Emails raise questions about Philadelphia children’s hospital transgender surgeries on minors

November 23, 2022 Catholic News Agency 6
Exterior of Children’s Hospital of Philadelphia. / Shutterstock

Boston, Mass., Nov 23, 2022 / 14:30 pm (CNA).

In a 2017 email, a doctor at the transgender clinic at Children’s Hospital of Philadelphia said she was not aware of any medical studies at the time that supported the irreversible surgeries the clinic had been performing on minors, public records show.

The statement is contained in internal emails, obtained by a private citizen through a public documents request, between Dr. Nadia Dowshen — co-director of the Gender and Sexuality Development Clinic at Children’s Hospital of Philadelphia — and Dr. Rachel Levine. At the time Levine, a biological male who identifies as a transgender female, was Pennsylvania’s physician general. Today Levine serves as assistant secretary for health for the U.S. Department of Health and Human Services.

Critics of so-called “gender-affirming” surgeries and treatments for young people with gender dysphoria were outraged by the disclosure, which one leading pediatrician says suggests that these procedures amount to “a giant experiment on children” that lack a clear understanding on the part of health care professionals and their young patients of the risks and long-term consequences involved.

But in a statement to CNA, Levine said there was “nothing unusual” about the email exchange and maintained that the “medical validity” of these procedures has been “affirmed.”

In one of the emails, Levine asked Dowshen and another co-director of the Gender & Sexuality Development Clinic, Dr. Linda Hawkins, about what Levine called “gender confirmation surgery” for “young people under 18 years of age,” which Levine said could include “top surgery for trans young men and top and bottom surgery for trans young women.”

“Top” and “bottom” surgery are the common parlance among transgender supporters for major, irreversible surgical changes to make a person appear to be a different sex. These include the removal of women’s breasts and the removal and reconstruction of male sexual organs.

Rachel Levine, then a nominee for assistant secretary of Health and Human Services, testifies before the Senate Health, Education, Labor, and Pensions committee in Washington, D.C., on Feb. 25, 2021. Caroline Brehman/AFP via Getty Images
Rachel Levine, then a nominee for assistant secretary of Health and Human Services, testifies before the Senate Health, Education, Labor, and Pensions committee in Washington, D.C., on Feb. 25, 2021. Caroline Brehman/AFP via Getty Images

“Is there any literature to support this protocol?” Levine asked in the May 4, 2017, email. “Please let me know if you have any references.”

The same day, Dowshen responded and wrote: “Hi Rachel, I’m not aware of existing literature but it is certainly happening. I think we’ve had more than 10 patients who have had chest surgery under 18 (as young as 15) and 1 bottom surgery (17).”

Dowshen said she was currently working with colleagues to “get some pre-post data for top surgeries for youth under 18” and suggested that a research assistant could do a literature search to make sure they were “not missing anything,” to which Levine agreed.

“A lot of our youth are being denied coverage for top surgery if under 18,” Dowshen said.

In a statement to CNA Wednesday, Levine downplayed the significance of the email exchange.

“As physician general of the state of Pennsylvania, I worked to remain aware of the latest science in a number of health areas. This allowed me to offer policy recommendations to the governor, to offer strong managerial oversight on behalf of the people of Pennsylvania, and to coordinate effectively with my peers,” Levine said.

“My question about the existing literature on surgeries for minors was asked in the same spirit as many of the other questions I asked in that role — that of making sure I was aware of the latest and most relevant data on an issue of public interest,” Levine said.

“There was nothing unusual about that exchange, and in the years since it occurred, the medical validity of gender affirming care has only been reaffirmed and strengthened,” Levine said. “It is important to note the standards of care for patients include psychological and medical evaluations and, if necessary, treatment and support for the young person and their family. Children who have not yet started puberty do not receive medical treatment — at that age, care focuses on counseling and being mindful of the needs of the young person, their family, and their school.”

CNA also contacted Children’s Hospital of Philadelphia for comment but did not receive a response.

‘A giant experiment on children’

Dr. Quentin Van Meter, president of the American College of Pediatricians — an organization of pediatricians that advocates for children’s health and well-being — criticized the email exchange. He told CNA that it is wrong for any doctor to be doing experimental surgeries when there are no long-term studies to support them.

