Who Blows the Whistle on the Whistleblowers?
A Legal and Ethical Analysis of Anti-Trans ‘Whistleblowers’.
Note: the contents of this article are my opinion and my interpretation/ reading of the law. This is not legal advice, nor is this opinion that of any court of the United States at this time. Any views herein are my own and are not at the time of writing legal fact.
The Health Insurance Portability and Accountability Act, better known as HIPAA, is probably the most well known and misunderstood law in the medical field. The Privacy Clause is the law’s most influential piece, allowing for Personal Health Information, or PHI, to be protected by the federal government. Hospitals take this very seriously. Every person who works in a hospital has to have HIPAA training, even if you don’t personally handle PHI. I should know; I was a simulated patient (I.e.. an actor that helps train doctors in real world situations) and worked in the COVID testing center for a hospital. I had to be trained, even when I was just working as an actor.
Hospitals go great lengths to not run afoul of Hipaa. They monitor who accesses patient files and when and for what reasons they are accessed. They have an intranet (think internal network like the early days of the internet, stuff like DARPAnet) so there is no connection to the outside internet hackers can exploit. They have all patient information on hospital owned and secured devices, so when you’re away from the hospital that PHI is still safe.
Recently, legal questions around HIPAA have come to light through the ‘whistleblowers’ who are calling foul on the treatment of transgender children in hospitals. Critics have argued these health care providers have violated HIPAA by leaking PHI to the press, mostly independent journalists. Defenders say this is covered by the Whistleblower Clause in HIPAA, and that the public deserves to know the unethical behavior of hospitals towards children. Which side is true? Legally where do these ‘whistleblowers’ fall? Bioethically where do they fall? Let’s look into it.
First thing’s first, what is HIPAA? HIPAA, passed in 1996, was designed to protect patients. It does so in several ways, but the most important is federally mandating the protection of information relating to patient health. Per the Health and Human Services website, this includes,
“Information your doctors, nurses, and other health care providers put in your medical record
Conversations your doctor has abou t your care or treatment with nurses and others
Information about you in your health insurer’s computer system
Billing information about you at your clinic
Most other health information about you held by those who must follow these laws”
It also states that this information is only to be accessed by certain people, like doctors caring for you, insurance providers, and hospital administrators that schedule appointments. It stipulates that this information can only be accessed for advancing the care of the patient. If personal health information is compromised, for each infraction there are civil and sometimes criminal penalties up to $50,000. The American Dental Association (also covered by HIPAA) breaks down how these penalties depend on culpability and whether or not it was timely corrected. This is decided on a case by case basis, litigated in court.
What does this look like in reality? Here’s an example: You are working as a nurse, and you see a football player from your favorite team come into the hospital’s orthopedic office. You don’t know what he’s there for, but you know he’s not on the injury report for the team. Your buddy has some money on him for the game, so you figure you should tell him. You send him a text. He thanks you, and pulls his money. You have just committed a HIPAA violation. This was one of the examples used to train me.
How could that be? You weren’t caring for him, you didn’t even know why he was there. But, crucially, you gave away Personal Health Information. His name, the date he came in, and the fact he came in, you are not allowed to disclose to people outside those caring for him for the purpose of that care. For instance: I can’t tell you who got tested for COVID when I was working in the testing center. If Jesus Christ himself went through my line to get COVID tested, I couldn’t tell anyone. It would be a violation of the law and professional ethics.
Yet, what if that previous scenario was different? What if you didn’t tell your friend, but rather the media about the player possibly being injured? After all, the team has to disclose who is and who is not injured because it changes how people bet on a game, so you’d be doing the league a service by blowing the whistle on this team, right? You could potentially save people thousands of dollars because the team lied about a player. Is that legal? No. That is still a HIPAA violation. Hipaa has specific cutouts around whistleblowers, but these do not include giving PHI to a press agency when there is no immediate threat to a person or the public.
