‘They Failed Him’—Cross-Sex Hormones Killed Her Gender-Confused Son

DAILY CALLER NEWS FOUNDATION—Dominick Dunlap began taking female hormones at age 26 after just one visit to a gender clinic to have a “more feminine appearance.” Less than two years later, he was dead.

Despite having a family history of blood clotting disorders, a gender clinic in Pittsburgh, Pennsylvania, put Dominick on estrogen after just one visit, his mother, Natalie Dunlap, told the Daily Caller News Foundation.

“My son was crying out for help, and the people he reached out to failed him. They failed him due to an agenda that is destroying the lives and families of too many,” Natalie said.

The Beaver County coroner’s report listed the cause of death as pulmonary embolism, noting he was on hormonal therapy. When given the report, Natalie was told the embolism seemed to be caused by the cross-sex hormone therapy.

“[The coroner] said that there was no other reason to indicate that it wasn’t from the hormone therapy,” Natalie told the DCNF.

Blood clots are a well-established risk of estrogen therapy in women, particularly for those with clotting disorders. The impacts of estrogen therapy on men is not widely understood, evidence suggests the risk of developing blood clots from estrogen use may be higher when used as part of a transgender medical regimen.

According to the National Library of Medicine, a 2018 medical review titled “Cardiovascular health in transgender people” found men taking estrogen had a “significantly increased risk for venous thromboembolism.”

“There is strong evidence that estrogen therapy for trans women increases their risk for venous thromboembolism over 5 fold,” the review states.

This finding was echoed in a scientific statement published in 2021 by the American Heart Association which noted a consistent elevated risk of thrombosis for “transgender” men taking estrogen.

“Data consistently demonstrate elevated risk for venous thromboembolism among people who are transgender receiving estrogen-based hormone therapy,” the statement said.

For Dominick’s family, the risks of blood clots associated with cross-sex hormone therapy appear to have led to unthinkable tragedy.

Sudden Gender Confusion 

Natalie describes Dominick as an easygoing, funny, and smart kid, who had a special talent for quickly solving a Rubik’s Cube.

“His claim to fame was he could solve a Rubik’s Cube in 35 seconds. Probably did it faster than that, like, behind his back, with his eyes shut. That was his big thing,” Natalie told the DCNF.

Dominick had successfully begun his life as an independent young adult and was working as a machine operator. He had even bought his own home. He was loved and cherished by his family.

During the Covid-19 lock downs, Dominick became increasingly isolated and began spending a lot of time online. Natalie believes he may have been on the autism spectrum, which made it more difficult for him to make friends.

“It was difficult for Dominick to make friends. He was lonely and isolated at home,” Natalie told the DCNF.

Dominick spent a lot of time online playing role-playing video games. One day in a chat group someone asked for his name and pronouns. After spending several months engaged with this online chat group, in the spring of 2021 Dominick began painting his fingernails and told his mother that he was transgender.

“He said they talked about it for a couple months, and he decided that he was transgender,” Natalie told the DCNF.

“I said to him, that’s not really how that works. You don’t just decide within three months, when you’re 26 years old, that you’re transgender.”

Dominick had never shown any signs of being gender dysphoric and had previously expressed aspirations of becoming a father.

“There was no reason for me to think that there was ever a gender confusion for him,” said Natalie.

Natalie tried to help and support Dominick, who had previously battled depression, suggesting he see a therapist.

Dominick continued joining family activities and Natalie hoped the idea that he was transgender was just a phase he’d work through.

In May 2022, more than a year after he had initially claimed to be transgender, Dominick told Natalie he was starting feminizing hormone therapy after just one visit to the Central Outreach Wellness Center in Pittsburgh.

The medical records from his initial appointment at the clinic, which the DCNF reviewed, state Dominick had “seen a therapist for depression in the past, but has not addressed gender identity in therapy.” The clinic provided referrals to transgender affirming therapists if Dominick felt therapy was needed.

However, Natalie told the DCNF that Dominick started taking cross-sex hormones’ days after the initial appointment, without attending therapy to address his gender confusion.

“There was no therapy involved,” said Natalie. “It was one appointment and then estrogen was going to be started.”

The DCNF reached out to the Central Outreach Wellness Center about its policy on giving feminizing hormones to patients with a family history of a clotting disorder but did not receive a response.