Van Meter said the result of the doctors doing experimental sex-change surgeries on minors is that “the lives of what will be tens of thousands of children are ruined.”

He said that there are no long-term studies in existence to support sex-change surgeries, whether that be for minors or adults.

“This is a giant experiment on children,” he said. “Medicine cannot be practiced that way.”

Van Meter also took issue with Levine’s response to CNA. 

Van Meter said Levine is wrong about transgender surgeries being “affirmed” by science, saying that “it’s actually been torn to shreds by science.”

“It’s the most embarrassing, non-scientific facade in a very scientific environment,” he said.

The original publicizer of the emails, Twitter user Megan Brock, told CNA she gained access to the emails through a Pennsylvania Right to Know Law public document request.

Children’s Hospital of Philadelphia (CHOP) is the latest hospital to come under fire after media exposés have shown that gender transition surgeries on minors have been taking place at medical institutions across the nation.

In August, Boston Children’s Hospital took heavy criticism when news broke that it was offering gender transition treatments and surgeries for kids. The hospital has since updated its website and says that only 18-year-olds qualify for “phalloplasty or metoidioplasty and for vaginoplasty surgeries.”

The website still says that the hospital will perform “chest surgery” on 15-year-olds.

In October, Vanderbilt University Medical Hospital paused gender transition surgeries on children after an investigation into the hospital was called for by Tennessee Gov. Bill Lee. Vanderbilt’s surgeries on minors — and the lucrative nature of its transgender surgeries in general — were originally exposed by Matt Walsh, an internet host for The Daily Wire.

[…]

Head doctor for Madrid soccer team calls Pope Francis a ‘very stubborn patient’

November 23, 2022 Catholic News Agency 1
Pope Francis in St. Peter’s Square, Sept. 28, 2022 / Pablo Esparza / CNA

Rome Newsroom, Nov 23, 2022 / 07:34 am (CNA).

The Vatican has recruited the head doctor of a Madrid soccer team among a team of specialists to help treat Pope Francis’ knee problem.

José María Villalón, a sports medicine specialist and the head doctor of the Atlético de Madrid soccer team, described the pope as a “very stubborn patient” in a radio interview this week.

The doctor said that Pope Francis is “a very nice and very stubborn patient in the sense that there are surgical procedures that he does not want. We have to offer him more conservative treatments so that he will agree to them.”

Speaking in an interview with COPE, the Spanish bishops’ conference radio station, on November 20, Villalón said that the pope’s issue with his knee had affected some of his other joints as well.

“Sometimes it starts with a joint with osteoarthritis and other joints deteriorate because they are overloaded,” he said. “We are trying to make sure that this does not advance and that things get better.”

Villalón said that he was contacted by both the Apostolic Nunciature in Spain and the Spanish bishops’ conference, who “asked a group of specialists if we could help the pope.”

Pope Francis, who turns 86 next month, has alternated between using a wheelchair and a walking cane since May. 

Earlier this month, the pope told journalists that he was in “a lot of pain” on a flight to Bahrain. Pope Francis has previously canceled public appearances and trips due to his knee trouble, including a scheduled trip to Africa in July.

Villalón said that at first he was “nervous” during his first communication with the pope, but that they bonded because “he likes soccer.” 

In particular, the pope expressed his fondness for Atlético de Madrid’s striker, Ángel Correa, an Argentine soccer player who used to play for the San Lorenzo soccer club in Buenos Aires.

Correa recently joined Argentina’s national soccer team at the FIFA World Cup in Qatar, where Argentina suffered a shocking defeat in a game against Saudi Arabia on Nov. 22.

[…]

Pope Francis gives a shoutout to 2022 FIFA World Cup 

November 23, 2022 Catholic News Agency 2
Pope Francis holds a soccer ball in St. Peter’s Square during the Wednesday general audience on Aug. 26, 2015. L’Osservatore Romano.

Rome Newsroom, Nov 23, 2022 / 03:48 am (CNA).

Pope Francis gave a shoutout to the 2022 FIFA World Cup in Qatar at the end of his weekly audience on Wednesday.

