A Washington therapist has revealed how she was told to “give up” all her medical training and provide “gender-affirming care” to an abused, autistic and suicidal 13-year-old.
Tamara Pietzke, 36, left the profession after she was reprimanded by her superiors for not immediately complying with children's requests for puberty blockers and gender reassignment surgeries.
Some of the children who wanted to be transgender had a variety of problems – including physical and mental abuse, high levels of anxiety, depression and suicidal thoughts.
Still, she was stopped from quickly signing papers to give them life-changing drugs — and when she raised her concerns, she was accused of being prejudiced against trans children, The Free Press reports.
Tamara Pietzke, 36, is pictured with her own children. She quit her job after agonizing and frustrating instances in which she was reprimanded by her superiors for failing to promptly comply with children's requests for puberty blockers and gender reassignment surgeries
A mother of three, Pietzke decided to become a therapist in her 20s and graduated from the University of Washington in 2012 with a master's degree in social work.
Pietzke has worked with hundreds of clients in Puget Sound, Washington, over the past decade — but she quit her job in January because she was told to “drop out” of her training if a young person suffered from gender dysphoria.
Instead of properly assessing her, she was told to simply approve her medical transition.
The therapist wrote in The Free Press: “I got the message from my superiors that I should give up all my training when a young person I was with expressed discomfort with their gender – the diagnostic term is gender dysphoria. “
“Regardless of the patient’s history or other mental illness that might complicate the situation, I should simply confirm that the patient is transgender and even authorize the start of a medical transition.”
Pietzke admitted she was afraid to speak out — “but that fear pales in comparison to my strong belief that we can no longer medically treat youth and potentially cause them irreversible harm.”
She explained that one of her clients, a 13-year-old girl, had a range of mental health issues. She was abused by her bipolar mother, sexually abused by her cousin, her mother's boyfriend, and a classmate.
The child suffered from depression, post-traumatic stress disorder, anxiety, intermittent explosive disorder and autism – and had previously been hospitalized for discussing suicide.
Pietzke began working with her as a therapist after she expressed ideas about gender dysphoria — and the Mary Bridge Children's Gender Health Clinic in Washington needed a therapist's approval before giving the 13-year-old period-suppressing medication and testosterone.
The therapist recalled in the Free Press that the autistic child could not communicate properly with her and began showing Pietzke “extremely sadistic and graphic pornographic videos on her cell phone” during her first visit.
She said the troubled girl was “hyper fixated” on the porn videos and said they were one of the only genres available to her while growing up with her abusive mother.
The girl, who grew up sucking on pacifiers and watching Teletubbies, remembered how her mother almost killed her sister. She had also just been expelled from school for threatening to blow up the building.
Pictured: Mary Bridge Children's Gender Health Clinic in Washington
Pietzke said the girl always seemed depressed in her therapy sessions – and never spoke to her about her gender dysphoria.
She wrote: “When I asked her what she thought about an upcoming appointment at the gender clinic, she told me she didn't know she had one.”
Pietzke felt she had made some progress in getting the child to open up in the first three sessions, but when she scheduled the fourth appointment with her guardian, her mother's boyfriend, they didn't want it.
Instead, they asked Pietzke to write her a letter of recommendation for cross-gender hormone treatment. That is, at the age of 13 she should start taking testosterone. A letter like this from me begins the process of medical transition for a patient.
The therapist immediately thought this was a bad idea because of the child's deep, varied problems. She said: “It appeared to be malpractice to abruptly start her on a medical sex change procedure that could quickly lead to permanent changes.”
But Pietzke was reprimanded by her superiors for her concerns. Her supervisor even took the child out of her care and gave her a new therapist.
The therapist was accused of having “personal prejudices against trans children” because she only asked questions and was cautious about taking life-changing medication.
She said, “I emailed a program manager in my department at MultiCare and outlined my concerns.” She wrote back that my client's trauma history had no bearing on whether or not she should receive hormone treatment.
Pietzke has worked with hundreds of clients in Puget Sound, Washington, over the past decade – but in January she quit her job because she was told by her superiors to “just confirm” the gender of young trans children. She was told to “drop out” of her training if a young person was suffering from gender dysphoria – and instead of properly assessing them, she was supposed to approve their medical transition
The email said: “There is no valid, evidence-based, peer-reviewed research to indicate that gender dysphoria is due to anything other than gender (including trauma, autism, other mental illnesses, etc.)”
“There is a risk that a client's mental health will be harmed if access to gender-affirming care is restricted.” Check [your] Personal beliefs and prejudices against trans children.
Months earlier, Pietzke said she had to attend a mandatory gender-affirming care training in which she asked the director “why 70 to 80 percent of female adolescents diagnosed with gender dysphoria were previously diagnosed with a mental illness.”
She was once again reprimanded by her colleagues for spreading “misinformation about trans children” and “exhibiting hostility toward trans people in direct violation of the Hippocratic Oath.”
Pietzke had another 16-year-old girl as a client who began saying during the pandemic she no longer felt like a girl. She also had a variety of mental health issues.
The girl began using the pronouns “they/he” and identified as pansexual and a gender-neutral name. Her father refused to let her take testosterone, so she didn't.
All the Mary Bridge Children's Gender Health Clinic could do in the meantime was give her contraceptives to stop her period due to her “menstrual dysphoria.”
By early 2023, the girl had decided that she was no longer gender neutral – but instead identified herself as an “injured male.” She was “xenogender,” a concept that “transcends human understanding of gender.”
She wanted to start wearing ears and a tail.
The therapist asked her colleagues if there had ever been a time when such free affirmation was not necessary – and the answer was no.
A colleague said, “It sounds like it's not 'broken' so let's not try to 'fix' it.”
“If someone told me that they use a litter box instead of a toilet and they are happy with it and it is a part of their life that brings them fulfillment, then great!”
Pietzke wrote in the Free Press: “I'm speaking out because nothing will change if people like me – who know the risks of medicalizing young people in trouble – don't speak out.”
“I really want to help my patients. And I think if I don't say anything, I will have betrayed them.'