This is the crux of the whole gender affirming care ‘whistleblower’ debacle. For those of you unaware, recently several health care employees have come forward to sound the alarm on youth gender affirming care. The first was Jamie Reed, but she has been joined by others like Eithan Haim and Tamara Pietzke. Jamie Reed’s new organization, the LGBT Courage Coalition, has championed health care providers who come forward and encourages more to do so. These three disclosed stories of harm done by providers to children to independent media sources including Christopher Rufo and Jesse Singal.
Since HIPAA is decided on a case by case basis, let’s look at each case individually. Jamie Reed’s was the first so we shall start there. Jamie was a social worker in Missouri at Washington University’s Transgender Center at St. Louis’ Children’s Hospital, taking care of organizing patient appointments and intake. She believes that there were certain kids that were being wrongfully pushed and rushed towards genders affirming care like hormones and puberty blockers. Eventually, she started making a list of people she believed were wrongfully being sent down this pipeline and their stories. After taking it to the board of the hospital, they told her to delete the spreadsheet immediately and that they wouldn’t change their procedures. Reed secretly kept the spreadsheet. Disillusioned, Reed left and started talking to reporters, one of whom being Jesse Singal. Reed later gave the spreadsheet to Singal as proof of her employment, who did not publish it but did publish her story. She also gave a copy of this spreadsheet and other documents to the Attorney General of Missouri.
The eagle-eyed readers will already see the possible violation. This case also goes into who can access patient records legally and why. Here’s an example that illustrates the problem with what Reed did: Let’s say you are an office administrator who wants to celebrate your friend’s birthday who works with you. You don’t know her birthday, but you know it’s coming up. You don’t want to raise her suspicion as you want to surprise her, so you decide to check her patient record at the hospital real quick to see her birthday. You’re not going to look at anything else, that’s wrong, but you just want to peek so you can plan. There’s no harm done, in fact you are trying to do something nice for her! Is that a HIPAA violation? Yes.
You are accessing patient information for a use other than providing care. That is against the law. Even for something as innocuous as planning a birthday, you cannot snoop in anyone’s records for any reason. If you are not treating that patient, you should have no access to that file. Hospitals are so strict that they even make computers lock doctors out if they are idle for more than a minute, just in case someone walks by and sees something in a file on screen.
The biggest issues with Reed’s actions revolve around the spreadsheet and who she disclosed information to. From the looks of it, Reed copied information from patient files onto a spreadsheet on an unsecured device. We don’t know exactly if the computer is unsecured, but it seems likely given she still had the files after she left the hospital. Regardless if it was an unsecured device or not, she legally cannot hold onto patient information after she left the hospital. She has to delete it all. Keeping it is in and of itself a violation, and depending on how a court rules, every time she was looking at that spreadsheet is an additional one for every person on that spreadsheet. Giving it to a journalist is also likely a violation. She gave a copy of this spreadsheet with 77 names to Jesse Singal.
But Reed thinks she has an ace in the hole: HIPAA’s whistleblower clause. HIPAA has built-in protections to disclose patient information to certain parties as long as it’s for documenting unethical or illegal behavior. There’s a couple of ways this can be done. The Department of Health and Human Services also discusses this on its website. The safe harbors are disclosures required by law, disclosures for law enforcement purposes, and disclosures to avert a serious and imminent threat to health or safety. Reed or her lawyers would be arguing she used the “serious threat to public safety” standard.
However, Reed seems to be mistaken on who the whistleblower clause states she can disclose patient information. She can “use or disclose protected health information, if the covered entity [in this case Reed], in good faith, believes the use or disclosure:
(A) Is necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public; and
(B) Is to a person or persons reasonably able to prevent or lessen the threat, including the target of the threat.”
