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Vanderbilt to pause gender-affirming procedures for minors

Image: Vanderbilt University Medical Center

NASHVILLE, Tenn. — Officials at Vanderbilt University Medical Center announced Friday that they are pausing gender-affirming surgeries for minors in order to review their practices.

The news, delivered in a letter sent to a lawmaker who has demanded an end to the surgeries, was publicly released Friday afternoon. It comes amid mounting political pressure from Tennessee’s Republican leaders — many of whom are running for reelection — who called for an investigation into the private nonprofit hospital after videos surfaced on social media last month of a doctor touting that gender-affirming procedures are “huge money makers.” Another video showed a staffer saying anyone with a religious objection should quit.

None of the politicians could point to a specific law that the hospital had violated, and no agency to date has committed to an investigation. Republican Gov. Bill Lee’s office said they had passed their concerns to the Attorney General Jonathan Skrmetti, but his office has not commented on whether he is looking into the Nashville-based hospital.

“We are pausing gender affirmation surgeries on patients under age 18 while we complete this review, which may take several months,” wrote C. Wright Pinson, VUMC’s deputy CEO and chief health system officer.

The GOP-dominated Legislature is scheduled to reconvene in January, and many lawmakers have vowed to introduce legislation further limit gender-affirming treatments. If successful, it’s unclear if VUMC would be allowed to resume gender-affirming surgeries for minors, regardless of their internal review.

“We should not allow permanent, life-altering decisions that hurt children,” Lee tweeted late Friday. “With the partnership of the General Assembly, this practice should end in Tennessee.”

According to Pinson, the World Professional Association for Transgender Health recently changed its recommendations for transgender treatment, which helped prompt the need for a review.

On average, VUMC has provided five gender affirming surgeries to minors every year since its transgender clinic opened in 2018. All were over the age of 16 and had parental consent, and none received genital procedures.

“The revenues from this limited number of surgeries represent an immaterial percentage of VUMC’s net operating revenue,” Pinson wrote.

Emails provided to The Associated Press through a public records request show hundreds of Tennesseans reached out to the governor’s office in support of shutting down VUMC’s transgender youth health clinic, with some asking him to call a special legislative session to address the issue. Others asked if he could suspend the licenses of the doctors who work at the clinic.

A few criticized Lee for not taking harsher steps earlier when he signed legislation banning doctors from providing gender-confirming hormone treatment to prepubescent minors.

Only a handful defended the clinic’s services, with some saying the transgender health care they received had been life-saving.

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Vanderbilt pauses gender affirmation surgeries on minors, says genital surgeries not performed

By: anita wadhwani - october 7, 2022 4:07 pm.

Vanderbilt University Medical Center. (Photo: John Partipilo)

Vanderbilt University Medical Center is temporarily halting gender affirming surgeries on patients under the age of 18 while it reviews new national recommendations on the treatment of transgender patients, the hospital’s deputy CEO and chief health system officer said in a letter to Tennessee Rep. Jason Zachary on Friday.

Until now, the hospital’s Transgender Health Clinic had performed an annual average of five surgeries on minors who were at least 16 years old — none were genital procedures, the letter from Deputy CEO and Chief Health System Officer Dr. C. Wright Pinson said.

Pinson’s letter served as a response to demands last week from Zachary and 61 other members of the House Republican Caucus that medical center immediately halt permanent gender affirmation surgeries on minors. The lawmakers said they were “alarmed” by reports from far-right publication the Daily Wire that the clinic was performing “surgical mutilations” on minors.

“It is an egregious error of judgement that an institution as highly respected as Vanderbilt would condone (and promote) harmful and irreversible procedures for minor children in the name of profit,” the Sept. 28 letter sent by the Republicans said . The letter demanded a response from Vanderbilt within 10 days.

Rep. Jason Zachary, R-Knoxville, changed his vote on Gov. Bill Lee's school voucher plan after cutting a deal to ensure his district was exempt. (Photo: John Partipilo)

The Daily Wire’s Matt Walsh first posted edited video clips last month of Vanderbilt staff discussing transgender surgery: one depicts a physician calling it a “big money maker,” although she does not mention minors; in another, a Vanderbilt plastic surgeon discussed “top surgeries” on 16- and 17-year- old patients who have been on testosterone and have parental permission. Another clip showed a Vanderbilt professor of law saying “conscientious objections” to gender affirming surgery were “problematic.”

