Judicial Watch: Transgender Scandal Documents Show UC San Francisco Doctors Gave Puberty Blockers to Children as Young as Nine

(Washington, DC) – Judicial Watch announced today it received 2,491 pages of records in a California Public Records Act lawsuit on behalf of The Daily Caller News Foundation that show top doctors in the University of California San Francisco (USCF) gave puberty blockers to children as young as age nine. 

Judicial Watch obtained the records as the result of a 2023 lawsuit for information about USCF’s transgender program’s targeting of children (Daily Caller News Foundation v. The Regents of the University of California (No. 23-518397)). 

The records include many emails from which participants’ names are redacted and withheld from the public. 

An October 12, 2022, email chain between The New York Times reporters, Children’s Hospital Los Angeles (CHLA), and National Institutes of Health (NIH) officials with the subject line “Final Qs on Trans Youth Care study” details discussion regarding “the big N.I.H. multi-site study” of “the use of puberty blockers on transgender adolescents” and whether an eight-year-old developed “significant osteopenia:”

Dear NIH team, Dr. [Redacted] and Ms. [Redacted],

Christina Jewett and Megan Twohey here, from The New York Times. We are preparing to publish a story on the use of puberty blockers on transgender adolescents that we have been working on for many months.

The story includes some information related to the big N.I.H. multi-site study on blockers and hormone treatment: 

• In a 2014 funding proposal to the National Institutes of Health, four prominent American gender clinics pointed out that the United States had never produced data on the physiological and mental health impact, safety and tolerability of the drugs, particularly among transgender patients under 12, leaving a “gap in evidence for this practice.”

• Awarded nearly $8 million to examine the effects of blockers and sex hormones, the investigators have yet to report on key outcomes of treatment.

• A child in the N.I.H. study who started blockers at age 8, developed “significant osteopenia,” and switched to hormone treatment at 11 “to support bone health,” according to investigator reports submitted to the N.I.H.

Please let us know any of the information is inaccurate.

Also, we know that the N.I.H investigators have produced some reports out of their study — such as baseline measures, telehealth dynamics and height velocity. But why have they yet to report on key outcomes of treatment, such as the effects of blockers on mental health and bones (Aim 1)?  

Do you have any comment on the case of the 8-year-old study participant who was put on CSH as a result of developing osteopenia, per the 2019 study update?

These questions are forwarded to Stephen M. Rosenthal, M.D, Medical Director, Child and Adolescent Gender Center, University of California San Francisco. A Children’s Hospital Los Angeles official writes: “Steve, you need to correct the information about your participant.”

Rosenthal writes to Children’s Hospital Los Angeles, requesting a copy of the “2019 study update,” and later writes:

OK, [redacted] and I have now reviewed all UCSF participants in both cohorts

First, with respect to the blocker cohort, we did not start a blocker on anyone age 8 years. The youngest participant in the blocker cohort from our site was 9 years, 3 months, and this individual did not develop osteopenia. Second, with respect to the GAH cohort, we had 7 participants who entered into the study having been previously treated with a blocker. None of these 7 participants started a blocker at 8 years of age, but were significantly older.  

***

 Here is the relevant text from the 2019 study update:

 “Within the CSH cohort, 311 participants have been enrolled across all study sites. Participants range in age from 11 to 20 years old, with a mean age of 16 +/- 1.9 years. Participants aged 13 and older made up 98% of the CSH cohort. The single 11-year-old who enrolled in the study was receiving cross-sex hormones in order to support bone health due to significant osteopenia.” 

This participant was not previously treated with a blocker at age 8, so the information described by the NYT reporters is incorrect. [Redacted]

In terms of the 24 month f/u bone paper, they can be told (as previously communicated to them through our email to the NIH) that the data analysis and related manuscript preparation are underway, and we are targeting December for manuscript submission. 

