A former case manager at a transgender medical care center has spoken out against gender-affirming surgery for kids and revealed key details about the medical procedures occurring there.

Jamie Reed, a 42-year-old St. Louis native and self-described far-left queer woman, penned a lengthy tell-all for The Free Press in which she calls gender clinics for kids "morally and medically appalling."

She worked at Washington University's infectious diseases division in St. Louis, Mo., for four years, helping HIV-positive teens and young adults. Her work there eventually led to a job at the transgender center of the children's hospital.

Reed was responsible for patient intake and oversight during her time at the hospital. She said that most young people who walked through the door received hormone prescriptions that can have life-altering consequences, such as sterility.

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"By the time I departed, I was certain that 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," she wrote.

Upon arriving at her new position, Reed said she was struck by the lack of formal protocols for treatment, with the center's co-directors acting essentially as the sole authority.

Before 2015, few young boys comprised the total population of pediatric gender dysphoria cases. But she then saw a dramatic increase in teenage girl patients with no previous history of gender distress coming in and demanding testosterone treatment.

"When I started there were probably 10 such calls a month. When I left there were 50, and about 70 percent of the new patients were girls. Sometimes clusters of girls arrived from the same high school," she said.

Reed detailed the stories of several patients, including correspondence with other medical practitioners. She noted that young patients were often not fully aware of the potential negative consequences of treatments and doctors at the clinic were quick to blame various symptoms on gender dysphoria. 

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In one instance, a patient was put on Bicalutamide, a medication used to treat metastatic prostate cancer. One side effect is that it gives feminine features, such as breasts, to the men who take it. However, the patient experienced liver toxicity and was taken off the drug. The patient's mother threatened to sue.

In another case, a 17-year-old biological female was rushed to the hospital after the patient bled through her pad, jeans and a towel. It was later revealed that the girl had intercourse while taking testosterone, which thins vaginal tissue. Her vaginal canal had ripped open, and she was admitted for emergency surgery.

Other stories in Reed's account included that of a young Black girl with a history of drug use and an unstable living situation. When she was 18, she went for a double mastectomy. Three months later, she called the surgeon's office and said, "I want my breasts back."

"The last I heard, she was pregnant. Of course, she'll never be able to breastfeed her child," Reed wrote.

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She added that doctors often viewed a gender transition as the only solution for kids with deeply concerning mental health diagnoses, such as schizophrenia, PTSD, bipolar disorder and more. Furthermore, doctors were uninterested in tracking desistance or detransition in former patients.

"Clinics like the one where I worked are creating a whole cohort of kids with atypical genitals—and most of these teens haven't even had sex yet. They had no idea who they were going to be as adults. Yet all it took for them to permanently transform themselves was one or two short conversations with a therapist," Reed wrote.

When she attempted to speak out at the hospital and push back on protocols and medical diagnoses, Reed was given below-average performance reviews and reprimanded by higher-ups. During a company retreat, the doctors scolded Reed and her colleague, telling them to stop questioning the science and their authority.

An administrator later told them to "get on board or get out."

While Reed revealed that nearly everyone advised her against speaking out, she chose to anyway.

"What is happening to scores of children is far more important than my comfort," she wrote.