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Editor's note: The following article first appeared in City Journal.

Last spring, executives at Texas Children’s Hospital announced that they would cease performing transgender medical procedures on children, citing potential legal and criminal liability. The hospital’s chief pediatrician, Catherine Gordon, an advocate for "gender-affirming therapy," abruptly resigned.

I have obtained exclusive whistleblower documents showing that, despite its public statements, the Houston-based children’s hospital—the largest in the United States—has secretly continued to perform transgender medical interventions, including the use of implantable puberty blockers, on minor children. (When reached via email, hospital spokeswoman Kelley Carville responded: "We have no comment.")

As an institution, Texas Children’s Hospital (TCH) has openly promoted "gender-affirming care" to its physicians. In January of this year, TCH and Baylor College of Medicine, which works in partnership with the children’s hospital, hosted a "pediatric grand rounds" presentation titled "Medical and Psychological Care of Gender-Diverse Youth," describing the process of sex-change interventions, from puberty blockers to cross-sex hormones to genital surgeries.

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According to this presentation, TCH and Baylor College of Medicine encouraged doctors to begin treatment with puberty blockers and hormones during adolescence, and then consider surgeries, including breast removal and genital reconstruction, in adulthood—though the presenters explained that some surgical procedures could be appropriate for "adolescents on [a] case-by-case basis."

Richard Roberts, a University of Virginia-trained endocrinologist and assistant professor at Baylor College of Medicine who co-presented the grand rounds, is also listed in medical records as performing transgender medical procedures on minors at TCH. According to these records, Roberts has managed patients ranging in age from 12 to 17 years old for "gender identity" and "gender dysphoria," with indications for "medication," "testosterone levels," "medicine refill," and "specialty services." 

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Despite the hospital’s statement that it had ceased these practices, Roberts has continued to manage a heavy caseload for "gender-affirming care," including multiple patient visits in a single day last week for "gender dysphoria" and "gender identity," and another for "HRT [hormone replacement therapy]."

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Another doctor at Texas Children’s, a Harvard-trained surgeon and assistant professor at Baylor College of Medicine named Kristy Rialon, has also been involved in conducting transgender surgical procedures on minors. The records indicate that Rialon inserted and removed "non-biodegradable drug delivery implant[s]" for "gender dysphoria in pediatric patient[s]" throughout 2022 and 2023—including one procedure on an 11-year-old "female-to-male transgender person," listed in records for three days after the hospital had announced that it had stopped performing "gender-affirming care." 

The patients getting implants (or removals) from Rialon were 11, 12, 13, 14, and 15 years old. Other medical records confirm that Rialon has administered the drug Supprelin LA, an implantable gonadotropin releasing hormone (GnRH) medication that is one of the most commonly used drugs for blocking puberty in transgender-identified children. 

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The executives at Texas Children’s appear to be playing a duplicitous game. They announced that the hospital had stopped performing transgender medical interventions on minors, but this is simply untrue. TCH doctors administered such procedures days after the announcement, and they have continued to perform them throughout 2022 and 2023.

If "gender-affirming care" is truly the gold standard in medicine, TCH should defend it openly, not perform it in secret. State legislators, currently considering a bill to ban such procedures, should launch an investigation into the hospital and require those involved to account for their practices—or face severe consequences.

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