Establishing a ‘Pronouns to Surgery Pipeline’ in Wisconsin

A Closer Look at Shady Practices
Woman Surgeon
Photo: Artur Tumasjan/Unsplash

Following a recent report from Philadelphia showing how a gender clinic is influencing teachers in nearby school districts, some Wisconsin parents are speaking out against an even more egregious case of “gender affirming” doctors funneling future patients their way. These doctors directly assisted the district to push controversial sex education curriculum onto divided communities.

This August, medical professionals providing “gender-affirming care” at Milwaukee Children’s hospital were instrumental in the development and approval of major revisions to the sex ed curriculum at nearby Wauwatosa, WI school district. Several different individuals associated with the clinic influenced the board either directly as a member or on an external committee that worked on the revisions since October of 2021.

Dr. Jacquelyn Smith, who played an influential role on the external committee, is a co-founder of the Milwaukee Children’s Gender Clinic and a member of the World Professional Association for Transgender Health (WPATH), whose recently updated “Standards of Care” lowered the minumum recommended ages to 14 for hormone treatments and 15 for sexual reassignment surgeries, before ultimately scrapping minimums altogether over malpractice concerns

Jennifer Hoag, Ph.D., a recent addition to the Wauwatosa school board, has been a pediatric psychologist at Children’s Wisconsin for 13 years and was a staunch advocate for the changes. Dr. Michelle Pickett, who also served on the external committee, is a Pediatric Emergency Medicine Physician at Children’s, and a clinical researcher in adolescent reproductive health care.

Also on the external committee was Shannon Malnory-Sibernagel, an “Annual Giving Officer” for Planned Parenthood of Wisconsin. Planned Parenthood offers “gender-affirming hormone therapy” to children as young as 16.

Parents reported that the changes to the previous “Human Growth and Development” curriculum now include the teaching of concepts based in gender identity theory to the youngest learners. They claim these major modifications, informed by the National Sex Education Standards, were pushed through over summer vacation without adequate time or opportunity for feedback. 

A review of the new curriculum confirms these reports. “Gender Identity & Expression” lessons to Kindergarteners and 1st graders teach them to “understand gender role stereotypes and define gender,” by hearing aloud the LGBTQ+ books “Sparkle Boy“, “Not all Princess Dress in Pink,” and “I Love My Purse.” In other K-2 lessons, children are walked through anatomically explicit drawings indicating the locations of the “vulva,” “anus,” “butt,” and “penis.”

Most lessons are sourced from the “3Rs” curriculum created by Advocates for Youth, as well as “Amaze, Jr.” videos created by

By Grade 3, children receive explicit instruction on gender identity distinct from sex, sexual orientation, pronouns and pronoun use, and the lesson “Pink, Blue, and Purple” introduces the concept of “Gender fluidity”. These are all designed to meet the learning standard of “Recognizing differences exist between sex assigned at birth and gender identity.” Fourth graders go on to learn the concept of “gender expansiveness” and how to “think outside the gender box“.

In Grade 6, students watch videos (again provided by Amaze) that distinguish between gender identity and gender expression. These lessons are in alignment with the following standard: “Define sexual identity and explain a range of identities related to sexual orientation (e.g. heterosexual, bisexual, lesbian, gay, queer, twospirit, asexual, pansexual).” Also introduced are the differences between oral sex, vaginal sex, and anal sex.

By Seventh grade, students are expected not only to internalize gender ideology concepts and accept them as fact, but also to act as advocates for it, under the guise of “helping others feel safe and respected.” The lesson “Be the Change You Want to See in the World” includes additional progressive causes that traditionally have had little to do with “Human Growth and Development.” 

At the end of the lesson, students are expected to “develop an action plan for their school to promote dignity and respect for everyone (e.g. race, ethnicity, socioeconomic status, differing abilities, immigration status, family configuration)

By high school, students are expected to have fully adopted the idea of “gender identity” as “a person’s internal sense of being male, female, or sometimes something else altogether,” and that questioning anyone who claims to be transgendered is harmful.

How does such a radical curriculum manage to be imposed in such short order, on a community described by one long-time resident as “purple, but mostly culturally conservative?”

The changes were adopted after ten months of collaboration between an internal committee of school teachers, admins, and counselors, and an external committee composed of experts, “caregivers,” students, and medical professionals like Smith, Pickett, and Malnory-Sibernagel. 

An initial survey illustrates how much more aggressive the external committee members were in terms of introducing gender ideology to the youngest learners.

Leigh Ann Fraley, the board member representative on the external committee, confirmed that the expert advice had an influence on her thinking: “To hear medical professionals say, ‘Here’s why we need to use these words at that age’ pushed me, given how I grew up, because those were definitely not used when I was that age.” Smith also admitted that the external committee “leaned heavily on the expertise we had in the group.”

Sex reassignment surgeries can generate substantial revenue for clinics such as the one in Vanderbildt, Tennessee. Not only is the “sex reassignment” surgery market $2.1 billion per year and projected to grow at 11% per year, gender-affirming care creates “patients for life” who can be counted on to act as subscribers requiring follow-ups, indefinite hormone injections and potential corrective surgeries. According to Dr. Nadia Dowshen, co-founder of the Children’s Hospital of Philadelphia gender clinic hormone treatments can cost $40,000 per year

The United States continues to go full-bore with gender affirmation, even as countries like Finland, Sweden, the U.K. and France back away from the practice.

Bringing in medical professionals at “gender-affirming” hospitals to consult on sex ed curriculum in schools presents a tremendous conflict of interest, particularly when they influence a board to introduce gender ideology to the youngest learners. 

What happened in Wauwatosa, Wisconsin offers a case study of how medical “experts” can succeed in establishing a pronouns-to-surgery pipeline.

Paul Rossi
Paul Rossi is a high school mathematics teacher, tutor, and writer. His essay, "I Refuse to Stand by While My Students are Indoctrinated," was published in April on Bari Weiss's "Common Sense" Substack. He's currently writing a book documenting the impact on K-12 education of the growing DEI consultant industry. You can find him on Twitter @pauldrossi.

The views expressed in this article are the opinion of the author and do not necessarily reflect those of the Chalkboard Review team.

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