This clause is mostly there so that should a patient who is a danger to themselves and others escape or otherwise indicate they want to cause harm to a community or person, healthcare providers can warn that person or community so they can take proper precautions to protect themselves. The threat of danger has to be imminent. Reed’s alleged threat is more existential than imminent, which is a knock against her whistleblower status. Also, she can’t disclose PHI to the media or journalists that are not able to reasonably prevent or lessen the threat. Given Jesse Singal is not a very big journalist, he does not have the reach to reasonably protect the public from the supposed dangers of gender affirming care. Moreover, consider the example the Department of Health and Human Services provides in regards to reproductive health:
“A pregnant individual in a state that bans abortion informs their health care provider that they intend to seek an abortion in another state where abortion is legal. The provider wants to report the statement to law enforcement to attempt to prevent the abortion from taking place. However, the Privacy Rule would not permit this disclosure of PHI to law enforcement under this permission for several reasons, including:
A statement indicating an individual’s intent to get a legal abortion, or any other care tied to pregnancy loss, ectopic pregnancy, or other complications related to or involving a pregnancy does not qualify as a “serious and imminent threat to the health or safety of a person or the public”.
It generally would be inconsistent with professional ethical standards as it compromises the integrity of the patient-physician relationship and may increase the risk of harm to the individual.”
From this example, it is clear that children receiving gender affirming care does not meet the standard for ‘serious and imminent threat to the health and safety of a person or the public’. Further, the violation of ethical standards mentioned echoes the ethical issues of Reed disclosing PHI specifically to anti-trans sources who have an audience who wish to harm trans people and their loved ones. The fact she appears to have only countacted Missouri Attorney General and went to the media after her institution rejected her is unethical as well. If she truly wishes to protect kids, she has done a poor job of it by compromising their identities.
We know for a fact she did compromise the identities of her patients. One of the things prosecutors look for when prosecuting HIPAA cases is if there is identifying information, like names, dates, ages, race, and specific anecdotes, that may lead a patient or others to identify the patient. Jamie Reed verifiably did that, including an anecdote in her piece about how the testosterone blocking drug Bicalutamide did serious liver damage to a pediatric patient. The child’s family was able to deduce this was their child, and actually refuted the claim that Bicalutamide caused liver damage to their daughter. First Alert 4 in St. Louis interviewed the family, who claims the liver damage actually came from a COVID antiviral when the child was in the hospital. Another parent whose child Reed cared for responded to her on twitter “Who else did you give my child’s personal health info to?” This exchange was posted after Reed admitted to drafting a form this parent presented which discussed the risks of testosterone. This is more evidence that gender affirming care for minors is not a ‘serious and imminent threat to a person or the public.’
I also find Reed to be of dubious credibility. In addition to the above misrepresentation of a drug causing liver damage, she also said in an anecdote that the hospital wished for her to dispose of the spreadsheet due to the fact they wanted to cover-up their actions. She claimed in her interview with Gender: A Wider Lens the hospital did not want to question gender affirming care, as that would invoke the ire of trans activists. This is highly unlikely. Hospitals are concerned with PR, but they are more concerned with money. Had the government come down or someone sued, they could be looking at upwards of 1.5 million dollars in damages alone. That doesn’t include legal fees, court fees, loss of income due to a reputation hit, etc. etc. The point being: the hospital was not afraid of trans activists, they were afraid of running afoul of HIPAA. It’s very suspicious that the narrative Reed weaves is more focused on how hospitals are ‘held captive by radicals’ than on how hospitals wish to avoid behavior that leads to litigation. It just doesn’t make sense to anyone who knows the inner workings of a hospital from even the most cursory glance. It can’t be known for sure, but Reed’s story seems unreliable.
Reed is lucky most of the parents don’t wish to sue her, and thus far has escaped the ire of the federal government. Eithan Haim is not so fortunate. His case, I find, is actually more egregious and his behavior more unethical than Reed’s.
