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.

The website can be accessed here. We find:

We offer transgender health services for youth ages 11 to 25.

Comprehensive services may include:

  • Therapy for anxiety, depression and ongoing emotional issues
  • A community health educator who works with transgender patients to put resources together, such as how to change your name or get voice therapy
  • Help finding resources for information and support
  • Sex and contraceptive education
  • Referrals to a licensed mental health professional for evaluations of gender dysphoria, which is the criteria [sic] for hormones or surgery
  • Puberty blockers, to delay the onset of puberty
  • (Note: Services for Cross-sex hormones are referenced here)
  • Surgery referrals

May include.

Frequently asked questions  There is a third web page for frequently asked questions here.

Apparently no one asks frequently about the near- and long-term effects of puberty blockers and cross-sex hormones in minors.

I note that the same clinicians who are introducing testosterone into minor females for gender transition are

enrolling girls ages 7 – 17 who have symptoms of high male hormones (excess hair growth, irregular periods). The purpose of the study is to determine how certain hormones contribute to the development of polycystic ovary syndrome (PCOS).

So they have questions about that. But apparently they are not curious about the effects of puberty blockers and artificially introduced testosterone in those same girls.

Are they not frequently asked about post-transition regret? Apparently, few ask “supportive” advocates about the regrets of their patients.

Messianic mind-set in parts of the medical community.  All of that is certainly “supportive,” I guess.

UVa Children’s offers to provide a list of “appropriate” mental health providers to provide the gender dysphoria diagnosis needed before hormone treatment.

  • They do not say that their own clinic can make the diagnosis, so I will presume they do not, even though they now have clinical psychologists assigned.
  • They do not say that the Child and Adolescent Psychiatrists (CAPs) at the hospital apparently won’t provide the diagnosis. But when one checks the Pediatric Psychiatry page, he will not find gender dysphoria among the list of disorders, because the “supportive” transgender medical community removed it from the list of mental disorders.

The thread throughout the American Psychiatric Association (APA) discussion on the subject is that children can be gender dysphoric no matter what emotional problems they may suffer simultaneously. The clear message is that a gender dysphoria diagnosis should be considered the default diagnosis for a child/parent that seeks one.

What is missing?  Missing are:

  • The video walk-through’s of the philosophy and affirming/messianic (“Puberty blockers are Great!”) nature of the clinic. Those videos were what caused me to investigate further in my earlier series of articles. They are gone.
  • The lists of clinicians assigned to the clinic that showed me they earlier had no mental health professionals assigned. They are gone.  They need not name names in order to show the professional mix.
  • Descriptions of the short- and long-term effects and hazards of puberty blockers and cross-sex hormones and any reference to the steps being taken in Europe to pause and assess the entire pediatric gender transition process because of those hazards. Those have never been disclosed on this web site.

What are the actual procedures at UVa Children’s?

Short answer: We have no idea.  There is no case management information.

Does UVa Children’s move ahead with hormone treatments while mental health therapy is underway? We don’t know. They just added the clinical psychologists, and have not published that information.

Notably, the video for adult transgender hormone therapy is still up. It advertises two days after a blood test to start hormones. Is it the same in the child clinic? We don’t know.

We also note that UVa Hospital is far more forthcoming about the effects of hormone treatments for gender dysphoria than is its Children’s Hospital. Why is that?

The World Professional Association for Transgender Health provides the following criteria for hormonal and surgical treatment of gender dysphoria:

  • Persistent, well-documented gender dysphoria;
  • Capacity to make a fully informed decision and consent to treatment;
  • Legal age in a person’s country or, if younger, following the standard of care for children and adolescents;
  • If significant medical or mental concerns are present, they must be reasonably well controlled.

Are those the criteria at UVa Children’s?