Speaking to a crowd of people from around the world Nov. 23, the pope expressed his hope the international soccer competition would foster fraternity and peace.

“I wish to send my greetings to the players, fans and spectators who are following, from various continents, the World Cup, which is being played in Qatar,” he said in St. Peter’s Square.

“May this important event,” he continued, “be an occasion of encounter and harmony among nations, fostering fraternity and peace among peoples.”

Pope Francis added to his appeal for peace, asking for prayers for an end to all conflicts, especially the conflict in Ukraine.

He highlighted the upcoming anniversary, Nov. 26, of Holodomor, also known as the Terror-Famine or the Great Famine, a man-made famine that took place in Soviet Ukraine from 1932 to 1933.

Pope Francis praying at the general audience on St. Peter's Square. Daniel Ibáñez / CNA
Pope Francis praying at the general audience on St. Peter’s Square. Daniel Ibáñez / CNA

Francis called Holodomor a “terrible genocide” and an “extermination by starvation,” which was artificially caused by Joseph Stalin.

The 2022 FIFA World Cup is being played in the State of Qatar, an emirate on the northeastern coast of the Arabian Peninsula, from Nov. 20 to Dec. 18.

The choice of Qatar as host country for the men’s soccer tournament has been criticized due to conditions in the country, including the situation of Christians.

Bishop Stefan Oster of Passau, who is the current sports commissioner of the German Bishops’ Conference, said in a statement published Nov. 17 that he did not want to give soccer fans “a bad conscience,” even if people were “asking how it came about that Qatar, of all places, was chosen by FIFA as the host country 12 years ago.”

“Non-Islamic religions, including Christianity, which are strongly represented among migrant workers, are granted freedom only to a limited extent,” the German prelate said.

Oster also said the role of women was “set back” and sexual minorities were prosecuted.

[…]

Pope Francis: What is spiritual consolation? The saints explain

November 23, 2022 Catholic News Agency 1
Pope Francis praying at the general audience on St. Peter’s Square / Daniel Ibáñez / CNA

Rome Newsroom, Nov 23, 2022 / 02:37 am (CNA).

Pope Francis used the example of several Catholic saints to explain the concept of spiritual consolation during his weekly audience on Wednesday.

“What is spiritual consolation?” he said Nov. 23. “It is a profound experience of interior joy, consisting in seeing God’s presence in everything. It strengthens faith and hope, and even the ability of doing good.”

The pope continued his teachings on the theme of discernment at his public audience in St. Peter’s Square, where he contrasted last week’s reflection on spiritual desolation with consolation, as experienced by several of the Church’s saints.

“The person who experiences consolation never gives up in the face of difficulties because he or she always experiences a peace that is stronger than any trial,” Francis said. Consolation “is, therefore, a tremendous gift for the spiritual life as well as life in general.”

Pope Francis arriving for the general audience on St. Peter's Square, Nov. 23, 2022. Daniel Ibáñez / CNA
Pope Francis arriving for the general audience on St. Peter’s Square, Nov. 23, 2022. Daniel Ibáñez / CNA

The pope began his explanation by drawing from the Spiritual Exercises of St. Ignatius of Loyola, who wrote about rules for the discernment of spirits.

Francis said “consolation is an interior movement that touches our depths. It is not flashy but soft, delicate, like a drop of water on a sponge.”

He went on to describe consolation as not “a passing euphoria,” nor something which tries to force our will or inhibit our freedom. “Even the suffering caused, for example, by our own sins can become a reason for consolation,” he added.

St. Augustine was consoled when he spoke with his mother, St. Monica, about the beauty of eternal life, the pope said. And St. Francis of Assisi experienced perfect joy despite the difficult situations he had to bear.

“Let’s think of the many saints who were able to do great things not because they thought they were magnificent or capable, but because they had been conquered by the peaceful

sweetness of God’s love,” Pope Francis said. “This is the peace that St. Ignatius discovered in himself with such amazement when he would read the lives of the saints.”

The pope also quoted St. Edith Stein, who is also known by the name she took in religious life: Teresa Benedicta of the Cross.

