Transgender Center Staffers at Washington University of St. Louis and St. Louis Children’s Hospital Advise Parkway Schools Not to Tell Parents About Child Chest Binder Use


Washington University of St. Louis Transgender Center and St. Louis Children’s Hospital Transgender Center staffers advised Parkway Schools officials to not require school employees to notify parents if their child uses a chest binder or identifies as the opposite sex at school, according to emails uncovered as part of a public records request. 

A Parkway Schools counselor inquired about students’ chest binder usage in an email to the program manager at St. Louis Children’s Hospital Transgender Center, who also worked in the division of adolescent medicine at the Washington University of St. Louis School of Medicine. Biological women who wish to appear more masculine use chest binders—a tight, sports-bra style undergarment—to flatten and conceal their breasts.  

“We are seeing an increase in students wanting to use chest binders.” The counselor said in an email. “…There were also times when the student’s parents did not know that their student was using a binder and would not have approved of it but the school counselor was made aware.” 

The counselor asked the program manager a series of questions: “Do we have an obligation to tell parents if we learn the student is using a binder?” and “It seems that it would be beneficial for others in the building (nurse, PE teacher, music teacher) to know if a student is using a binder for safety reasons. Should we have a procedure for telling others on a need-to-know basis? (Again for safety).” 

In subsequent emails, the counselor admitted that “we had a few instances where a student passed out when wearing one that was too tight (when participating in PE activities or singing and out of breath… Just wanted to put that into context).” 

The counselor continued: “I know our staff wouldn’t necessarily want to tell the parents but were curious if they HAD to if it becomes a health issue?” 

The program manager replied to the counselor’s first email, saying “it’s not technically an issue of parental consent for a minor to have access to a binder. However, parents can make it an issue…” 

In a reply to the counselor’s second email, the program manager included a response from one of the co-directors of the St. Louis Children’s Hospital Transgender Center, who also works in adolescent medicine at the Transgender Center at the Washington University of St. Louis.

“‘I would actually decline any requirements for disclosure by students or from school to parents. I would, however, provide general education to school nurses, teachers, school counselors so that they are aware this may be something they encounter. In some circumstances a private conversation between PE teacher and student may be appropriate (Or between student and school counselor).’”   

The program manager shared a “Safer Binding” document that said binding “may help reduce dysphoria, ease body discomfort and help affirm one’s gender.” It includes links to websites where one can access a binder, as well as a “binder sizing chart” and “binder safety tips.” 

Another email included in the results of the public records request included a link to a YouTube video of the program manager training Parkway Schools officials on LGBTQ+ issues in August 2021.  

During a discussion on parental notification, the program manager states:  “…There is a lot of ethical debate about this… cause like, parents are the parents, they’re in charge, on the other hand the kids are with all of you 6 to 8 hours a day. I believe that the best practice would be to respect that kid’s gender identity to the best that you can, without informing the parents, throughout the school day as much as you can… Working with the student, okay we can’t change your name on all the things because we have to tell your parents… so we can’t do that, but here’s where we can change your name.” 

Parents Defending Education uncovered the January 2022 email exchange as part of a public records request. A separate public records request with Francis Howell Public Schools found that St. Louis Children’s Hospital Transgender Center employees hosted training for Francis Howell Public School employees and invited district employees to “Community Providers” Meetings. However, there was no indication that the gender clinic employees had explicitly advised the district to exclude parents from conversations about their child’s gender identity. 

Several Washington University Transgender Center Doctors and employees staff The Children’s Hospital of St. Louis Transgender Center. The St. Louis Children’s Hospital of St. Louis Transgender Center co-director also works at The SPOT, a youth clinic out of Jennings High School.