The Mayo Clinic:

A pre-treatment medical evaluation is done by a doctor with experience and expertise in transgender care before hormonal and surgical treatment of gender dysphoria. This can help rule out or address medical conditions that might affect these treatments This evaluation may include:

  • A personal and family medical history
  • A physical exam
  • Lab tests
  • Assessment of the need for age- and sex-appropriate screenings
  • Identification and management of tobacco use and drug and alcohol misuse
  • Testing for HIV and other sexually transmitted infections, along with treatment, if necessary
  • Assessment of desire for fertility preservation and referral as needed for sperm, egg, embryo or ovarian tissue cryopreservation
  • Documentation of history of potentially harmful treatment approaches, such as unprescribed hormone use, industrial-strength silicone injections or self-surgeries

Are those the pre-treatment procedures at UVa Children’s?

Does UVa Children’s offer behavioral health therapy to the same extent as Mayo Clinic?

We cannot find out from its web site.

Bottom line. It is the “transgender health services for youth age 11” part which I and many others oppose. We may or may not ever ban such “services” for minors in Virginia.

But UVa Children’s, our flagship state children’s hospital, must be transparent about:

  • The sources and criteria for a gender dysphoria diagnosis in minors;
  • How exactly they manage cases and treat their patients;
  • The off-label nature and potential negative consequences of the puberty blocker and cross-gender hormone treatments;
  • The near statistical certainty that a minor who takes puberty blockers will take cross-gender hormones; and
  • the instances and prevalence of post treatment regret in their patients.

The Board of Visitors, embarrassed by the in-your-face removal of necessary and previously available public information from the UVa Children’s web site, should take that for action at once.

Hiding information necessary for decision making is profoundly unethical.

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30 responses to “Profoundly Unethical: UVa Children’s Hospital Hides Child Gender Transition Information from Public Scrutiny”

  1. I suppose it is remotely possible that they took down the videos because they realized they were flawed and/or misleading; and/or they are in the process of changing their approach and/or procedures related the treatment of children with gender dysphoria and have not yet made new videos.

    1. James C. Sherlock Avatar
      James C. Sherlock

      They are welcome to say so. But the information that has never been on the website is the key. I list it.

    2. Or maybe it’s because a week prior to Sherlock’s September article, another hospital had a bomb threat against it? Maybe the increasing hysteria over this is inciting violence towards these hospitals, and the hospital took it down to try and minimize harassment?

      1. James C. Sherlock Avatar
        James C. Sherlock

        So, transparency from government activities is hazardous? Is that your argument?

        I suggested a way to protect individuals from connection to the larger hospital enterprise. Is that not enough?

        Or can government declare any piece of information “hazardous” and keep it from the public?

        Waiting for your response to those questions..

        1. I am saying the website isn’t the end-all of transparency. It’s an arbitrary metric you have invented so you can continue to rail against the hospital. Have you called the hospital with inquiries? Emailed them? I checked the heart surgery section and that isn’t going over risks and long-term effects. Parents aren’t using the site for all of their information: that’s what consultation and other appointments intend to accomplish.

          The protections you offered are not in place, and I imagine it’s easier to take down items than set up new ones. Especially in this environment.

          1. James C. Sherlock Avatar
            James C. Sherlock

            If I read you right, you contend that web sites are not the primary means for government activities to communicate with the people. That truly is breaking news.

            Yes I have called. They will not answer phone inquiries. You may have noticed that few go acrtivites will.

      2. Unfortunately, many public institutions are threatened these days. Offenders need to be prosecuted. That doesn’t give public institutions the right to keep information the public has a right to know, secret.

        It’s not hysteria to be concerned about the potential genital mutilation of children. Expressing concern is appropriate, given the grave consequences of getting it wrong.

        Inciting violence? You mean like Schumer did?

        “I want to tell you Gorsuch, I want to tell you Kavanaugh – you have released the whirlwind, and you will pay the price. You won’t know what hit you if you go forward with these awful decisions,” Schumer told the cheering crowd.

        Which was followed by:

        “Man with gun is arrested near Brett Kavanaugh’s home, officials say”

        “Court documents indicate that the man told police he wanted to kill a Supreme Court justice”

    3. Or maybe it’s because a week prior to Sherlock’s September article, another hospital had a bomb threat against it? Maybe the increasing hysteria over this is inciting violence towards these hospitals, and the hospital took it down to try and minimize harassment?

