vanderbilt university medical center

Read Vanderbilt hospital’s letter to lawmakers on transgender clinic

Reps. Jason Zachary (R-Knoxville), center, and Scott Cepicki (R-Culleaoka), right attend a briefing in Nashville on March 16, 2020. (Erik Schelzig, Tennessee Journal)

Vanderbilt University Medical Center says no minors have received genital procedures at its transgender clinic and that all patients were at least 16 years old and had parental consent. The hospital told Rep. Jason Zachary (R-Knoxville) it will pause gender affirmation surgery on patients under age 18 while it seeks advice from local and national experts, a process that could take several months.

“We understand this issue is likely to be taken up by the General Assembly in its next legislative session,” Deputy CEO C. Wright Pinson wrote.

Here is the letter:

Representative Zachary,

I write in response to your letter of September 28, 2022 on behalf of Vanderbilt University Medical Center (“VUMC”) and its Board of Directors regarding the concerns about surgical care provided through the transgender clinic for those under age 18.

VUMC began its Transgender Health Clinic in 2018 because transgender individuals are at high risk for mental and physical health issues, and have been consistently underserved by our nation’s healthcare systems. Among those patients under 18 receiving transgender care, an average of 5 per year have received gender-affirming surgical procedures. Contrary to some media reports, all were at least 16 years of age, none have received genital procedures and parental consent to these surgeries was obtained in all cases. None of these surgeries have been paid for by state or federal funds; the revenues from this limited number of surgeries represent an immaterial percentage of VUMC’s net operating revenue.

VUMC approaches its responsibility to care for patients by following the most widely recognized national and international standards of care, while at all times doing so in accordance with state and federal laws. Our clinical teams provide transgender care that is informed by the professional practice standards and guidance established by leading medical specialty societies, such as the Endocrine Society and the World Professional Association of Transgender Health (WPATH). We fully comply with the requirements of legislation passed by the General Assembly in 2021, now codified at Tenn. Code Ann. §63-1-169, which prohibits providing hormone therapy to prepuberal children.

VUMC serves as the employment home for over 40,000 people and our people express their views in many forums, including hundreds of open conferences on our campus facilities each year. Comments from videos posted on social media that are obtained at these kinds of events should not be construed as statements of VUMC policy. VUMC’s policies and practices allow employees to request an accommodation to be excused from participating in surgeries or procedures they believe are morally objectionable. We do not condone discrimination against employees who choose to request accommodations.

You have asked that VUMC halt permanent gender affirmation surgeries being performed on minor children. On September 6, 2022, WPATH published a new version of its recommendations to health care professionals for treatment of transgender persons, known as SOC-8. In light of these new recommendations, and as part of completing our internal clinical review of the SOC-8 guidance in patients under 18, we will be seeking advice from local and national clinical experts. We are pausing gender affirmation surgeries on patients under age 18 while we complete this review, which may take several months.

In addition, we understand this issue is likely to be taken up by the General Assembly in its next legislative session. As always, we will assure that VUMC’s programs comply with any new requirements which may be established as a part of Tennessee law.

I trust this letter has been responsive to the concerns which have been surfaced to you and your colleagues.

Sincerely yours,

/signed/

C. Wright Pinson, MBA, MD

Deputy CEO and Chief Health System Officer

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