The Watchmaker’s Daughter sets out to tell what The Hiding Place left out, and it succeeds. Loftis intersperses accounts familiar to The Hiding Place readers with details of Allied and Nazi military tactics and espionage attempts as well as wartime experiences of Anne Frank and Audrey Hepburn, who both lived in the Netherlands at the time. Loftis includes Corrie’s post-war travel, as she told her family’s story in more than 60 countries, and a final ­section that tells what happened to ­several people during or after the war.

Millions of people have read the Ten Boom family story of courage and faithfulness during World War II as shared in the 1971 bestseller The Hiding Place. Corrie ten Boom, along with her father and sister, coordinated underground work during the Nazi occupation of the Netherlands, hiding Jews and other underground workers in their home. Larry Loftis’ The Watchmaker’s Daughter (William Morrow 2023) pulls together information from letters, journals, and books written by Ten Boom family members or their friends to tell about their underground activities and their faith even after Nazis arrested them.
The Watchmaker’s Daughter sets out to tell what The Hiding Place left out, and it succeeds.
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Some critics describe the kind of treatment offered at places like the Transgender Center where I worked as a kind of national experiment. But that’s wrong. Experiments are supposed to be carefully designed. Hypotheses are supposed to be tested ethically. The doctors I worked alongside at the Transgender Center said frequently about the treatment of our patients: “We are building the plane while we are flying it.” No one should be a passenger on that kind of aircraft.

I am a 42-year-old St. Louis native, a queer woman, and politically to the left of Bernie Sanders. My worldview has deeply shaped my career. I have spent my professional life providing counseling to vulnerable populations: children in foster care, sexual minorities, the poor.
For almost four years, I worked at The Washington University School of Medicine Division of Infectious Diseases with teens and young adults who were HIV positive. Many of them were trans or otherwise gender nonconforming, and I could relate: Through childhood and adolescence, I did a lot of gender questioning myself. I’m now married to a transman, and together we are raising my two biological children from a previous marriage and three foster children we hope to adopt.
All that led me to a job in 2018 as a case manager at The Washington University Transgender Center at St. Louis Children’s Hospital, which had been established a year earlier.
The center’s working assumption was that the earlier you treat kids with gender dysphoria, the more anguish you can prevent later on. This premise was shared by the center’s doctors and therapists. Given their expertise, I assumed that abundant evidence backed this consensus.
During the four years I worked at the clinic as a case manager—I was responsible for patient intake and oversight—around a thousand distressed young people came through our doors. The majority of them received hormone prescriptions that can have life-altering consequences—including sterility.
I left the clinic in November of last year because I could no longer participate in what was happening there. By the time I departed, I was certain that the way the American medical system is treating these patients is the opposite of the promise we make to “do no harm.” Instead, we are permanently harming the vulnerable patients in our care.
Today I am speaking out. I am doing so knowing how toxic the public conversation is around this highly contentious issue—and the ways that my testimony might be misused. I am doing so knowing that I am putting myself at serious personal and professional risk.
Almost everyone in my life advised me to keep my head down. But I cannot in good conscience do so. Because what is happening to scores of children is far more important than my comfort. And what is happening to them is morally and medically appalling.
The Floodgates Open
Soon after my arrival at the Transgender Center, I was struck by the lack of formal protocols for treatment. The center’s physician co-directors were essentially the sole authority.
At first, the patient population was tipped toward what used to be the “traditional” instance of a child with gender dysphoria: a boy, often quite young, who wanted to present as—who wanted to be—a girl.
Until 2015 or so, a very small number of these boys comprised the population of pediatric gender dysphoria cases. Then, across the Western world, there began to be a dramatic increase in a new population: Teenage girls, many with no previous history of gender distress, suddenly declared they were transgender and demanded immediate treatment with testosterone.
I certainly saw this at the center. One of my jobs was to do intake for new patients and their families. When I started there were probably 10 such calls a month. When I left there were 50, and about 70 percent of the new patients were girls. Sometimes clusters of girls arrived from the same high school.
This concerned me, but didn’t feel I was in the position to sound some kind of alarm back then. There was a team of about eight of us, and only one other person brought up the kinds of questions I had. Anyone who raised doubts ran the risk of being called a transphobe.
The girls who came to us had many comorbidities: depression, anxiety, ADHD, eating disorders, obesity. Many were diagnosed with autism, or had autism-like symptoms. A report last year on a British pediatric transgender center found that about one-third of the patients referred there were on the autism spectrum.
Frequently, our patients declared they had disorders that no one believed they had. We had patients who said they had Tourette syndrome (but they didn’t); that they had tic disorders (but they didn’t); that they had multiple personalities (but they didn’t).
The doctors privately recognized these false self-diagnoses as a manifestation of social contagion. They even acknowledged that suicide has an element of social contagion. But when I said the clusters of girls streaming into our service looked as if their gender issues might be a manifestation of social contagion, the doctors said gender identity reflected something innate.
To begin transitioning, the girls needed a letter of support from a therapist—usually one we recommended—who they had to see only once or twice for the green light. To make it more efficient for the therapists, we offered them a template for how to write a letter in support of transition. The next stop was a single visit to the endocrinologist for a testosterone prescription.
That’s all it took.
When a female takes testosterone, the profound and permanent effects of the hormone can be seen in a matter of months. Voices drop, beards sprout, body fat is redistributed. Sexual interest explodes, aggression increases, and mood can be unpredictable. Our patients were told about some side effects, including sterility. But after working at the center, I came to believe that teenagers are simply not capable of fully grasping what it means to make the decision to become infertile while still a minor.
Side Effects
Many encounters with patients emphasized to me how little these young people understood the profound impacts changing gender would have on their bodies and minds. But the center downplayed the negative consequences, and emphasized the need for transition. As the center’s website said, “Left untreated, gender dysphoria has any number of consequences, from self-harm to suicide. But when you take away the gender dysphoria by allowing a child to be who he or she is, we’re noticing that goes away. The studies we have show these kids often wind up functioning psychosocially as well as or better than their peers.”
There are no reliable studies showing this. Indeed, the experiences of many of the center’s patients prove how false these assertions are.
Here’s an example. On Friday, May 1, 2020, a colleague emailed me about a 15-year-old male patient: “Oh dear. I am concerned that [the patient] does not understand what Bicalutamide does.” I responded: “I don’t think that we start anything honestly right now.”
Bicalutamide is a medication used to treat metastatic prostate cancer, and one of its side effects is that it feminizes the bodies of men who take it, including the appearance of breasts. The center prescribed this cancer drug as a puberty blocker and feminizing agent for boys. As with most cancer drugs, bicalutamide has a long list of side effects, and this patient experienced one of them: liver toxicity. He was sent to another unit of the hospital for evaluation and immediately taken off the drug. Afterward, his mother sent an electronic message to the Transgender Center saying that we were lucky her family was not the type to sue.
How little patients understood what they were getting into was illustrated by a call we received at the center in 2020 from a 17-year-old biological female patient who was on testosterone. She said she was bleeding from the vagina. In less than an hour she had soaked through an extra heavy pad, her jeans, and a towel she had wrapped around her waist. The nurse at the center told her to go to the emergency room right away.
We found out later this girl had had intercourse, and because testosterone thins the vaginal tissues, her vaginal canal had ripped open. She had to be sedated and given surgery to repair the damage. She wasn’t the only vaginal laceration case we heard about.
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Written by Carl R. Trueman |
Wednesday, January 17, 2024
Lutheranism has much to offer the church catholic at this moment in time. Like all confessional Christianity, it is anchored in realities that transcend the political particularities of our day; and it also reminds us of the church’s true task and realistic expectations in a time such as this.