    4. James C. Sherlock Avatar
      James C. Sherlock

      They are welcome to say so. But the information that has never been on the website is the key. I list it. Look at the FAQ section.

      1. Perhaps we will find out more in the years to come after someone files suit against the hospital for medical malpractice. It’s happened elsewhere – tragically.

        “Defendants falsely informed Chloe and her parents that Chloe’s gender dysphoria would not resolve unless Chloe socially and medically transitioned to appear more like a male,” the suit reads.

        According to Cole, her parents were given an “ultimatum” by her doctors: “Would you rather have a dead daughter or a live son?”

        After undergoing a double mastectomy that surgically removed both of her breasts, Cole’s “mental health and suicidality issues worsened significantly,” the suit states.

        “At 15, I wasn’t really thinking. I was a kid, just trying to fit in — not thinking about the possibility of becoming a parent,” Cole told CNA.

  2. As I wrote else… Why only two options, given the ever expanding lists from the Left of what people supposedly can be?

    1. DJRippert Avatar

      As in, “I want to transition from a Xe to a Them”?

      1. Lefty665 Avatar

        For Chinese kids it could be from Xi to Xe. What’s a vowel between friends?

        1. Lefty665 Avatar

          Exactly, a gender fluid letter! It can be either a vowel or a consonant.

          1. Nancy Naive Avatar
            Nancy Naive

            Everything depends on X or Y… according to some.

          2. Lefty665 Avatar

            Just depends on which axis is most important at the moment.

          3. So from Xi to Yi?

  3. LarrytheG Avatar

    I bet a 10K FOIA would get you a little more… 😉

    1. James C. Sherlock Avatar
      James C. Sherlock

      Why should citizens have to resort to FOIA to get baseline decision information from government organizations like UVa Children’s?

  4. Nancy Naive Avatar
    Nancy Naive

    Messianic applies to more than those in the medical field.

    Even those entitled to be aren’t always good at it…

    1. James C. Sherlock Avatar
      James C. Sherlock

      You should know that this website’s Discus account is under constant attack.

      I use the most popular protection system, Norton 360. Because of the effectiveness of the attacks, it identifies any link like the one you inserted above as a dangerous website.

        1. Nancy Naive Avatar
          Nancy Naive

          He thinks he’s being clever about “information”.

      1. Nancy Naive Avatar
        Nancy Naive

        Norton? Protection? Ah ya.

    2. James C. Sherlock Avatar
      James C. Sherlock

      It is necessary to fight fire with fire. The progressive left is relentless in its attacks on humanity.

      Writing that series of articles earlier this year, I got a change out of UVa Children’s, which could not stand the heat.

      They offered a modest potential advance, psychologists in the youth gender clinic.

      But they traded that by reducing further the information available to the public. The information that parents need in order to make informed decisions before visiting that shop with their children.

      Why, exactly, do you think they will not reveal the information that I have pointed out?

      Why, exactly, do you think one of the UVa Children’s endocrinologists is conducting a trail to examine the negative effects of natural occurrence of testosterone in girls is unconcerned about the testosterone that she herself introduces artificially into healthy children?

      You are naturally curious. Don’t you want to know?

  5. David E Gignac Avatar
    David E Gignac

    To think that health professionals not only allow, but apparently encourage, ‘gender transitioning’ in kids before puberty completely wobbles the mind, to borrow a phrase from Kelly Bundy. In a sane world these doctors would be hunted like animals and disposed of quietly.

    Mr. Sherlocki, you have produced a master work on a subject that needs a sodium halide light shone on it.

    Please sir, pursue these people with your pen so the people who wield the law will notice and correct this insanity.

  6. From the article:

    “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.”

    There is cause for concern!

    “A teen’s developing brain places them at greater risk of being reactive in their decision-making, and less able to consider the consequences of their choices.”

    “…children and teenagers have been found to be poor decision-makers if they feel pressured, stressed or are seeking attention from peers.”

    “Research has shown youth aged 12 to 17 years are significantly less psychosocially mature than 18 to 23 years who are also less psychosocially mature than adults (24 and older).”

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