A year after her baptism as a Christian, following her conversion from Judaism, St. Edith Stein wrote about her interior feeling of peace: “As I abandon myself to this feeling, little by little a new life begins to fill me and — without any pressure on my will — to drive me toward new realizations. This living inpouring seems to spring from an activity and it gives a strength that is not mine and which, without doing me any violence, becomes active in me.”

Francis emphasized the importance of action following consolation.

“Consolation is such peace, but not to sit there enjoying it, no, it gives you peace and draws you to the Lord and sets you on a path to do things, to do good things,” he said.

“In a time of consolation, when we are consoled, we get the desire to do so much good, always. Instead, when there is a time of desolation, we get the urge to close in on ourselves and do nothing. Consolation pushes you forward, in service to others, to society, to people.”

He recalled when St. Therese of the Child Jesus, at the age of 14, visited the Basilica of the Holy Cross of Jerusalem in Rome.

The girl from Lisieux, France, “tried to touch the nail venerated there, one of the nails with which Jesus was crucified,” the pope said. “Therese understood her daring as a transport of love and confidence. Later, she wrote, ‘I truly was too audacious. But the Lord sees the depths of our hearts. He knows my intention was pure […] I acted with him as a child who believes everything is permissible and who considers the Father’s treasures their own.’”

This, Pope Francis said, is a “splendid description of spiritual consolation.”

“We can feel a sense of tenderness toward God that makes us audacious in our desire to participate in his own life, to do what is pleasing to him because we feel familiar with him, we feel that his house is our house, we feel welcome, loved, restored,” he added.

Consolation gives one the strength to continue in the face of difficulty, Francis said, pointing to St. Therese’s request to the pope to enter the Carmelite order even though she was too young.

According to the pope, St. Bernard teaches us about consolation and discernment, especially the pitfall of “false consolations.”

“If an authentic consolation is like a drop on a sponge, is soft and intimate, its imitations are noisier and flashier, like straw fires, lacking substance, leading us to close in on ourselves and not to take care of others,” Francis said. This is where discernment comes in.

“False consolation can become a danger if we seek it obsessively as an end in itself, forgetting the Lord,” he pointed out. “As St. Bernard would say, this is like seeking the consolations of God rather than the God of consolations.”

There is a risk of treating our relationship with God in a childish way, he concluded, “of reducing it to an object that we use and consume, losing the most beautiful gift which is God himself.”

[…]

Catholic publisher pulls book on princess saints after illustrator says it was her idea

November 22, 2022 Catholic News Agency 1
An illustration by Fabiola Garza (left) and the cover of Ascension Press’ book, “Catholic Princess Saint Stories, Volume I.” / Images courtesy of Fabiola Garza and Ascension Press

Washington, D.C. Newsroom, Nov 22, 2022 / 17:30 pm (CNA).

A major Catholic publishing house is pulling a book on Catholic princess saints days after an illustrator took to social media saying that the company had published the book based on her ideas and illustrations. 

Ascension, a publisher of Catholic books and digital media, including Father Mike Schmitz’s “Bible in a Year” podcast, emailed a statement to CNA Tuesday announcing that it would no longer be selling the book, “Catholic Princess Saint Stories, Volume I,” which was released earlier this month.

Fabiola Garza, the illustrator who is at odds with Ascension, posted on social media that she had spent months talking with the publisher about plans for a book on princess saints. When those talks did not lead to a contract, she decided to shop her idea around, and eventually signed a contract with Word on Fire to publish a book on princess saints. 

Garza, who works as an illustrator for the Disney Design Group in Orlando, Florida, published an account of her dealings with Ascension on Instagram, Facebook, and Twitter following the publication of the publisher’s book on princess saints.

PLEASE SHARE Hold Ascension accountable,” Garza wrote. “MY EXPERIENCE WITH ASCENSION HAS BEEN THE MOST AWFUL OF MY CAREER. I like many artists cannot afford a lawyer, and my hope is that by making this known no other Catholic creative will have to go through this,” she wrote.

In her social media post, Garza said that in 2019 she was approached by an editor at Ascension about a book on saints who were princesses.

“Ascension contacted me because he heard me speaking on Leah Darrow’s Podcast about my idea to do a PRINCESS SAINTS BOOK,” she wrote, adding that she signed a mutual non-disclosure agreement with the publisher.

