Free Press “Whistleblower” Exposes Private Details of Therapy Sessions

Tamara Pietzke has strong opinions about the medical decisions three of her former transmasc clients made. A social worker in the Puget Sound area of Washington state, she describes providing individual therapy to “hundreds” of clients over a six-year period within a large hospital system, Multicare. Three of those clients were apparently teenage trans youth. In an essay for the Free Press, Pietzke writes that she disagreed, and disagrees, with the gender identity consistently displayed by these three youth over a period of years, and with the medical decisions made by some of their families and medical teams. (If she’s ever treated a trans person of any age whose gender identity she accepted, she doesn’t say.)

One trans boy, who saw Pietzke when he was 13, had been consistent in his gender identity for over a year before becoming a client of hers. Pietzke shares the details of his custody arrangement, his prior history of sexual abuse, his various mental health diagnoses, his history of hospitalization for a suicide attempt, and names the gender clinic he was referred to.

Misgendering him throughout, Pietzke describes this former client in terms dripping with contempt.

It feels necessary to Interject that having greasy-hair and loose-fitting clothes, not to mention staring at the floor during therapy sessions, wouldn’t seem to be terribly unusual for a 13-year-old boy. In Pietzke’s telling, these details become part of a caricature of dysfunction and poor mental health.

At the end of this anecdote the client was assigned to a new therapist. While Pietzke seems to disagree with this decision (she sees it as resulting from a culture of pushing young people towards medical transition), her attitude of open disdain and disgust for this 13-year-old trans boy may also have played a role.

As with all three of the cases Pietzke describes, there is no indication that this boy’s diagnosis of gender dysphoria was wrong or that he was harmed by it in any way.

Pietzke claims to have her clients’ best interests at heart, waxing poetic about the safe-space the therapeutic relationship provides, but she also breaks each client’s confidentiality, exposing the most private information gleaned within that therapeutic context in a news article published for the world to read. Pietske, of course, uses no names, but as any ethical therapist can tell you, personal details of clients are confidential and should never be shared outside of professional supervision and other highly specific situations, none of which are relevant here. Contrary to popular belief, it’s not enough to simply avoid sharing a client’s name: Location, age, and specific personal history can all be identifying.

These are the exact sorts of details Pietzke shares alongside her client’s history of abuse and mental health concerns. They provide a rich and create a compelling picture… one that could easily allow her former clients to recognize themselves, or to be identified by others.

The second client Pietzke describes in even closer detail, going as far as sharing exact quotes from their therapy notes. Pietzke started seeing them in 2019, when they were 16, before their gender exploration began. She was still seeing them as recently as 2023.

Again, Pietzke describes her client’s appearance in harshly negative terms, very similar to those of the story above.

This client, who is now over 18, explored the possibility of testosterone therapy but never went ahead, which Pietzke links to their father’s resistance and refusal to provide consent in 2022. “Five months [after the father’s refusal],” Piezke writes, “[they] swallowed a bottle of pills and [their] mother had to rush [them] to the emergency room.”

In addition to including the most sensitive details of this client’s life, the anecdote is also interesting in the ways it fits, or fails to fit, within the broader narrative of opposition to gender-affirming care. Here, a youth was offered therapy to explore their gender, but not affirmed unquestioningly or provided gender-affirming care. They attempted suicide months after a parent refused affirming-treatments, and do not seem to have accessed any such treatments after turning 18.

We absolutely shouldn’t know these details, but it can hardly escape notice that Pietzke and the non-affirming parent didn’t find a successful alternative to gender-affirming care. The therapy-only approach Pietzke provided did not prevent the suicide attempt or subsequent hospitalization of this nonbinary youth. Would gender-affirming care have led to any better outcome? It’s impossible to know.

The final client is an adult transgender man who Pietzke, again, misgenders throughout. Pietzke describes a 23-year-old who began testosterone five years before, at 17, long before they met. There is no indication he was harmed by or regrets his treatment, though again Pietzke goes out of her way to convey scorn for his appearance, as well as for other aspects of his life.

Here, Pietzke’s complaint is that sometimes transgender men have mental health struggles after transitioning. Although this young man, unlike the non-transitioning nonbinary young person above, does not seem to experience acute crises, the fact of his continued need for mental health treatment is presented as proof that testosterone therapy did him no good. No room is made for the possibility that if he’d been refused treatment things might have gone far worse.

The relentless scorn and disgust heaped on transmasculine young people, the disregard for their privacy and the confidentiality of their therapy sessions, and the lack of self-reflection over which of Pietzke’s three patients seems to have fared the worst combines to create a familiar picture of the way the transmasculine community is treated in such stories. Any possibility that a transmasc might have agency or a right to self-determination, or know what’s best for him, even after passing into adulthood, is off the table. Rather than concern and care, stories like this one communicate only disgust, hatred, and fear. That a therapist would take such an approach to her clients should shock the conscience. These clients deserved better than to have the mosr sensitive details of their lives exposed for Bari Weiss’ clicks.