On October 14, 2022, an official at Children’s Hospital Los Angeles emails The New York Times: 

Here’s clarification on the following statement you provided:

• A child in the N.I.H. study who started blockers at age 8, developed “significant osteopenia,” and switched to hormone treatment at 11 “to support bone health,” according to investigator reports submitted to the N.I.H

This statement is incorrect. There is no such participant in our study.

On October 19, 2022, Jewett from the Times emails the university, “Thanks for patiently answering our questions so far. This one is quick and hopefully easy. What’s the Z-score where one considers that a young person (14) has osteopenia? Wasn’t sure if it was -1.5 and below or -2 and below.”

An Assistant Professor of Pediatrics and of Medicine from the University of California San Francisco responds to the inquiry:

We do not use the terminology “osteopenia” or “osteoporosis” in children and pre-menopausal individuals solely based on DXA. Rather, the definition of “low bone density for age” is a BMD Z-score less than or equal to -2. The diagnosis of “osteoporosis” in pre-menopausal individuals requires some evidence of skeletal fragility, as detailed in the references above.

On November 14, 2022, a clinical research manager from Children’s Hospital Los Angeles emails Rosenthal, university and Children’s Hospital officials, sending them the link to The New York Times article:

The NYT article has been published. Here’s the link, and I’ve attached a PDF.

https://www.nytimes.com/2022/11/14/health/puberty-blockers-transgender.html

The link in the article to our study takes readers to the JMIR protocol paper.

Steve, you were quoted in the article around not prescribing stand-alone blockers to anyone over 14, and there’s a link to your statement against the Alabama ban on medical treatment for trans youth.

Dr. Spack and Boston Children’s Hospital are mentioned as leading the US adoption of blocker treatment.

In an October 2, 2022, email Dr. Madeline Deutsch, director of University of California San Francisco’s gender affirming health program, states that the World Professional Association for Transgender Health’s Standards of Care Version 8 (WPATH SOC8) no longer requires a letter from a mental health professional to perform transgender surgical procedures:

WPATH SOC8 is out and no longer requires a mental health “letter”. So we can now focus on patient-centered assessments. A single “letter” is provided by any qualified provider to attest to the patient’s need for and appropriateness for surgery. In general, this letter should be able to come from the treating surgeon. Our new social worker, [redacted] focus will be on perioperative assessment and support, rather than formal gender dysphoria assessments and letter writing.  

Please change your workflows accordingly. It remains to be seen how insurance companies will respond to these changes, but we should begin following SOC8 and then sort out insurance issues as they arise.  

Please begin referring all of your surgical patients (once they have decided to pursue surgery here) to REF452 Transgender Care Social Work, so that [redacted] can and assess for needs. Also, [redacted] and I have been working on 2 initiatives:  

1. We would like [redacted] work directly with discharge planning, when appropriate, to assist with postop needs, for example, finding a trans-affirming SNF, making sure IHSS workers are trans-inclusive, making sure social supports actually show up etc…. Can you please each provide the contact for your discharge planning teams? Ideally, [redacted] will be able to shadow these teams to better understand their flow.

2. [Redacted] would like to observe surgical cases, to become more familiar with the procedures and after-care needs. Are any of you able to host her for OR cases? Ideally, she will follow the patient from pre-op to PACU, and to the floor if an inpatient case.

3. Once up and running, [redacted] will round on inpatients with high psychosocial needs. We will work out a mechanism for this. 

On October 4, 2022, a university official writes to Deutsch: “Thanks for the update Maddie. Sounds good. I will let the facial plastics team know about the change in workflow.”

In a November 10, 2022, email Daily Caller News Foundation reporter Rachel Page in an interview request states:

I am producing a documentary on the journey of adults who underwent the gender affirmation process. Many of our interviewees underwent both HRT and gender affirming surgeries. Several of our interviewees “detransitioned” from their transgender identity.

