Complaint filed after writer and "whistleblower" publish details of young trans patient

In 2018, Jesse Singal wrote a controversial cover story in The Atlantic, "When a Child Says She's Trans." Focused on teens who de-transitioned, it appealed to skeptics and critics of gender-affirming care, but offered little acknowledgement to the majority of young transfolk who are happy to have affirmed their genders. Needless to say, many trans people were not pleased with Singal's article. They were, as is often the case in mainstream journalism, cut out of their own stories.

Since then, Singal's committed himself to such "rational skeptic" punditry, with a substack, a podcast and social media presence snarled up in the topic of transgender life. Typically, this means cherry-picking the evidence from scientific papers and countering critics with a stream of academese and anecdote.

Flash forward to this year. In February 2023, Bari Weiss's The Free Press published a first-person account from a former caseworker at a clinic for trans youth in St. Louis, who claimed she was drawing attention to the "morally and medically appalling" practices at said clinic. As is often the case with Weiss's writing, it was an emotional appeal, light on facts, relying on cryptic allusions to worst-case-scenario fears. The author of the piece, Jamie Reed, claims to be a whistleblower and urged the state to end these supposedly horrid practices. The lawyer representing her is both an elected official and a representative of a transphobic "child protection" organization.

Reed's essay initial attracted a lot of attention, and indeed, rushed the Missouri state legislature into action despite its lack of verifiable facts. The literati of "Trans Skeptical" Pundits ate it up. The St. Louis Dispatch published a follow-up that poked holes in her narrative and presented the perspectives of parents and their children who had overwhelmingly positive experiences with the clinic.

Enter Singal, who took up Reed's public defense. In response to the reporting from the St. Louis Dispatch, Singal contacted Reed and published a lengthy account refuting pretty much everything the Dispatch reported.

In Singal's response, he shared screenshots from an Excel document that Reed had given him as proof to support her claims. It seems that Reed had kept her own, private records about the trans youth at the clinic where she worked, whom she thought were being mistreated or misled by the medical staff (despite not being a medical professional herself). Reed also provided Singal with more specific patient details of the kind that were otherwise absent from her initial account.

About this time Singal tweeted looking for someone to speak to about HIPAA concerns. Not long after he deleted his Twitter account, for reasons he writes are unrelated.

But now, according to the St. Louis Dispatch, both Reed and Singal have been named in a public complaint about potential HIPAA violations — filed by parents who felt that their child, and thus their family's safety, was exposed through the details that Reed (and later Singal) shared publicly. As the Dispatch notes:

Whistleblowers, like Reed, are covered by an exception to the privacy rule in which they are allowed to disclose protected health information to certain oversight agencies and attorneys if they believe professional standards have been violated.

Journalists are not among that group.

Reed's Free Press narrative alone raised "significant concerns," [Matthew Cortland, a health care lawyer and activist based in Washington who filed the complaint] said. "When Singal wrote about things Reed told him and had given to him — either what Singal has published is not true or Reed has violated the privacy rule."

HIPAA breaches often result in a corrective plan or technical assistance, but fines can also be levied. Criminal violations, which are rare, can incur fees or jail time; they involve knowingly and wrongfully obtaining and disclosing protected health information.

Parents of patients at St. Louis transgender center fear privacy breaches, file complaints [Colleen Schrappen / St. Louis Dispatch]