The Murky Business of Transgender Medicine

by JD Rucker, Discern Report:


The “gender-affirming care” business has always had an aura of madness around it. Wielding the authority of white coats and prestigious degrees, doctors have convinced large swaths of the public that some children are “born in the wrong body.” The solution? Stop puberty, prescribe cross-sex hormones, and then, with the stroke of a knife, remove body parts—most commonly breasts, less frequently genitalia.

These medical practices use scientific rhetoric to affirm what is, at bottom, an ideological program. And gender activists have been successful enough at capturing the legitimizing institutions—medical societies, regulatory bodies, and teaching hospitals—to repel most challenges to the burgeoning child sex-change industry.


Now, though, the consensus appears to be shifting. European governments have backed away from many of these dubious procedures. In England, the Cass Review has raised grave questions about the scientific evidence behind “gender-affirming care.” In the United States, the public has turned decisively against the use […]

I have reported on one of these programs, the pediatric gender clinic at Texas Children’s Hospital. Last year, I published an investigation demonstrating that, though it had promised to shut down its program, Texas Children’s had continued to administer hormone drugs to children as young as 11. Following the story, the state attorney general launched an investigation, and state legislators passed a bill, SB 14, prohibiting all transgender medical interventions on minors.

While these scandals caught the headlines, another story involving the same institution was brewing in the background: medical fraud.

According to a new whistleblower, doctors at Texas Children’s Hospital were willing to falsify medical records and break the law to keep practicing “gender-affirming care.” Caught in the wave of ideological fervor, two of the hospital’s prominent physicians, Richard Ogden Roberts and David Paul, cut corners and, according to the whistleblower, committed Medicaid fraud to secure funds for the hospital’s child sex-change program.

(Texas Children’s Hospital, Roberts, and Paul did not respond to a request for comment.)

This is a story of fanaticism, hubris, and the murky business of transgender medicine. It would have remained hidden, except for the courage of two people inside the hospital, a surgeon named Eithan Haim and a nurse who has now decided to come forward. Both have risked much to alert the public to the barbarism that is occurring at the nation’s largest, and arguably most prestigious, children’s hospital.

Some years ago, Vanessa Sivadge thought she had it made, having just accepted a position as a registered nurse at Texas Children’s Hospital. She had wanted to be a nurse since high school and felt a sense of joy in helping children.

But her feelings toward Texas Children’s didn’t last. Beginning in 2021, Sivadge saw a dramatic rise in the number of “transgender children” treated at the hospital. These patients struggled with various problems: depression, anxiety, addiction, suicide attempts, physical abuse, and discomfort with puberty. But rather than deal with these underlying psychological conditions, Sivadge says, doctors at the hospital would diagnose them with “gender dysphoria” and assign them to a regimen of “gender-affirming care.”

The practice made Sivadge recoil. “In the cardiac clinic, we were taking sick kids and making them better,” she says. “In the transgender clinic, it was the opposite. We were harming these kids.”

Then, the following year, she breathed a sigh of relief. Under pressure from the state attorney general, Ken Paxton, Texas Children’s CEO Mark Wallace said that he was shutting down the child gender clinic. But it wasn’t true. Mere days later, it had secretly reopened for business.

And business was booming. Doctors, including Roberts, Paul, and Kristy Rialon, were managing dozens of pediatric sex-change cases, performing surgeries, blocking puberty, implanting hormone devices, and making specialty referrals. They were motivated not only by ideology, but by hope for prestige: they were saviors of the oppressed, the vanguard of gender medicine.

Sivadge soon had seen enough. She read my investigative report exposing Texas Children’s sex-change program, which relied on testimony from Haim, and reached out to share her own observations.

“I work very closely with this provider, Dr. Richard Roberts. I’ve been in the room with him when he speaks with these patients,” she told me in an interview. “Dr. Roberts is extremely encouraging of their transition and will essentially do whatever he can to make sure that they are happy, at least externally happy. Because I am absolutely certain that they are not internally happy. He is very accommodating. He does whatever they want. Essentially, there is no critical analysis of the process.”

In Sivadge’s view, Roberts and other providers were manipulating patients into accepting “gender-affirming care.” When parents objected, the doctors bulldozed them, she claims. Some families, she believed, feared that the hospital would call Child Protective Services if they dissented.

Then, two months after I spoke with her for that story, Sivadge called me in a panic. The FBI had sent two special agents, Paul Nixon and David McBride, to her home. The agents knocked on the door, asked her about “some of the things that have been going on at [her] work lately,” and then asked to enter her home. She was terrified. (The FBI declined to comment.)

The agents told Sivadge that she was a “person of interest” in an investigation targeting the whistleblower who had exposed the child sex-change program. They told her that the whistleblower had broken federal privacy laws. “They threatened me,” Sivadge said. “They promised they would make life difficult for me if I was trying to protect the leaker. They said I was ‘not safe’ at work and claimed that someone at my workplace had given my name to the FBI.”

The authorities—the FBI, the hospital, and, as Sivadge would later discover, federal prosecutors—were all circling the story. Both the Department of Justice and the hospital leadership were ideologically committed to “transgender medicine.” They had been embarrassed by the investigation that had exposed their actions, and they were looking for revenge.

Things went quiet for a while afterward. Sivadge resumed her work as a nurse, and the FBI did not reappear.

Texas Children’s Hospital continued its sex-change program but focused instead on patients who had reached the legal age of 18. Sivadge saw the same terrible medical regimen being prescribed for these young adults: testosterone for girls, estrogen for boys, and referrals for specialty services. While Roberts and Paul had stopped providing sex-change procedures for minors, the gender clinic still overflowed with “transgender” teens.

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