ST LOUIS — One day after Missouri Attorney General Andrew Bailey announced an investigation into complaints that a St. Louis transgender clinic is rushing to give children gender-affirming care without informed consent, his office said it was asking the clinic to put a moratorium on prescribing certain medications to new patients.

In a letter to Trish Lollo, President of St. Louis Children’s Hospital and Dr. Andrew Martin, Chancellor of Washington University, Bailey said the Transgender Center at St. Louis Children’s Hospital should stop prescribing puberty blockers or cross-sex hormones to new patients while state and federal investigations play out. 

“We are hopeful that the leaders of these institutions will choose to do the right thing for the safety of Missouri’s children, as we work to root out any possibility of children being harmed by predatory adults with a radical social agenda,” Bailey said in a news release Friday,’’

The state’s social services department and U.S. Sen. Josh Hawley are also investigating claims made by a former case manager, who claimed in an affidavit that the center mainly provides gender-affirming care but does little to address mental health issues that patients also faced.

Jamie Reed, who said she worked at the clinic from 2018 through November 2022, claimed one minor received a mastectomy and months later wanted the procedure to be undone. She said one doctor prescribed a medication to enlarge breasts that also caused liver damage.

Reed said she saw "healthcare providers lie to the public and to parents of patients about the treatment, or lack of treatment, and the effects of treatment provided to children."

“I witnessed staff at the center provide puberty blockers and cross-sex hormones to children without complete informed parental consent and without an appropriate or accurate assessment of the needs of the child," Reed wrote. "I witnessed children experience shocking injuries from the medication the center prescribed.”

Reed also claimed that physicians often referred patients to on-site therapists who would recommend gender-affirming treatments to children after spending one or two hours with them. She said doctors would “bully” parents into giving permission for treatment by saying, “You can either have a living son or a dead daughter.”

Studies have found some children and teens resort to self-mutilation to try to change their anatomy. Research has shown that transgender youth and adults are prone to stress, depression and suicidal behavior when forced to live as the sex they were assigned at birth.

Missouri LGBTQ advocacy group PROMO spokesman Robert Fischer in a statement said the organization has heard “dozens upon dozens of positive personal stories from transgender and gender non-conforming youth and families about the ethic of care they’ve received” at the center.

“We’ve also sat in rooms with over 30 parents who have shared stories about how their children thrived when they received interdisciplinary, holistic care from a team of providers at the Center,” Fischer said. “We have no insight into these allegations and accusations from one person.”

Washington University released a statement Thursday said it was also investigating the allegations.

“We are alarmed by the allegations reported in the article published by The Free Press describing practices and behaviors the author says she witnessed while employed at the university’s Transgender Center. We are taking this matter very seriously and have already begun the process of looking into the situation to ascertain the facts. As always, our highest priority is the health and well-being of our patients. We are committed to providing compassionate, family-centered care to all of our patients and we hold our medical practitioners to the highest professional and ethical standards.”

Transgender medical treatment for children and teens is increasingly under attack in many states, labeled child abuse and subject to criminalizing bans. But it has been available in the United States for more than a decade and is endorsed by major medical associations.

Many clinics use treatment plans pioneered in Amsterdam 30 years ago, according to a recent review in the British Psych Bulletin. Since 2005, the number of youth referred to gender clinics has increased as much as tenfold in the U.S., U.K, Canada and Finland, the review said.

Several Missouri lawmakers this year filed bills to ban gender-affirming treatment for transgender youth, and Senate President Pro Tem Caleb Rowden said that's a priority for Senate Republicans.

Bailey’s Friday letter asked for a response by Feb. 14.