This week I had the privilege of speaking at a seminar for the Collegium Fellows of Doxology, a group of Lutheran Church–Missouri Synod pastors committed to spiritual care and counsel. There are serious theological differences between the Lutheran tradition and my own Reformed tradition, most obviously in the area of the Lord’s Supper. But there is an ethos that binds confessional Protestants together in a world where Catholics are in frequent turmoil over the actions of the present pope and where evangelicals are tearing themselves apart over attitudes to the current political malaise that has enveloped American public life.
Toward the end of the seminar, one pastor asked what I thought confessional Lutheranism could offer to the church catholic at this moment in time. My answer was threefold.
First, confessional Protestantism in general, when faithful to its defining documents, focuses the minds of believers upon the great truths of the Christian faith that take no account of the vicissitudes of the age. God, Trinity, Fall, Incarnation, redemption, and grace: These are truths that feed the mind and the soul, regardless of which side wins and which side loses elections. And they are the central concerns of the great confessional documents of Protestantism. Whether the Book of Concord for Lutherans; the Westminster Standards for Presbyterians; the Three Forms of Unity for the Reformed; or the Thirty-Nine Articles, the Book of Common Prayer, and the Homilies for Anglicans—all speak of the eternal weight of glory that is to come and thereby relativize the slings and arrows of this world as so many light, momentary afflictions. The implications of this are liturgical: The church goes about its ordinary work of proclaiming Christ in Word and Sacrament even as earthly regimes come and go. Thus it was in the time of Nero. So it is today.
I went on to say that confessional Lutheranism, more specifically, has two particularly important contributions for the church catholic today. First, the Lutheran distinction (echoing Augustine), between the heavenly kingdom and the earthly kingdom. This distinction is vital, especially in a time of deep political division and seductive political temptation. Much has been made of Christian nationalism as an “existential threat” to the nation and to democracy. Setting aside the rather fluid definitions of Christian nationalism, even in its most extreme form it is unlikely to pose a significant threat to society at large. But it may well prove to be a threat in the much smaller world of our congregations and denominations, where a confusion between church and world and between the power of the Word and the power of the sword would devastate the gospel.
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