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ST. LOUIS — Missouri’s senior senator and the state’s new attorney general both announced investigations Thursday after publication of allegations that a transgender clinic in ÃÛÑ¿´«Ã½ was providing substandard care to children and teens.

The allegations, published , were made by Jamie Reed, a 42-year-old native ÃÛÑ¿´«Ã½an, who said she worked at the as a case manager between 2018 and 2022.

“I left the clinic in November of last year because I could no longer participate in what was happening there,� Reed wrote. “By the time I departed, I was certain 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.�

Among Reed’s allegations: Instead of providing mental health treatment to children who needed it, the center gave them puberty blockers or cross-sex hormones. She also alleged the center regularly referred minors for gender-transition surgery, contrary to public assurances by its doctors.Ìý

In response, U.S. Sen. Josh Hawley on Thursday said his office was launching an investigation.

“This is a sickening account of forced sterilization and child abuse. Happening in Missouri at an institution that receives federal taxpayer funds,� Hawley, a Republican, wrote on Twitter. “Missouri children deserve to be protected.�

Missouri Attorney General Andrew Bailey also announced Thursday afternoon that his office opened an investigation two weeks ago after hearing from the whistleblower. Bailey, a Republican who took office last month, said he waited to disclose the probe until Reed went public.

Washington University, , said it was alarmed by Reed’s allegations, and it was also investigating.

“We are taking this matter very seriously and have already begun the process of looking into the situation to ascertain the facts,� the statement read.

Hawley said late Thursday he spoke with Washington University Chancellor Andrew D. Martin, and received the university’s assurance that it will “fully cooperateâ€� with his investigation. Hawley said he also was assured that the whistleblower will be fully protected from retaliation. In a letter to Washington University and ÃÛÑ¿´«Ã½ Children’s Hospital, Hawley directed both institutions to preserve all records “regarding gender-related treatments performed on minors.â€�

The transgender center opened in 2017, with one arm serving adults older than 18, and . The center provides gender-affirming care to those who identify as transgender, gender non-conforming, non-binary or genderqueer.

“Gender affirming care isn’t meant to influence people in any particular direction. We don’t ‘treat’ anyone’s identity or tell anyone what they should or shouldn’t do,� the website states. “We’re here to educate you about your options and help you decide which path is best.�

Treatment options include adjustments in gender expression (such as use of pronouns, makeup, hair, voice, clothing or behavior), puberty blockers, hormone therapy and referrals to psychologists and therapists.

pause the physical changes of growing up. With , transgender girls receive estrogen and transgender boys, testosterone.

Hormone therapy helps transgender girls develop breasts and wider hips; transgender boys, facial hair and a deeper voice. Some, but not all, of the changes are reversible if the patient goes off hormones.

‘Lack of protocols and treatment’

Reed, who describes herself as a progressive queer woman married to a trans man, said staff at the center too freely prescribed medications and did not properly explain the side effects. “I was struck by the lack of protocols and treatment,� she wrote.

During the four years she worked there, around a thousand young people came through the doors and a majority received hormone prescriptions.

To begin transition, Reed wrote, all children needed a letter of support from a therapist, who was often one recommended by the center.

Reed said her encounters with patients left her feeling like they did not know about the side effects of hormone therapy. For example, transgender males taking testosterone, which thins vaginal tissues, suffered vaginal lacerations during sex; and a transgender female taking experienced liver toxicity.

Reed began seeing many kids with diagnoses such as schizophrenia, PTSD and bipolar disorder referred to the center from ÃÛÑ¿´«Ã½ Children’s Hospital.

“Yet no matter how much suffering or pain a child had endured, or how little treatment and love they had received, our doctors viewed gender transition — even with all the expense and hardship it entailed — as the solution,� she wrote.

She was also disturbed by cases where parents did not agree on their child’s need for gender-affirming care. “It seemed the center always took the side of the affirming parent,� she wrote. In Missouri, only one parent’s consent is needed for treatment.

Reed said she advocated for tracking desistance and detransition among patients, but the idea was turned down. “Desisters� end up choosing not to go through with transition, and “detransitioners� decide to return to their birth gender after transitioning.

She and a colleague tracked the cases anyway, she said, calling it the “Red Flag List.�

, Washington University stressed its commitment to “providing compassionate, family-centered care� to all patients, and holding is medical providers “to the highest professional and ethical standards.�

Bailey said his office has already taken sworn testimony from Reed, “so that parents are fully aware of the nature of these allegations.�

The Missouri Department of Social Services will also look into allegations of abuse of the state’s Medicaid program, and the Division of Professional Registration will determine if action needs to be taken against the providers’ licenses.

“We take this evidence seriously and are thoroughly investigating to make sure children are not harmed by individuals who may be more concerned with a radical social agenda than the health of children,� Bailey stated.

Growth in transgender care

The number of gender clinics treating children in the U.S. has gone from zero to more than 100 in the past 15 years, according to a recent story by Reuters, yet the long-term impacts of puberty blockers and sex hormones on brain development and fertility are not well understood.

Major medical organizations, such as the American Academy of Pediatrics and the Endocrine Society, endorse puberty blockers and hormone treatments as . They say the mental health ramifications of not addressing the needs of such patients put them in peril.

More than half of transgender teens have considered suicide, , an LGBTQ crisis-intervention nonprofit. A study released a year ago found that receiving gender-affirming care lowers the risk of depression and suicide for transgender teens.

, a Washington University pediatric endocrinologist who co-founded the Transgender Center at ÃÛÑ¿´«Ã½ Children’s Hospital, told the Post-Dispatch in a story that published in May 2022 about a transgender youth that doctors there see 250 new patients a year.

Some of that increase is due to a greater understanding of transgender care, he said, and broader insurance coverage.

Last year, Lewis traveled to Jefferson City to testify against a bill that would have prohibited transitioning treatment for transgender youths.

“We are taking away the autonomy and dignity of these patients and families …,� he told lawmakers. “It will limit access to care that we know benefits them. It’s only going to harm them.�

Misconceptions about treatment can color people’s opinions, Lewis told the Post-Dispatch. No one younger than 18 undergoes gender-affirming surgery — and many transgender adults never have surgery. Patients are monitored regularly by a team of specialists who keep a close eye on hormone levels and potential side effects, such as blood clots and bone-density loss.

The incidence of regret is small, he said, and is almost always attributed to social consequences: lack of family acceptance, job loss or victimization.ÌýÌý

Includes reporting by Colleen Schrappen of the Post-Dispatch.

Related stories:

•ÌýFamilies of transgender children wait, worry as Missouri lawmakers debate bills

•ÌýWhy Jamie Reed went public with her allegations about a ÃÛÑ¿´«Ã½ transgender clinic

•ÌýReport on ÃÛÑ¿´«Ã½ transgender center could propel measures limiting treatments