political reporter Roger Sollenberger skewered Luria for publicly criticizing Facebook, while owning between $1 million and $5 million worth of stock in the company.

“Those holdings, owned jointly with her husband, make her the largest Facebook shareholder in Congress and might appear to undercut the force of her criticism,” Sollenberger wrote.

Might?

It definitely makes her look hypocritical.

If Luria genuinely believes that Facebook traffics in misinformation why would she hold stock in the company? Better yet, why would she spend hundreds of thousands of dollars advertising on the platform? Continue reading

Exploding Requirements and Workforce Shortages – An Existential Threat to the Public Schools

by James C. Sherlock

The hottest buzz around many of the public schools, including my home area of Virginia Beach, is around the very real hardships posed by unprecedented staff shortages.

On return from COVID, it seems that our schools faced record shortages of personnel to deal with students that were traumatized and afflicted with massive learning losses.

I said “seems” because there is no accurate count. The new online report VDOE has recently published shows billet vacancies as of October 1 2021 to be 2 1/2 times a similar count it provided me two years ago.

A compelling and disturbing trend. Yet the personnel problem is even worse than we presently have documented.

The new, comprehensive VDOE report of public school personnel shortages is false because some of the inputs were false. The real numbers were higher.  In some cases much higher. Lies were told. I will demonstrate that in this article.

Other well-documented data show both an outsized number of pending retirements from the schools and the ongoing and rapid collapse of the new teacher pipelines.

And we don’t have a sufficient number of professional support specialists — school psychologists, social workers, school counselors and others. That also cannot be quickly remedied.

So the trends are all going in the wrong direction. For the schools, supply is decreasing. Demand, driven by programmatic decisions at VDOE as well as the strain of remediation of COVID learning losses, has been increasing.

This word for the crisis is existential. With a tip of the hat to Herb Stein, things that cannot continue will stop. Continue reading

Moran’s Green Energy Ties Ignored by Media

Matt Moran
Photo credit: Creative Direct

by Steve Haner

If the Commonwealth of Virginia was not paying Matthew Moran to serve as Governor Glenn Youngkin’s deputy chief of staff and point person with the General Assembly, as recently revealed, who was? Based on the websites for his employers, mainly the renewable energy industry.

For example, Moran is identified as on the Virginia advisory board of an advocacy group called Conservatives for Clean Energy, strong supporters of the push to eliminate fossil fuel use in the state and replace it with solar and wind-driven electricity. Continue reading

Not the Normal Governor Means Not the Normal Ethics

Matt Moran, Deputy Chief of Staff, aka Special Advisor
Photo credit: Creative Direct

by Dick Hall-Sizemore

Glenn Youngkin recently declared, “I guess I’m maybe not the normal governor. I think one of the differences is that I am an outsider and I come in with ideas on how we communicate.”

We are beginning to find out how true that is. The Richmond Times-Dispatch reports that one of the Governor’s top policy aides is not a state employee, but a lobbyist on the payroll of a lobbying company. Matt Moran is on a paid leave of absence from Creative Direct, a political consulting firm, and LINK Public Affairs, an offshoot from Creative Direct. When Youngkin first announced his appointment, he listed Moran’s title as “deputy chief of staff and director of policy and legislative affairs.” A sign on his door in the Patrick Henry Building bore the title, “deputy chief of staff.” The statement of economic interest he filed upon taking office listed his position as “deputy chief of staff.”   In appearances before legislative committees, he identified himself as “deputy chief of staff.” He is now labeled “special advisor” and the January 21 news release announcing his appointment has been “corrected.” Continue reading

More Morrissey! We Can’t Get Enough!

by James A. Bacon

Love him or hate him, Senator Joe Morrissey, D-Richmond, is hands down the most colorful politician in Virginia. The list of his transgressions against ethics and law is too long belabor here. I refer you to his Wikipedia biography, specifically the sections on “Reprimand, suspensions and first law license revocation,” “Conviction for delinquency of a minor,” and “Second law license revocation” for the details.

Now local NAACP activist Lafayette Jefferson is charging Morrissey with threatening him with violence. During a meeting about casino legislation, Morrissey reportedly told Jefferson, “I’ll rip your heart out of your chest.”

I will concede that such inflamed rhetoric may be described fairly as intemperate. But I will rise to Morrissey’s defense. From the account provided in the Richmond Times-Dispatch, Jefferson had it coming. Continue reading

Dominion and Despicable Voter Suppression

So it was Dominion Energy paying for campaign ads opposing gun regulation! Here is why.

by Steve Haner

Dominion Energy Virginia’s knowing participation in an effort to suppress the November 2 vote, aimed mainly at Western Virginia Republicans, is a truly despicable act. It should enrage all Virginians, without regard to party. This is a state-created and regulated monopoly and the $200,000 it spent on this underhanded activity was provided by captive customers.

