Emails raise questions about Philadelphia children’s hospital transgender surgeries on minors

Boston, Mass., Nov 23, 2022 / 14:30 pm

In a 2017 email, a doctor at the transgender clinic at Children’s Hospital of Philadelphia said she was not aware of any medical studies at the time that supported the irreversible surgeries the clinic had been performing on minors, public records show.

The statement is contained in internal emails, obtained by a private citizen through a public documents request, between Dr. Nadia Dowshen — co-director of the Gender and Sexuality Development Clinic at Children’s Hospital of Philadelphia — and Dr. Rachel Levine. At the time Levine, a biological male who identifies as a transgender female, was Pennsylvania’s physician general. Today Levine serves as assistant secretary for health for the U.S. Department of Health and Human Services.

Critics of so-called “gender-affirming” surgeries and treatments for young people with gender dysphoria were outraged by the disclosure, which one leading pediatrician says suggests that these procedures amount to “a giant experiment on children” that lack a clear understanding on the part of health care professionals and their young patients of the risks and long-term consequences involved.

But in a statement to CNA, Levine said there was “nothing unusual” about the email exchange and maintained that the “medical validity” of these procedures has been “affirmed.”

In one of the emails, Levine asked Dowshen and another co-director of the Gender & Sexuality Development Clinic, Dr. Linda Hawkins, about what Levine called “gender confirmation surgery” for “young people under 18 years of age,” which Levine said could include “top surgery for trans young men and top and bottom surgery for trans young women.”

“Top” and “bottom” surgery are the common parlance among transgender supporters for major, irreversible surgical changes to make a person appear to be a different sex. These include the removal of women’s breasts and the removal and reconstruction of male sexual organs.

“Is there any literature to support this protocol?” Levine asked in the May 4, 2017, email. “Please let me know if you have any references.”

The same day, Dowshen responded and wrote: “Hi Rachel, I’m not aware of existing literature but it is certainly happening. I think we’ve had more than 10 patients who have had chest surgery under 18 (as young as 15) and 1 bottom surgery (17).”

Dowshen said she was currently working with colleagues to “get some pre-post data for top surgeries for youth under 18” and suggested that a research assistant could do a literature search to make sure they were “not missing anything,” to which Levine agreed.

“A lot of our youth are being denied coverage for top surgery if under 18,” Dowshen said.

In a statement to CNA Wednesday, Levine downplayed the significance of the email exchange.

“As physician general of the state of Pennsylvania, I worked to remain aware of the latest science in a number of health areas. This allowed me to offer policy recommendations to the governor, to offer strong managerial oversight on behalf of the people of Pennsylvania, and to coordinate effectively with my peers,” Levine said.

“My question about the existing literature on surgeries for minors was asked in the same spirit as many of the other questions I asked in that role — that of making sure I was aware of the latest and most relevant data on an issue of public interest,” Levine said.

“There was nothing unusual about that exchange, and in the years since it occurred, the medical validity of gender affirming care has only been reaffirmed and strengthened,” Levine said. “It is important to note the standards of care for patients include psychological and medical evaluations and, if necessary, treatment and support for the young person and their family. Children who have not yet started puberty do not receive medical treatment — at that age, care focuses on counseling and being mindful of the needs of the young person, their family, and their school.”

CNA also contacted Children’s Hospital of Philadelphia for comment but did not receive a response.

‘A giant experiment on children’

Dr. Quentin Van Meter, president of the American College of Pediatricians — an organization of pediatricians that advocates for children’s health and well-being — criticized the email exchange. He told CNA that it is wrong for any doctor to be doing experimental surgeries when there are no long-term studies to support them.

Van Meter said the result of the doctors doing experimental sex-change surgeries on minors is that “the lives of what will be tens of thousands of children are ruined.”

He said that there are no long-term studies in existence to support sex-change surgeries, whether that be for minors or adults.

“This is a giant experiment on children,” he said. “Medicine cannot be practiced that way.”

Van Meter also took issue with Levine’s response to CNA. 

Van Meter said Levine is wrong about transgender surgeries being “affirmed” by science, saying that “it’s actually been torn to shreds by science.”

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“It’s the most embarrassing, non-scientific facade in a very scientific environment,” he said.

The original publicizer of the emails, Twitter user Megan Brock, told CNA she gained access to the emails through a Pennsylvania Right to Know Law public document request.

Children’s Hospital of Philadelphia (CHOP) is the latest hospital to come under fire after media exposés have shown that gender transition surgeries on minors have been taking place at medical institutions across the nation.

In August, Boston Children’s Hospital took heavy criticism when news broke that it was offering gender transition treatments and surgeries for kids. The hospital has since updated its website and says that only 18-year-olds qualify for “phalloplasty or metoidioplasty and for vaginoplasty surgeries.”

The website still says that the hospital will perform “chest surgery” on 15-year-olds.

In October, Vanderbilt University Medical Hospital paused gender transition surgeries on children after an investigation into the hospital was called for by Tennessee Gov. Bill Lee. Vanderbilt’s surgeries on minors — and the lucrative nature of its transgender surgeries in general — were originally exposed by Matt Walsh, an internet host for The Daily Wire.