Haim’s story begins with Christopher Rufo leaking on twitter that an “internal source” from Texas children’s hospital had some pressing information. Haim was a resident at the hospital at this time. Rufo said that though the hospital announced in 2022 that they were no longer providing children gender affirming care in accordance with a non legally binding announcement by Texas Attorney General Ken Paxton, they had started back up in secret by 2023. Included were patient records, with name, medical record number, and date of birth blacked out as proof. Crucially, the date, the time of the appointment, location (including the room number some patients received care in), some ages, and the doctor they saw were all uncensored. One patient also had their race uncensored. As previously stated, time, date, race, doctor seen, age, and location are all identifiable information. It is trivially easy to identify these patients. The poor anonymization appears to be done on a phone with a finger and the photo editor tool, meaning these pictures of PHI were likely taken on Haim’s phone and given to Rufo. His pictures are most certainly HIPAA violations and theft of patient information. Many hospitals require strict courses on how to correctly anonymize patient data for studies, reporting, and other clerical work. Evidently Haim didn’t take this course.
It’s also unclear if Haim was responsible for caring for these patients. Given his aversion to gender affirming care, and his residency in general surgery, it’s unlikely he performed any surgical procedures on these children (mostly being implantation or removal of puberty blocking implants, we have no evidence of other more invasive forms of gender affirming surgery conducted on minors at the hospital at this time). This leads to the question of why he was given access to these records and why he was viewing them in the first place? Epic systems,which runs the patient data software at Texas Children’s hospital, has ways of tracking who was in a specific patient record, for how long, for what reason, and if it was printed. These are audited regularly for suspicious activity. In a compliance demonstration for hospital workers, another children’s hospital, Rady Children’s hospital, gives guidelines on when to access patient records. They say,
“You may access patient information only if it is necessary for you to do your job and care for the patient, and only the information you need for that purpose.¦
You may give information to other employees, physicians and other healthcare providers who are involved in the patient’s care.
You may not access or view patient information for personal use or curiosity”
Haim’s usage of records would fall under personal use or curiosity if he was not involved in these cases. In interviews he has said as such: he wanted to check to see if the hospital was doing these procedures by looking at patient files.
Haim’s whistleblower status is called further into question as Haim’s documents are not proof of an ethical breach of responsibility on the part of the hospital. Haim claims in his Gender: A Wider Lens interview that, because child gender affirming care was banned by Texas only a day after Rufo published his documents on May 17, 2023, his actions account to whistleblowing because this new law was about to be ratified. This is not how the law works. The US constitution explicitly forbids “Ex-post facto” laws, I.e. laws that retroactively apply before the law is passed, both federally and on the state level (article 1 section 9 clause 3 and article 1 section 10).The law also wouldn’t go into effect until September 1 of that year. Therefore the hospital never violated a law. They publicly stated they were pausing gender affirming care for minors in response to a statement by the Attorney General. Haim claims the hospital lied about stopping care and secretly started back up privately, which violated professional ethics. Going back on a public statement is not an ethical violation. It’s not proven they even went back on their word. The Houston Chronicle reports the hospital’s statement was, “The mission of Texas Children’s Hospital is to create a healthier future for all children, including transgender children, within the bounds of the law... After assessing the Attorney General’s and Governor’s actions, Texas Children’s Hospital paused hormone-related prescription therapies for gender-affirming services. This step was taken to safeguard our healthcare professionals and impacted families from potential criminal legal ramifications.” The hospital claimed to pause the care but not halt it. This is reported differently in other outlets which could’ve led Haim to believe the hospital stated this was a permanent halt. There is little evidence to suggest the hospital wanted to permanently halt the program. Hospitals didn’t quietly accept Paxton’s decree, either. In fact, another Children’s hospital in Dallas announced it was challenging the order on May 12, 2022. The courts approved this and the gender clinic was set to resume operations. Texas Children’s likely saw this and due to internal pressure and an ethical responsibility to provide care, quietly reopened their clinic as well. Thus, Haim’s assertions that the hospital both went back on their word and violated an ethical boundary are false.
Haim’s actions are particularly egregious violations of HIPAA, and the federal government seems to agree. In June of 2023 Haim decided to go public with his identity after he learned about a federal investigation into him. That is currently ongoing, but Haim has raised thousands of dollars for his legal defense and has guest starred on podcasts, YouTube videos, and featured in articles about the dangers of gender affirming care for minors. He seems to be unrepentant in his actions, but as time goes on it remains to be seen how the court views this.