Family History of Blood Clotting Disorders

Dominick’s medical records from the Central Outreach Wellness Center, obtained by the DCNF, show that in May 2022 he was put on “feminizing hormone therapy,” a pharmaceutical regimen intended to make males look more feminine by raising their estrogen levels while reducing the impact of testosterone in their bodies. Major medical organizations, including the American Academy of Pediatrics and the Endocrine Society, advise doctors to prescribe gender-dysphoric patients with large doses of their lesser sex hormone.

Estrogen is not approved by the Food and Drug Administration (FDA) for the treatment of gender dysphoria and is used off-label by gender medical practitioners.

Endocrinologist Dr. Michael Laidlaw, who has testified on the harms of gender medicine in legal cases across the country, told the DCNF that estrogen use in males “for the treatment of gender dysphoria is experimental because of the very high doses used.”

“There have been no FDA trials for safety or efficacy at these high doses for males with gender dysphoria. It is also experimental as used in combination with spironolactone,” Laidlaw told the DCNF.

Estrogen is the primary female sex hormone that takes three major forms during a woman’s life: estrone, estradiol, and estriol. Estradiol, the most potent form of estrogen, is prevalent during a woman’s reproductive years. The maximum recommended oral estradiol dosage for women wanting to relieve menopause symptoms is 2 mg a day. The FDA notes that a “minimal effective dose” should be used for longer maintenance therapy when treating menopause.

“The lowest dose and regimen that will control symptoms should be chosen and medication should be discontinued as promptly as possible,” states the FDA.

Higher doses of estradiol are only recommended by the FDA when palliatively treating cancer.  For example, 1 to 2 mg of estradiol three times a day is recommended for the palliative care of patients with androgen-dependent carcinoma of the prostate.

Medical records from the Pittsburgh gender clinic show Dominick was initially put on a daily 2 mg dose of oral estradiol, a synthetic version of estrogen, which was later increased to 8 mg a day—a dose higher than what is recommended for the palliative treatment of prostate cancer.

Dominick was also started on a 100 mg of Spironolactone, an anti-androgen drug that decreases the effect of testosterone. He was put on Progesterone, another female sex hormone, in February 2023.

Knowing their family history of blood clotting disorders, Natalie said she told Dominick he should not take the medication.

“I have a blood clotting disorder which is elevated with estrogen,” said Natalie, who had developed a blood clot when she was pregnant with Dominick.

“You can’t take this medication because of blood clots,” Natalie recalls telling her son.

Dominick started the estrogen therapy despite Natalie’s advice.

“It was quite sad because it really made no sense on why he was doing this, other than I personally think he was just looking for a group of people,” Natalie told the DCNF.

“He didn’t really have connections of friends and when you start putting the pieces together it’s kind of like ‘Oh, he checked that box. He checked that box.’ I feel like the battle, along with the possibility of him being on the spectrum, was just this perfect storm for people to suck him in and take advantage of him.”

‘Increased Risk’

The World Professional Association for Transgender Health (WPATH) acknowledged the potential risks of feminizing hormone therapy in their clinical gender medicine guidance called the Standards of Care version 8 (SOC 8), which is routinely used by medical associations, governments, and insurance companies in the U.S. and abroad to create policy driven by gender ideology.

In the SOC 8, WPATH acknowledges the risks of thrombosis associated with estrogen therapy, noting those with a family history of blood clots might benefit from being on an anticoagulant and that there is “limited data to guide treatment decisions.”

“[Transgender and gender diverse] people seeking feminizing treatment with a history of thromboembolic events, such as deep vein thrombosis and pulmonary embolism, should undergo evaluation and treatment prior to the initiation of hormone therapy. This is because estrogen therapy is strongly associated with an increased risk of thromboembolism, a potentially life-threatening complication,” the SOC 8 says.

“In patients with nonmodifiable risk factors, such as a known history of thrombophilia, a past history of thrombosis, or a strong family history of thromboembolism, treatment with transdermal estrogen concomitant with anticoagulants may decrease the risk of thromboembolism. However, there are limited data to guide treatment decisions,” states the SOC 8.

Dominick’s medical records do not indicate he had been on any anticoagulants.

Trying ‘To Feel Better’

A note in Dominick’s medical record written in February 2023 states his goal for taking feminizing hormones was “[t]o feel better about myself.”

The feminizing therapy do not appear to have relieved Dominick’s insecurities.

