‘Appalling’: Unearthed Documents Reveal How Hospital Pushes Medical Transitions On Children

• Seattle Children’s Hospital offers education guides that encourage medical professionals to quickly offer cross-sex medical treatments such as menstrual suppression and puberty blockers to youth patients with gender identity issues.
• The guides largely fail to mention mental health services, and indicate that they are optional and must be sought through outside institutions; the hospital’s gender clinic does not offer long-term mental health therapy. 
• “The most damning aspect of these documents is the repeated assertion that the gender clinic does not provide mental health services,” Dr. Stanley Goldfarb, former associate dean for curriculum at the University of Pennsylvania School of Medicine and current chair of Do No Harm, told the Daily Caller News Foundation. “The notion that these children, who are often depressed, anxious, and even autistic, are not provided with those services in a way that is closely linked with the activities of the gender clinic is appalling.”

Seattle Children’s Hospital encourages medical professionals to offer swift biomedical interventions as the default treatment for young patients with gender identity issues, even when parents are skeptical, and largely avoids recommending mental health services to gender dysphoric youth, according to documents published by the hospital.

The hospital, which recently attracted criticism for advertising transgender surgical procedures for minors, published several guides to instruct medical professionals on their treatment decisions regarding “gender affirming medical care” for youth. The guides promote puberty blockers and menstrual suppression drugs for young patients, do not list mental health screenings as a necessary step before medications are administered and instead indicate that mental health treatments are optional and must be sought externally.

“The most damning aspect of these documents is the repeated assertion that the gender clinic does not provide mental health services,” Dr. Stanley Goldfarb, former associate dean for curriculum at the University of Pennsylvania School of Medicine and current chair of Do No Harm, told the Daily Caller News Foundation. “The notion that these children, who are often depressed, anxious, and even autistic, are not provided with those services in a way that is closely linked with the activities of the gender clinic is appalling.”

Children with autism are vastly overrepresented in the population of transgender-identified youth, and mental health problems including anxiety and depression are common among this demographic.

A Seattle Children’s Hospital guide titled “Algorithm: Gender Affirming Medical Care for Youth” listed interest in cross-sex treatments as the sole necessary qualification for patients getting puberty blockers and cross-sex hormones. It lists various pathways to biomedical interventions while mentioning mental health treatment as an “additional resource” only in the context of patients who are not interested in blockers, hormones or surgeries.

If the patient is interested in cross-sex treatments but the parents are unsure, practitioners should follow the “yes” path, meaning they should make puberty blockers available, refer the child to a gender clinic and provide advice on binding and tucking, according to the document. A spokesperson for the hospital told the Daily Caller News Foundation that parental consent is required for “gender-affirming medical care” for minors and did not respond to a follow-up about the discrepancy between this claim and the guidance. (RELATED: Dem State Rep Says Doctors Should Be Held ‘Accountable’ If They Won’t Perform Trans Procedures)

“Screen for depression, anxiety, and suicidality, and refer to a mental health therapist if there are any concerns, or for continued gender exploration. Please note: Gender Clinic does not provide long-term mental health therapy,” the guide says under a section for patients who aren’t interested in transgender medical procedures.

Children who are interested in cross-sex treatments but have not yet started puberty should undergo a physical exam every six months to monitor for signs of puberty, and in the meantime should receive guidance on chest-binding and “tucking,” according to the guide. Blockers become an option in early puberty, and patients aged 13.5 and older can be referred to gender clinics if they’re interested in taking cross-sex hormones.

Similarly, a November 2021 guide from the hospital titled “Algorithm: Menstrual Suppression for Gender Diverse Youth” only mentions mental health services in the context of patients who aren’t interested in menstrual suppression, in which case it tells medical workers to “consider referral to a mental health therapist if there are any concerns for depression or anxiety, or for continued gender exploration.” The majority of the guide is about when and how to block a patient’s menstruation.