September 22, 2022 - 1:30pm

Healthcare in the United States is big business, and that includes gender clinics. For all their faults — I reported on them recently — NHS Gender identity Clinics are free at point of use. Not so in the US. The patient (or their insurance company) pays.

The Clinic for Transgender Health at Vanderbilt University Medical Center in Tennessee got on the gravy train in November 2018. Assistant Professor Dr. Shane Taylor explained that “these surgeries make a lot of money” and charged “female to male chest reconstruction” at $40,000, while a patient “just on routine hormone treatment that we’re only seeing a few times a year could bring in several thousand dollars”.

According to Taylor, gender reassignment surgeries — “huge money makers” — could support an entire clinic. “These surgeries are labour intensive,” she said, requiring “a lot of follow up time and they make money for the hospital”. Up to $100,000 each was her estimate.

What is the target market? According to an archive copy of Vanderbilt’s website, Taylor’s “areas of expertise” include Adolescent LGBT Health Pediatric General Practice.

A cursory inspection of Vanderbilt’s website gives no indication of their services for under-18s. In fact the clinic’s web pages are currently unavailable following recent media scrutiny in the United States. Archived copies, however, provide a chilling insight into what might have been going on. The Pediatric Transgender Clinic at Vanderbilt Children’s Hospital has been offering ‘gender affirming hormone therapy’ and pubertal blocking. A video clip that emerged this week appeared to suggest that Vanderbilt clinicians would perform “top surgery”, i.e., mastectomy, on teenage girls who had not reached the age of “majority”.

The row in the US is intense and further developments are likely now that Republican politicians are on the case. Congressman John Rose could not be clearer as he called for an investigation: “Children are being permanently, physically altered for financial gain – it is inexcusable.”

But this is an issue that is split down political lines, and more so than in the UK. Randal Cooper, Democratic Party challenger for Rose’s district in Tennessee, retorted: “Here’s my opponent, playing to the extreme right wing by attacking children and healthcare workers.”

I suspect that Cooper — like Rose — thinks that he is doing the right thing, but he is going to have to offer more than ad hominems if he is to help the children that he accuses Rose of attacking. What was once a niche psychiatric condition affecting a tiny number of adults, has become a major issue among young people.

Never before have doctors administered cross-sex hormones to young people who were unhappy with their sexed bodies, nor have they removed healthy organs from them. Rose is right, and Cooper is wrong: this is not about Right-wing or the Left-wing issue; this is about children and Vanderbilt needs to be prepared to answer for their actions.

Debbie Hayton is a teacher and a transgender campaigner.