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Requiring “Affirming” Care

Written by Penna Dexter February 16 - 2024
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Washington state has some of the nation’s most progressive laws regarding teen gender transitions.

This became a problem for Puget Sound therapist Tamara Pietzke. She was employed for six years by MultiCare, one of Washington’s largest hospital systems. In a piece for The Free Press, she expresses her growing concern at being required to “approve all teen gender transitions.”

“I was getting the message from my supervisors that when a young person I was seeing expressed discomfort with their gender—the diagnostic term is gender dysphoria—I should throw out all my training. No matter the patient’s history or other mental health conditions that could be complicating the situation, I was simply to affirm that the patient was transgender, and even approve the start of a medical transition.”

This, she writes, “challenges the very fundamentals of what therapy is supposed to provide.”

Ms. Pietzke goes on to describe three cases that heightened her alarm at this protocol and ultimately resulted in her resignation—a risky move for a single mom of three children under six. Each case involved prior mental health diagnoses, often autism, family dysfunction, and even abuse. One teenaged female patient began identifying as a “wounded male dog.”

In each case, Ms. Pietzke was told she must refer the patient to a gender health clinic to begin hormone treatment which normally continues for life.

When she questioned this, she was accused of “spreading disinformation." She was removed from cases and eventually left her job so she could speak freely. She writes, “Nothing will change unless people like me—who know the risks of medicalizing troubled young people—blow the whistle.”

Last week the American College of Pediatricians released a statement based on its review of over 60 studies of adolescents with gender dysphoria. The authors conclude that these so-called “affirming” interventions destroy healthy bodies but provide no long-term benefit to psychological well-being.

A timely vindication.penna's vp small

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September 16, 2026
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