Haim has claimed this case against him is an intimidation case designed to silence him and all opposition to gender affirming care. However, given the evidence, there is very little to suggest this is retaliation by the government. Haim also claims, because of his criticism of COVID policy and gender affirming care, that the Biden White House is targeting him. Joe Biden himself does not have the judicial authority to prosecute Haim, and the Department of Justice has said nothing on the issue. The Harris County Attorney, Christian D. Menefee is prosecuting the case, as per his press release. It is highly unlikely the Biden White House is targeting one specific surgical resident for their beliefs. It is more likely one specific surgical resident violated HIPAA and is being investigated. Haim claims the speed of the investigation proves he is being unjustly targeted, as it is as only 2 months after Rufo’s post that he was investigated. Haim is correct in that these investigations typically take around 6 months to a year, however, he also claims that he shopped around this story to various outlets since January 2023. This means he accessed documents as early as January 2023, which could’ve been found in an audit. It’s also possible other outlets that received correspondence from him reported him to the Department of Health and Human Services. Regardless, if Haim truly cared about these child patients, he would not have shown so much identifying information about them to an audience of thousands to prove a political point. Privacy is important to keeping people, especially children, safe.
Tamara Pietzke is a relatively new ‘whistleblower’ on the scene. On February 5th, 2024, she published an article in The Free Press about Multicare and their pediatric hospital in Washington State. In the article, several anecdotes are presented about youth in her care, and their presentations and ages. She gives the location at Mary Bridge, age, and approximate dates as well as identifying details like life history, presentation at school, and the fact that one mother has a restraining order against a trans sibling of a patient. This calls into question if this is a HIPAA violation. Years and approximate dates are not themselves identifying information, but several concrete dates, like the date Pietzke sent an email about her patient to her colleagues which was disclosed, can be used to prove that enough personally identifiable info was leaked given those dates correspond to around when a specific patient was seeing Pietzke.
The case around Pietzke is less solid than Haim’s. While the anecdotes are specific, do they allow a patient or someone close to a patient to identify the patient? I would argue yes. There are very few people who have a restraining order against their transgender children. Restraining orders are public record in Washington. With enough digging, one could identify the patient given the information. That meets the standard for a HIPAA violation, but it is less certain. This case is the most contentious presented here because it does not involve specific access of patient records nor their disclosure to a third party. Both Reed’s spreadsheet and Haim’s pictures are tangible proof they accessed patient information for their own curiosity, Pietzke does not seem to have done this. Still, some of the details shared are things that are extremely personal and violate the privacy of therapy. If she did not violate the law, she certainly violated professional ethics.
Regardless, she has already faced some punishment for her actions. Pietzke was fired from her new job with another company after going public with her accusations. She claims this is retaliation for her blowing the whistle in her interview with Gender: A Wider Lens. But is this retaliation? It would be an extremely poor case if brought before the court. According to the Department of Labor, you are protected from retaliatory firing for reporting issues relating to a wide range of activities including Agricultural Work, Minimum Wage and Overtime Pay, Recordkeeping, Lie detector testing, family and medical leave, and youth employment. Being fired for being a potential liability is not protected under retaliation laws. While being blacklisted from an industry can fall under some kind of retaliation if an employer talks to other industry employers, Pietzke says she voluntarily sent HR at her new job the article in the Free Press. If the company took an action to fire her for the content in this article, that is not retaliation nor blacklisting from the industry. She was fired because either the company did not believe she could do her job given her anti-trans beliefs, did not trust her to respect the professional ethics of the therapist-patient relationship, or because of her poor handling of PHI and a potential HIPAA violation.
So, if these cases are violations under the law, are they ethical violations? Both are not one in the same. You can run afoul of the law while being perfectly ethical, and Vice versa. The ethics of medicine is a field known as bioethics. The four pillars of bioethics are beneficence, nonmaleficence, autonomy, and justice. Let’s go over all of these to see if the ‘whistleblowers’ meet these standards.
