During a February 14 presentation on gender surgery, a doctor associated with Intermountain Healthcare commented that he has performed top surgery on minors. Primary Children’s Hospital (PCH), a part of the Intermountain Healthcare (Intermountain) system, also appears to be limiting information about its adolescent gender clinic on its website, referring to it only as the GeMS (gender management and support) clinic.
GeMS at Primary Children’s Hospital
The GeMS clinic website can only be accessed through University of Utah Health, another affiliated healthcare organization in Utah to PCH. According to the website, under the “when can I have surgery” section, most surgeons want you to be “18 years old” before top or bottom “gender-affirming surgery.”
During 2019, however, according to internet archives, no such 18 year recommendation is listed.
Nicholas Kim and Project ECHO
Nicholas Kim, a doctor at Intermountain- but not directly associated with GeMS- made a presentation on gender surgeries over a live streamed, Febraury 14 meeting as part of Intermountain’s Project Echo (Extension for Community Healthcare Outcomes). He said, “I have done top surgery on minors… In the world of plastic surgery, we’re quite comfortable with breast surgery on minors because breast reductions are well, you know, that literature has been around for a long time.”
[READ: Bill Banning Gender Surgeries on Minors Passes, Chloe Cole Addresses the Damage of Gender Transition]
Kim said in the stream that he trained in Belgium for gender surgery, and from pictures he showed in the livestream, appears to have trained with Stan Monstrey. This is supported by this article as well as a second. Monstrey “is one of the world’s foremost Gender Surgeons” in Belgium and has “served as the president of WPATH” (the World Professional Association for Transgender Health) according to transhealthcare.org. His bio goes on, saying, “gender-affirming surgeries are performed weekly” at the hospital where he works.
Streams from the project are openly available to the public when shown live. This stream and others have been uploaded onto the Intermountain Project ECHO YouTube channel.
Primary Children’s website has little to no info about GeMS doctors, University of Utah Health affiliation provides more information
The GeMS clinic, which is located at the Primary Children’s Eccles Outpatient Services building in Salt Lake City, is only referred to in 3 subsections of PCH’s main website. It is found under “Medical Records,” “Endocrinology,” and “Gynecology.” The only section which directly links to the official GeMS University of Utah website is gynecology. No other information about GeMS is on the PCH website.
Two doctors who are directly associated with the GeMS clinic include Nichole Mihalopoulos and Adam Dell.
Mihalopoulos’ profile on the University of Utah Health website explains she does transgender healthcare. However, her PCH affiliated bio only reads, “My clinical research is focused on preventing cardiovascular disease risk factors in adolescents and young adults.”
Adam Dell, likewise, has little to no info found on the Primary Children’s website.
They both, along with the Medical Director of Transgender Health of University of Utah Health, Cori Agarwal, have contributed to the book, “Providing Affirming Care to Transgender and Gender-Diverse Youth.”
Agarwal contributed to chapter 4, titled “Gender Affirmation: Surgical.” At one point, the chapter explains that the “rate of revision surgery for chest reconstruction ranges considerably in the literature from 8% to 40%.” According to the passage, “unplanned revisions include scar revisions, removal of residual excess skin, and dog ear excisions.”
In addition, Agarwal has a presentation video about top surgery on her University of Utah page. She said in the presentation that “there are 15 year olds, 16, 17 year olds, who are very mature and understand what the surgery is about.” She indicated that some under 18 should be able to get top surgery; although parental consent is required, she said it “is just a legal issue and hopefully isn’t a barrier.”
Agarwal, although not directly affiliated with the PCH GeMS clinic, has an affiliation with PCH as seen on her Intermountain profile.
Is there a GEMS trend?
GeMS at PCH also shares the same acronym as an annual “GEMS” conference called the “Gender Education DeMystification Symposium.” The website is not available, but it has been going on for several years. The symposium took place in Salt Lake City in 2018 according to internet archives as well as a newsletter from All Kinds of Therapy. The location for the conference was a 10 minute drive from the University of Utah and the Primary Children’s Eccles Outpatient Services building.
The symposium included a session available for students who were able to attend. However, when the Chronicle contacted the organization, a spokesman said the “GEMS conference does not have any connections with the GeMS clinic” at PCH.
Another clinic in California called the “Gender-Affirming Medicine & Sexual Health Clinic (GeMS)” uses the acronym as well. The clinic is part of the San Ysidro Health organization.
GeMS is also what Boston Children’s Hospital (BCH) uses on their website for their adolescent transgender clinic. BCH has been reported on by Libs of Tiktok for putting out videos where they claimed that children “will often know that they are transgender from the moment that they have any ability to express themselves.”
Boston Children’s Hospital (@BostonChildrens) says that toddlers can know they are transgender. Some signs are refusing a haircut or playing with the opposite gender toys. pic.twitter.com/bEoWt1wI1l— Libs of TikTok (@libsoftiktok) August 14, 2022
The parties mentioned in this story have been contacted for comments and it will be updated as is needed.
Written by: Thomas Stevenson, Jacob Christensen, Thomas Olsen, and Eva Terry
Contributors at The Cougar Chronicle
The Cougar Chronicle is an independent student-run newspaper and is not affiliated with Brigham Young University or The Church of Jesus Christ of Latter-day Saints