Doctors were wearing pins sporting the transgender flag. Nurses were asking children, most with no history of gender dysphoria, for their preferred pronouns, which were entered into an electronic record system and documented on white boards outside their rooms. More patients were on puberty blockers and cross-sex hormones, especially young girls. And the top-ranked hospital was telling staff that people could change gender based on their "mood," according to slides from a mandatory training reviewed by the Washington Free Beacon.

The training, which was offered as recently as January, included a primer on "zi/hir" pronouns and used a "gender unicorn" to illustrate the "spectrum" of "other gender(s)."