Emails reveal school district sought out advice from St. Louis Children’s Hospital transgender center regarding multiple fifth graders transitioning at the same time


In 2021, a staff member at Parkway Schools reached out to the Washington University Transgender Center at St. Louis Children’s Hospital for advice on how to manage fifth grade students coming out as transgender. The email states that “the short story is that one of the students in the 5th-grade class is coming out as Trans. She has told several of her friends and now several of them are also saying they are Trans.”

A response from the transgender center states “Depending on who you ask, this is common, but also in varied ways. There are schools of thought that have ‘documented’ this as an issue of significance, in that a student coming out as transgender, becomes a ‘contagion.’ This language isn’t affirming and the few studies on phenomenon are, in my personal and professional opinion, invalid.”

The staff member continues by explaining that it is “normal in that when one person realizes who they are and shares it, others realize they are similar.”

In a final exchange, the center staff member shares comments from the Transgender Center’s co-director Dr. Garwood, writing that the “best we can do is affirm, validate and allow for the exploration, if in a few weeks or months, a student wants to go by their legal name and pronouns that match their sex assigned at birth, no harm was really done in affirming them before.”

Dr. Sarah Garwood, co-director of the Transgender Center, is also the medical director in charge of the The Supporting Positive Opportunities with Teens (SPOT) clinic inside Jennings Senior High School.

The SPOT clinic states that its vision is for youth to partner with the community for “social justice and health.”

A now deleted directory from the SPOT clinic website references the Washington University School of Medicine Pediatric Transgender Center as a place for “Health and Medical Care.” The description states that it offers “Medical transition care including hormone therapy and puberty blockers, psychology, psychiatry, gynecology, menstrual management, HIV/STI testing, PrEP, case management, surgical transition referrals, voice therapy referrals, legal transition assistance; accepting new patients under age 21.”

The Washington University Transgender Center at St. Louis Children’s Hospital was founded in August of 2017. According to its website, it is “designed to be a safe and affirming space where kids and young adults can express who they are.” It states that it provides services such as “determining the best transitioning plan for each person,” “puberty blockers,” “hormone therapy” and “menstrual suppression.”

A Transgender Center PowerPoint from 2018 states that the center was “strengthening relationship [sic] with WU surgeons, streamlining referrals” and outlines the “Numbers of New and Return Patients” since the center’s opening.

The center states in a post that the care it provides is “based in part on the age and pubertal status at which children or adolescents are seen initially.”

It continues:

“For patients who have started puberty, pubertal blockers exist as an option to suppress undesired, irreversible secondary sexual characteristics” and “patients between the ages of 14 and 16 may begin taking cross-sex (gender-affirming) hormones that help make their physical body match their inner gender.”