Most of these ‘whistleblowers’ claim to be working under the standard of nonmaleficence. They claim gender affirming care is hurting children. They claim to want to stop gender affirming care from hurting children. This is their most believable claim. After all, we can’t just give kids experimental drugs or lop off body parts! That’s inhumane! What these whistleblowers are committing here is the Opportunity cost fallacy. What they do is only present the costs of gender affirming care but not the benefits. Oftentimes they do this in a way that uses graphic language to scare readers into agreeing with them. It’s like the Dihydrogen Monoxide spoof.
For those unaware, the Dihydrogen Monoxide ‘scandal’ was a satirical hoax designed to use complex, scientific sounding language to scare the public into believing something everyone uses everyday, water, was in fact a dangerous chemical. Most famously, Nathan Zoehner created a scientific experiment for his school’s science fair project titled “How gullible are we?” In this experiment, he stated true facts about water, such as,
[Dihydrogen Monoxide] is also known as hydroxyl acid, and is the major component of acid rain.
It contributes to the "greenhouse effect."
It may cause severe burns.
It contributes to the erosion of our natural landscape.
It accelerates corrosion and rusting of many metals.
It may cause electrical failures and decreased effectiveness of automobile brakes.
It has been found in excised tumors of terminal cancer patients.
Using these facts, he got 43 students to vote to ban water, with 6 undecided and 1 against. He never lied, he never said anything untrue; Zoehner simply used fear, inflammatory rhetoric, and public ignorance to get his results.
The ethical principle of nonmaleficence these ‘whistleblowers’ claim to espouse when shown in this light are lacking, then. The harms of suicide (which many of anti-trans activists downplay), lifelong depression, self-harm, and self-loathing pale in comparison to almost any side effect of medication or surgery. All medications have side effects, and all surgeries have complications. People have gotten sepsis and died from piercings. RWBY creator Monty Oum famously passed away after an allergic reaction to anesthetic during a routine medical procedure. Anesthesia is known to cause life threatening anaphylaxis and death in between 1 in 100,000 patients receiving it. Should anesthesia and piercings be banned because of their potential life threatening harm? No, that is not how the principle of nonmaleficence should be used.
Nonmaleficence as a bioethical principle does not simply mean ‘doing no harm at all, no matter the costs’, it means to do no excess harm than is necessary for the life and wellbeing of the patient. This comes up a lot in palliative (end of life) care, where there is little done to treat the patient and instead the care team’s focus shifts to providing relief for pain, spending time with loved ones, and bringing about a dignified and painless end to the patient’s life. To have someone not suffer at the end of life, even if there may be more to be done to save them that the patient does not want, is nonmaleficence. You are easing the pain of an often lengthy and difficult process to help another human live their final moments to the best they can. It would be unethical at that time to try and painfully save that patient’s life against their wishes, which also has to do with the bioethical principle of autonomy we shall get to later.
Beneficence is all but ignored by these ‘whistleblowers’. Whatever benefits to gender affirming care studies report, whatever patients report, and whatever supportive parents report is hand-waved away. Reed herself has argued that most studies on puberty blockers are not rigorous enough in their control groups to fully come to any conclusions, ignoring the fact that such a study she designed would be inherently unethical for withholding care. Haim claims this too. Reed, to her credit, does see use in adult care that is “careful, regulated, and provides mental health oversight”. Haim evidently does not think this. Pietzke has been mostly silent on twitter and elsewhere so it is unknown what her personal beliefs on the matter are. As such, for this last section, Pietzke will mostly be absent. What Reed is advocating, though, is a return to old standards.