We’re going to be in the SF-area on Nov. 16 and we were hoping to sit down with you to discuss the importance of supporting the LGBT agenda as well as rebut misconceptions about trans rights (i.e. transgender women are a threat to women’s sports). 

Shortly thereafter, an assistant professor in the Division of Child & Adolescent Psychiatry writes to Rosenthal and Deutsch at the University of California, San Francisco: “FYI looks like journalists from the conservative Daily Caller will be in SF. I’m obviously ignoring this email, but not sure if they’d tried to ambush any of our providers? I’m cc’ing Steve and Maddie as well, so they’re aware.”

A senior public information representative then states: “It’s good to be aware that they are in town. I’ll alert [redacted] in Strat Comms to see if other steps should be taken.” 

Rosenthal responds: “Thanks for letting me know and for your insights about these journalists.” 

On September 21, 2022, a producer from Fox News’ The Tucker Carlson Show writes to UCSF’s Transgender Care Navigation Program:

Ahead of imminent coverage, please let me know how many genital surgeries you have performed on minors in the past year. Your published guidelines say these operations on minors are appropriate on a ‘case by case basis.’ How many? Also, are you worried about being sued into the ground like Tavistock? Deadline in 3 hours. Thanks.

The email is forwarded to Deutsch, Rosenthal, Vice Chancellor in the Office of Communications Won Ha, the office of Risk Management, and others.

Ha writes:

The Tucker Carlson show does not follow ethical journalistic standards nor is it a news program, but an opinion program. Whether we respond or not, this will be a negative story based on falsehoods and misleading claims. They will use any response from us in any way that suits their preconceived, false narrative, and will likely generate more attention to their partisan cause.

Rosenthal responds: “Thanks for the update, [redacted] Maybe at some point they can be sued.” 

Deutsch responds to all: “An unfortunate segment. I am assuming they focused on Vanderbilt because it is located where their base is located. I’ve taken down our peds content in the guidelines for now and instead direct people to the SOC8 [WPATH SOC8]. The content they referenced is 6 years old anyway and slated for updating next year. I’ve also made a few light edits to the rest of our website to minimize any ability for the content to be weaponized.”    

Rosenthal writes: “Maddie, I’m so glad you removed the pediatric content from the UCSF guidelines.” 

A September 22, 2022, email from someone in pediatrics at the University of Chicago to Rosenthal states:

A report on top surgery in transgender and nonbinary adolescents and a related editorial caught my eye. I thought this was not standard of care until the age of legal majority because of issues of regret and potential physician legal liability, and that puberty blocking therapy to prevent this sort of thing was the standard of care. Am I mistaken?

(The email apparently references two articles included in the UCSF production which ran in the American Medical Association’s JAMA Pediatrics titled “Top Surgery and Chest Dysphoria Among Transmasculine and Nonbinary Adolescents and Young Adults” and “Top Surgery in Adolescents and Young Adults—Effective and Medically Necessary.”)

The records include a December 22, 2022, letter from Rep. Viginia Foxx (R-NC), then-ranking member of the House Committee on Education and Labor to Rosenthal which asks whether UCSF “ever delivered medical interventions for a minor diagnosed with gender dysphoria whose parents have objected to such interventions?”

In an October 4, 2022, email, Rosenthal forwards a Washington Post articled entitled “Okla. GOP ties hospital’s covid funds to end of gender-affirming care,” which he calls “a new low.”

“Normal people know that introducing permanent sex changes for nine-year-olds is sick. That’s why these people tried so hard to hide the information. Thanks to our partners at Judicial Watch, Americans can finally see what they were up to. People deserve the truth,” said Neil Patel, chairman of the Daily Caller News Foundation.

“There is something rotten in the state of California: UCSF and LA Children’s Hospital were conducting transgender drug and surgical experiments on little children – and trying to cover it up,” said Judicial Watch President Tom Fitton.

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Source: https://www.judicialwatch.org/transgender-scandal-documents/