Over the 18 months he was on feminizing hormone therapy, Dominick’s depression medication was increased, he gained almost 30 pounds, and was struggling in his personal life.

“There was some depression in there, which [to me, was like] you would think would be a red flag,” said Natalie.

“But that’s not the case. They just kept upping the progression of estrogen.”

Dominick’s medical records show he visited the Pittsburgh gender clinic in late August 2023, four months before his death, with a complaint of increased migraines and “severe, sharp pressure” behind his left eye. Migraines can indicate an increased risk of having a thrombotic event.

Notes from the medical record state a clinician from the gender clinic discussed with Dominick the “increased risk of VTE [venous thromboembolism] associated with estradiol use with migraines” as well as the “urgent” signs and symptoms that would require a visit to the emergency department. Notes from his August appointment, however, do not mention his family history of blood clots. Blood work taken during that appointment shows Dominick’s estradiol levels were extremely high, nearly 11 times higher than his baseline level and almost 450% higher than the normal range for an adult male. A month later, his estradiol dosage was increased from 6 mg to 8 mg a day.

Throughout his gender confusion, Natalie continued to love and support her son while affirming his male identity. The Central Outreach Wellness Center referred to Dominick as “Victoria” in medical records but Natalie would not affirm his gender confusion by using his female name.

“Our kind of compromise was, which is sad, I wasn’t going to call him by his new name, I just wouldn’t say a name at all we would just talk,” said Natalie.

“I just basically said to him I love you with all of my heart. There is nothing I wouldn’t do for you but I can’t lie to you,” she said.

In October 2023, Dominick decided he would move back home with Natalie in the new year. Natalie saw it as a chance to get Dominick the help he needed and get off of hormone therapy.

That chance never materialized.

‘Dominick Deserved Better’

Ten days before his death, Dominick visited the gender clinic again. This time with intense chest pains and shortness of breath, both symptoms of a pulmonary embolism. His medical records show that he told the clinic about his family history of a clotting disorders.

The medical records state: “Reports a sharp pain to the right thoracic/subscapular region that occurs when taking a deep breath for the past 1-2 weeks. Seems to radiate ‘straight through to the front of chest.’ Rates pain ‘3/10’ now. Seems to worsen as the day progresses. Last night it was most constant rates ‘8/10.’ Tried Ibuprofen but didn’t seem to be effective. Does report mild dyspnea, feels ‘out of breath a lost easier,’ but does note some weight gain.”

“[Patient] does report both parents have a history of blood clots, but [patient] is unsure of origin.”

The clinic notes they discussed the risks of a pulmonary embolism associated with estradiol and recommended Dominick urgently visit the Emergency Department (ER) for imaging and a d-dimer test, which is used to detect a blood clot. The medical records state Dominick declined to go to the ER via emergency transport. Natalie told the DCNF she was unaware of him having gone to the ER that evening. His medical records noted his plan was to “Continue feminizing hormone therapy” and remain on his high dose of estrogen.

Dominick died alone in his home on the evening of Dec. 6, 2023. The coroners’ report notes the primary cause of death as “Pulmonary Embolism,” noting this finding was supported by the presence of a “Blood clot occluding the right main bronchi” and the patient being “On hormonal treatment.”

“He passed away by himself at home which was, is very hard for all of us,” said Natalie.

Dominick’s body was discovered by his father and grandfather, Natalie’s dad, who tried to revive him.

“He [Dominick] had already passed away, and my dad, of course, just starts trying to resuscitate him, which is the saddest thing. It was just so sad. He was just so devastated,” Natalie said.

“He just kept saying ‘Natalie, I kept trying. I kept trying. I kept trying,’ which makes me feel so sad.”

Natalie and her family were left with a void that will never be filled.

“There will be no Mother’s Day cards, no seat filled … at his sisters’ weddings, or phone calls to even say hello. There will be no surprise reunion video for me, like those seen on social media, of my son walking through the door where I get to run and put my arms around him crying happily. We are forced to move on without him and deal with the emptiness and loss of his smile, sense of humor, laugh, and amazing hugs. I will not allow them to take away the wonderful memories that we all have of Dominick while he was with us,” Natalie told the DCNF.

“Dominick deserved better. He needed the people that he met during that time in his life to take the time to learn more about him and to treat him with the proper intentions.”

Originally published by the Daily Caller News Foundation

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