Yet, Reed forgets the maleficence of the old standards and their lack of beneficence. The pathologization of trans identities and focus on genitals over identities was always an issue for trans people under previous WPATH standards of care. Nonbinary people were practically nonexistent under these previous standards. Lying to obtain care was extremely common as transgender care was heavily gatekept. Any standard that encourages patients to have to lie to obtain care should be reworked, just as trans care has been. Personally I know the harm these kinds of standards can do. I went to a clinic using the old model soc 7 in 2022 and had an emotional breakdown following my intake session. My ambivalence towards my genitals was a knock against me going on hormones. I had to dig into a lot of childhood trauma that I really wasn’t ready to unpack. The social worker questioned if I was answering some of her questions at the end honestly due to the rest of our conversation. It felt humiliating. I felt like I wasn’t really trans because I didn’t meet the guidelines to a T. I’m reminded of this interaction every time I see anti trans activists claim “this person is just gay.” I felt like that’s how I was perceived. Thankfully, the therapist the social worker put me in contact with was fantastic, and immediately made me relax. I am not the only one with this experience. Lexie Bean said that this kind of grilling by healthcare providers only served to postpone their transition due to their abuse as a child. Their desires were softened due to them not feeling as if their body is really their own. All this interrogation did was postpone their transition. Indeed, Florence Ashley notes that the ‘alternative’ therapy offered by Haim and Reed’s supporters at Genspect is more akin to a ‘gender inquisition’ than its title of ‘gender exploratory therapy’ suggests. All it seeks to do is constantly question and belittle the experiences of the patient in order to discourage transition. Transitioning, under this paradigm, is a bad outcome to be avoided at all costs. Ken Zucker, a psychologist often cited by Genspect (who is a key backer of all 3 individuals mentioned here), says as much.
These ‘whistleblowers’ are most hostile to the bioethical principle of autonomy. Bodily autonomy is crucial to our medical system, and is a strong protection against abuse by healthcare professionals. Reed and Haim seek to undermine the principle of autonomy by arguing children under 18 cannot consent at all to these procedures and medications. This is dubious because the medical age of consent is in most places in the United States 16, and in states where it isn’t, there are special laws to allow minors to consent to specific procedures given certain conditions. Note: medical age of consent is not sexual age of consent. Many anti-trans activists will conflate the two in an effort to paint supporters of the trans community as pedophiles. These are two legally distinct and only distantly related legal concepts. One is about the legal rights of patients, the other is about criminal penalties under the law. They are covered under different statutes because they are legally distinct. Do not confuse the two, it only serves to muddy the waters.
Reed’s supporters at Genspect seek to increase the age at which one can get gender affirming care to 25 years old. They claim this is because this is when brains fully mature and only then can full consent can be given, as before then, the brain is too underdeveloped to fully consent to lifelong consequences. Despite the “brain matures at 25” discourse being dubious at best, this is a direct attack on patient autonomy. Legally, you can go to war and die at 17. You can destroy your liver with alcohol at 21. You can give yourself crippling debt at 18 by taking out a loan you can’t repay. In court, being between 18 and 25 is not a defense for being unable to consent to a contract, even if that contract has destroyed your life financially. There is no reason to delay treatment until 25 and it is ethically abhorrent to imply that patients under 25 are too mentally underdeveloped to consent to treatment. Both Reed and Haim are heavily involved with Genspect, going on founder Stella O’Malley’s podcast. Reed went to the organization’s 2023 conference in Denver. Genspect has used all three ‘whistleblowers’ mentioned in their campaigns to limit access to gender affirming care. Their policy proposals fly in the face of the bioethical principle of autonomy. If they were to pass, would damage beyond repair the right of anyone under 25 to their bodies, a right which is already heavily under attack following the overturn of Roe V. Wade.
Perhaps more damning, the parents of Reed’s own patients have directly challenged her opinion that parents were not given enough information to form informed consent to hormones. Besides the aforementioned First Alert 4 article, on Twitter Christine Hyman (a parent of a patient under Reed) disputed her claim that parents were uninformed on the side effects of testosterone. Reed confirmed Hyman was one of her patients’ parents, before leaving the conversation after Hyman lambasted her for lying about the consent forms given to parents and giving out her child’s PHI. Reed’s advocacy for a complete stop to pediatric gender affirming care also challenges the autonomy of parents over their child, a right she claims to support. She only appears to care about autonomy of parents when their opinions go against gender affirming care, never for. Again, autonomy is being brushed aside.