Tennessee’s Republican leaders quickly expressed outrage, pledging to introduce legislation prohibiting gender affirming surgery for minors. Gov. Bill Lee said the claims warranted a “full investigation.”

Democrats pushed back, saying that “hate” was being used “for political purposes.”

“Parents should be able to make decisions in regard to their children’s health. That is something Republicans claim to fight for, but refuse to acknowledge when it comes to transition-related care,” Rep. Vincent Dixie, House Democratic Caucus Chair said.

Vanderbilt has been tight-lipped since the controversy emerged. Hospital officials simply noted the healthcare provided to transgender kids is “in compliance with state law and in line with professional proactive standards and guidance established by medical speciality societies,” but declined to answer specific questions.

The clinic’s website, which included photos and contact information for staff at the clinic, was immediately taken down. STAT News reported that at least 20 children’s hospitals across the nation have been singled out by right-wing pundits and all but three modified or removed website information, in part to protect staff and doctors from threats.

Similar social media campaigns regarding transgender care for minors have led to threats of violence against staff and doctors. Earlier this week, the American Academy of Pediatrics, American Medical Association and Children’s Hospital Association, writing on behalf of 220 children’s hospitals, urged Attorney General Merrick Garland to “investigate the organizations, individuals, and entities coordinating, provoking, and carrying out bomb threats and threats of personal violence against children’s hospitals and physicians across the U.S.”

On Friday, a VUMC spokesperson referred questions from the Lookout to Zachary’s Tweet of Pinson’s letter.

Please see Vanderbilt Medical’s response to the @tnhousegop . VUMC has agreed to pause gender transition surgeries on minors as well as honor religious objectors. https://t.co/xXlbSaAOMS pic.twitter.com/4G8laJfQfY — Rep. Jason Zachary (@JasonZacharyTN) October 7, 2022

The letter notes that Vanderbilt established its Transgender Health Clinic in 2018 “because transgender individuals are at high risk for mental and physical health issues, and have been consistently underserved by our nation’s healthcare systems.”

Pinson’s letter did not specify how many minors have been treated at the clinic, but notes that only a small number of surgeries are performed each year on minors — and all on adolescents at least 16 years of age. None of the surgeries were performed without parental consent, and no surgery involved genital procedures, the letter said.

Revenues from those surgeries constitute “an immaterial percentage of VUMC’s net operating revenue,” the letter said. Pinson noted that VUMC’s policies allow employees to be excluded from medical care they believe is morally objectionable.

Vanderbilt nevertheless is halting such surgeries while it reviews new recommendations from WPATH, the World Professional Association for Transgender Health, issued Sept. 6, the letter said.

“We are pausing gender affirmation surgeries on patients under 18 while we complete this review, which may take several months,” the letter said.

The pause may become indefinite. Pinson acknowledged GOP lawmakers have plans to introduce legislation regarding transgender care, which could be taken up as soon as the Legislature reconvenes in January.

“As always, we will assure that VUMC’s programs comply with any new requirements which may be established as part of Tennessee law,” Pinson said

by Anita Wadhwani, Tennessee Lookout October 7, 2022

Tennessee Lookout is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Tennessee Lookout maintains editorial independence. Contact Editor Holly McCall for questions: [email protected] . Follow Tennessee Lookout on Facebook and X .

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Anita Wadhwani

Anita Wadhwani is a senior reporter for the Tennessee Lookout. The Tennessee AP Broadcasters and Media (TAPME) named her Journalist of the Year in 2019 as well as giving her the Malcolm Law Award for Investigative Journalism. Wadhwani is formerly an investigative reporter with The Tennessean who focused on the impact of public policies on the people and places across Tennessee.

Tennessee Lookout is part of States Newsroom , the nation’s largest state-focused nonprofit news organization.