“In the end, I decided not to sign with ASCENSION,” she wrote in the social media post.

In its statement, Ascension said it had decided to pull the book after Garza went public with her story.

“An illustrator Ascension worked with several years ago recently posted on social media about her experience working with us. We strongly disagree with the allegations in her post and we are confident that our approach was consistent with the law and industry standards,” the statement said. 

“Nevertheless, as a leader in Catholic publishing, Ascension aspires to hold itself to a higher standard and we will therefore be voluntarily discontinuing sales of the book in question,” the statement said.

‘Different creative visions’

In its statement Ascension said that after Garza told the publisher that she had decided not to work with the company it went ahead with plans to come out with a book about princess saints by a different author and illustrator. Ascension maintains that the book it published was different from the one it had discussed with Garza.

Over the eight months Ascension had discussed the project Garza had provided one illustration of St. Joan of Arc, and when it went with a new illustrator, it chose different saints to highlight, Ascension said.

“As we each had different creative visions for the project, we continued our vision with a new illustrator. We chose different saints for our book alongside a different storytelling style and different illustrations,” Ascension said.

“For background on the project, we provided the new illustrator with the single image of St. Joan of Arc that Fabiola had shared publicly. Our new illustrator went on to create illustrations for 80 pages of stories about St. Margaret of Scotland, St. Bathild of France, and St. Jadwiga of Poland,” read the statement.

Garza posted photos of her illustration of St. Joan of Arc alongside an illustration from Ascension’s book, noting the similarities between the two. Both illustrations feature blue ribbons and banners surrounding the drawings of the saints.

In its statement, Ascension denied any wrongdoing but said it regretted showing the new illustrator Garza’s original drawing.

“Any similarities between Fabiola’s St. Joan of Arc drawing and our illustrator’s depiction of St. Margaret of Scotland (such as a banner, ribbons, a crown, and a blue garment) are incidental and common in portraits of princesses in works by other artists,” the company said.

“Nevertheless, we understand and respect that Fabiola is deeply invested in her artwork, and we acknowledge that a better course of action would have been to use other public sources rather than her drawing as a reference for our illustrator.”

Garza posted emails she had exchanged with Ascension. In their correspondence, she says that on Oct. 7, 2020, she decided to discontinue talks on the book because no contract had been signed.  

Garza wrote to Ascension explaining her reason for looking for another publisher. 

She said she had asked for “some details on contract and compensation before I continued to work.” She said she was told “that we hadn’t got to the contract stage because we didn’t yet have a complete sample chapter.” She said she was told that the firm was “contemplating bringing in another author entirely, who I would have no ability to vet, interview, or apparently control in any way.”

In an email to CNA, Ascension said that it never signed a contract in part because Garza “wanted to be both the author and illustrator.”

“This creative difference was one of the key reasons that Fabiola and Ascension never signed a contract together,” Ascension said in its statement.

Garza told CNA that she decided to break off talks with the publisher because she began to get nervous when no contract was proposed.

After emailing Ascension earlier this month to express her disappointment that it had published a book on princess saints, the publishing house offered to compensate her for the time spent on the project.

Garza then took to social media because, she told CNA, she could not afford to get legal help. She explained that she felt that by going public she could help other “Catholic creatives” facing similar situations.

“So many people have emailed me with similar stories, and nobody has ever talked about it publicly. I could see that I’m in a position to do this, and perhaps I owe it to the community to start a conversation on it,” she said. “But if everything has always been treated in a very hush hush way, I was like, ‘There’s never going to be any change.’”

Upon being informed by CNA that Ascension had pulled its book, Garza said she was relieved.

“Oh, my gosh, I’m gonna cry,” she said after reading Ascension’s statement. “I know that it’s not a direct apology. I mean, it’s corporate speak, you know. I understand that they have to protect themselves as much as possible. I would have loved a direct apology,” she said. 

“But even the fact that because of people helping this is able to happen without having to go to court is amazing, because that sounded awful. Yeah, that sounded awful,” Garza said. Later, Garza thanked Ascension for pulling the book.

Her book with Word on Fire is written but still being edited and won’t be published for over a year, adding that she works full-time.

[…]