Justice is another major pillar of bioethics that these ‘whistleblowers’ mostly ignore. The transgender community has notoriously been underserved and outright abused by the medical establishment. Yet, Reed and Haim only focus on one side of justice: the side of detransitioners. Reed makes a note that detransition is not covered by health insurance, which is true and is a problem. Haim also advocates for those who have been harmed by hormones and surgery. He especially focuses on the discussion of loss of sexual gratification due to hormones. However, this is not in service of any kind of actual justice. Actual bioethical justice would focus on access to care for all people dealing with gender dysphoria, not just detransitioners. Actual bioethical justice would focus on damages from withholding care as well as damage from care. The justice advocated by these ‘whistleblowers’ only serves to restrict care to more trans people and force people to detransition. What little justice that is achieved by helping those who find out transitioning isn’t for them is drowned out by the injustice afforded to the people that desperately need transition to help their mental distress. It pits the justice detransitioners seek against the justice trans people seek. This should not be so. Detransitioners deserve care just as much as trans people do. Justice is not a finite resource; detransitioners should not have to find justice at the expense of trans people or vice versa. The tactics of Reed and Haim employ damage the relationship between trans people and detransitioners. Now, whenever detransitioners come up in trans spaces, they are met with skepticism. Detransitioners like Chloe Cole and Ritchie Herron are being used to show the dangers of gender affirming care. In using the plight of those who feel hurt by the medical community, they destroy the fight for just treatment on both sides.
All 3 of these ‘whistleblowers’ actions are unethical. Revealing patient information to groups that might harm them is a violation of nonmaleficence. Advocating against their treatment goes against their autonomy and a doctor’s aim to provide beneficence. I could go on. The point is that in a fraught political climate, these individuals tried to gain fame by putting the lives and health of their patients in jeopardy. This is legally and ethically reprehensible. Thousands of doctors, nurses, social workers, and administrators do their jobs every day in order to save lives. They ask for no special recognition as saviors. They ask for no special treatment as whistleblowers fighting a righteous crusade. They ask for no national media attention. These three individuals betrayed the good name of all in their fields to further persecute a minority that is already weary from constant assault. They are not whistleblowers. They are Quislings.
See also these links for further reading and investigation:
https://www.law.cornell.edu/cfr/text/45/164.512
https://twitter.com/jamiewhistle/status/1722029616552951859?s=46&t=hYQMmsnAfKSvu4ElEHIqBA
https://twitter.com/jamiewhistle/status/1700253329417441501?s=46&t=hYQMmsnAfKSvu4ElEHIqBA
https://www.whistleblowerllc.com/whistleblower-guide-hipaa/?amp=1
https://www.city-journal.org/article/what-happened-at-multicare
https://www.texastribune.org/2023/05/17/texas-trans-kids-health-care-ban-sb14/
https://www.texastribune.org/2022/05/12/transgender-gender-affirming-care-genecis/
https://www.texastribune.org/2022/03/04/texas-transgender-children-hormone-therapy/
https://twitter.com/genspect/status/1720878187888992596?s=46&t=hYQMmsnAfKSvu4ElEHIqBA
https://twitter.com/shellenberger/status/1764804936515371373?s=46&t=hYQMmsnAfKSvu4ElEHIqBA
https://twitter.com/jamiewhistle/status/1723776379970269328?s=46&t=hYQMmsnAfKSvu4ElEHIqBA
Thank you for this excellent article destroying the narrative about "whistleblowers." These liars stole patient information and used it for their own gain, for malice towards children. Haim in particular had no association with TCH at the time and did not treat any of these children. Hope he goes to jail!!
I am not a lawyer but am a librarian at a law firm with a trans kid who had Jamie Reed as his first case worker. She is indeed a liar and we very much want to sue, as do all the other parents I kniw that she dealt with. Unfortunately, HIPAA provides for no private right of action, meaning we as parents cannot sue her under HIPAA. Only the health care provider can sue for her taking their records of our PHI.