In December 2022, a then-17-year-old named Fred announced that he identified as a transgender woman. Fred, with a history of developmental issues, ADHD, impulse control disorder, and autism, had never displayed any signs of gender confusion prior to his announcement. Because Fred enjoyed typically “manly” interests like power tools, guns, and metalworking, the revelation caught his family off guard.
But his declaration followed a similar revelation by Fred’s best friend, who also has autism. Concerned that Fred was succumbing to peer pressure but wanting to support their son, Fred’s parents sought guidance from the Gender and Autism Program at Children’s National Hospital, the only clinic in the country specializing in autistic youth.
However, the clinic had a year-long waitlist, and Fred, now nearly 18, couldn’t wait. In July, while his parents were away, Fred went to Planned Parenthood, where he received a prescription for estrogen following just one 30-minute consultation without their knowledge or consent.
As waitlists grow at gender clinics, many young people are turning to Planned Parenthood to expedite the process, making it challenging to maintain rigorous oversight in gender-affirming care.
Planned Parenthood, the provider of on-demand abortions, now prescribes easy access to cross-hormone medications for legal adults without the customary prerequisites. Potential candidates don’t need a recommendation, a psychological evaluation, blood work, or a formal gender dysphoria diagnosis. Instead of a comprehensive assessment, these facilities provide a brief consultation focusing only on the potential side effects of the prescribed drugs. These side effects can range from mood swings and male pattern baldness to permanent infertility. After a half-hour office visit, patients leave with prescriptions in hand.
The lack of comprehensive assessments has raised concerns about the potential for individuals to make irreversible decisions without a full understanding of the implications. This approach alarms even advocates of gender medicine, who argue that some 18-year-olds, particularly those with special needs, may not be capable of giving informed consent without extensive counseling.
Prominent figures within the field of gender medicine have expressed growing concerns about Planned Parenthood’s role in providing cross-sex hormone therapy. Laura Edwards-Leeper, a co-founder of the nation’s first pediatric gender clinic at Boston Children’s Hospital, voiced her apprehensions, despite being a staunch supporter of Planned Parenthood. She highlighted the organization’s inadequacy in managing the complexities of gender-affirming care and pointed out instances where her own patients had received hormones from Planned Parenthood prior to seeking her assessment.
Erica Anderson, a former president of the US Professional Association for Transgender Health, added to these concerns. She disclosed that several of her patients, to whom she had advised caution regarding immediate transitioning, had resorted to Planned Parenthood instead.
This trend is reflective of Planned Parenthood’s growing prominence in the realm of gender-affirming care. Planned Parenthood is now one of the United States’ largest providers of cross-sex hormones. Several affiliates have reported a significant surge in “gender-affirming care visits.” Notably, demand for hormones appears to be outpacing that for abortion services in some branches.
Critics have underlined Planned Parenthood’s lack of readiness to handle complex cases, especially those involving individuals like Fred. Its reliance on nurse practitioners and limited psychiatric expertise, they argue, puts such patients at risk. These clinicians are not adequately trained to assess factors like developmental trajectory, the role of social media, or childhood trauma in their patients seeking gender transition.
Additionally, critics caution, the presence of autism, which often co-occurs with gender dysphoria, warrants a more cautious approach to hormone therapy, as per multiple sets of clinical guidelines. These guidelines emphasize that adolescents with autism may face difficulties in comprehending the long-term risks and implications of gender-related medical interventions, making the consent process more complex in this population.
Edwards-Leeper emphasizes that removing all safeguards on gender-affirming care at the age of 18 is concerning, even for individuals without special needs. She points out that the brain continues to develop until at least age 25, with the prefrontal cortex, responsible for long-term planning and decision-making, being the slowest to mature.
In the face of the life-altering and potentially devastating repercussions associated with cross-hormone therapy, Planned Parenthood has streamlined access to these risky treatments. It’s as if they’ve become the fast-food drive-through of “healthcare,” offering an ever-expanding menu of horrific options. It’s a place where informed consent dies, and hasty choices become the combo meals of the day.