I further assert that in previous election cycles, as heavily as Dominion funded various candidates, this type of expense would not have been approved by the management, including the late Thomas Farrell. But Farrell is dead and the political deciders at the top now are both long-time partisan Democrats who fully understood they were paying for voter suppression.

I would be expressing no anger whatsoever if Dominion had merely donated $200,000 directly and openly to Democratic candidate Terry McAuliffe. It would have been a logical move to support a former governor who strongly backed its failed natural gas pipeline project, and now has pledged to deeply enrich the company by accelerating the transition to unreliable renewable generation instead.

McAuliffe is nothing if not flexible. I used another word to describe his subservience to Dominion on Twitter yesterday and got blocked for 12 hours. Continue reading

How Does Virginia Budget Early-Childhood-Education Money Wind Up in a Park in Detroit?

by James C. Sherlock – updated Oct 15

I’d like to report an organized crime. It’s just not illegal in Virginia.

The political Left, fully in control of Virginia government, sends taxpayer money to leftist non-profits, who take their cuts and then send it on to local government entities and yet more nonprofits.

It is unethical, but that does not matter to Virginia’s elected Democrats.

But they have set themselves up for a fall. They may not know enough about nonprofit reporting laws to understand it opens the tax money transfers up to public examination.

Federally required independent accountants of nonprofits won’t play along. When non-profits touch the money, they have to report it to the IRS on their annual Form 990’s, where we mere taxpayers can see it.

In this case we will trace early childhood education money from the Virginia budget to a park in Detroit. Continue reading

Virginia’s Self-Inflicted Nursing Home Crisis – Part 3 – McAuliffe & Herring

by James C. Sherlock

In the first two parts of this series, I wrote about the shortage of state inspectors for nursing homes in the Virginia Department of Health Office of Licensure and Certification (OLC)  and the continuing danger it poses to Virginia patients.

The problem, unfortunately, is much wider than just nursing homes.  So is the scandal.

That same office inspects every type of medical facility including home care agencies as well as managed care plans. Except it cannot meet the statutory requirements because it does not have sufficient personnel or money. And it have been telling the world about it for years.

Terence Richard McAuliffe was the 72nd governor of Virginia from 2014 to 2018. Mark Herring has been Attorney General since 2014.

We will trace below that they can reasonably be called the founding fathers of overdue inspections of medical facilities in Virginia.

VDH has been short of health inspectors since McAuliffe and Herring took office and still is .

Both of them know it. And they know that lack of inspections demonstrably causes unnecessary suffering and death.

Continue reading

Virginia’s Self-Inflicted Nursing Home Crisis — Part 2, the Business

by James C. Sherlock

Nursing homes are businesses.

Seventy percent of those in Virginia are for profit. They are run not by doctors but registered nurses with physicians on call. 

Nursing facilities very widely in size in Virginia, from the 300-bed Mulberry Creek Nursing and Rehab center in Martinsville to facilities of less than 30 beds, especially the long-term care units of a few mostly rural hospitals.

They include facilities designated as skilled nursing facilities (SNF), often post-op care and rehabilitation, and others designated as long-term-care nursing facilities (NF). Most nursing homes in Virginia have facilities and certified beds for each.

Insurer mix and staffing costs are keys to profitability.

Many of these businesses are worth what they get paid, but many are not. Continue reading

Virginia’s Self-Inflicted Nursing Home Crisis – Part 1

by James C. Sherlock

None of us ever knows when we will need a nursing home for ourselves, our parents or our kids. Yes, kids.

While long-term nursing care is mostly for older patients, skilled nursing facilities are needed for patients of all ages, including children, for shorter term post-op treatment and recovery.

The patients in many of Virginia’s nursing homes suffer greatly from a combination of known bad facilities and a lack of government inspections. The health and safety of patients in those facilities are very poorly protected by the state.  

In this series of reports I am going to point out some nursing homes (and chains) whose records will anger you. Government data show some have been horrible for a very long time in virtually every region in the state.

Those same records show that Virginia is years behind on important, federally mandated health and safety inspections.

VDH’s Office of Licensure and Certification doesn’t have enough inspectors — not even close. And the government of Virginia — officially based on budget data — not only does not care but is directly and consciously responsible.

When I am done reporting on my research I suspect you will demand more inspectors.

You will also  reasonably ask why the worst of them are still in business when the Health Commissioner has the authority to shut them down.

Good question. Continue reading