Published August 26, 2021
lanned Parenthood dresses itself up in pink and calls itself an essential women’s health-care organization, but its business model tells a different story. Each year, Planned Parenthood clinics perform upwards of 330,000 abortions, making the group the most prolific abortion provider in the country.
But recently, Planned Parenthood has quietly begun expanding into a new arena: hormone therapy for individuals with gender dysphoria, a service the group calls “gender affirming care.”
Hormone therapy has become popular as a means of artificially suppressing the sex characteristics of those who feel misaligned with their biological sex. Biological men who identify as women take estrogen and women who identify as men take testosterone, hormones that mask or even permanently alter unwanted male or female sex characteristics — including, in many cases, their fertility.
Judging from its own documents, Planned Parenthood’s provision of hormone therapy has increased exponentially since the group first mentioned the word “transgender” in its 2014 annual report. That year, Planned Parenthood reported just 26 centers in ten states offering these services.
Planned Parenthood’s most recent report, from 2019, recorded more than 200 centers in 31 states that “provide hormone therapy for transgender patients.” According to the group’s website, that number is even larger now: close to 300 centers across 38 states.
It isn’t clear exactly how many instances of “gender affirming care” Planned Parenthood provides, but its reports give us a hint. Hormone therapy is grouped under the umbrella of “other services,” along with things like “adult preventive care” and “pediatric services.” Last year, Planned Parenthood reported about 18,000 “other services,” nearly double what the group had reported for the same category in 2018–2019.
Back in February, journalist Abigail Shrier reported that the website for Planned Parenthood’s Western and Central New York affiliate stated, “Nationally, Planned Parenthood is the second largest provider of Gender Affirming Hormone Care.” As of this writing, Planned Parenthood had removed that statement from the site and replaced it with a stock photo. (I verified on an Internet-archive site that Shrier’s description was accurate.)
In 2017, meanwhile, Mara Keisling, executive director of the National Center for Transgender Equality, told the Daily Beast that about 65 Planned Parenthood locations offered transition-related procedures. “It’s possible they’re the largest provider of trans health in the country,” Keisling said at the time. “We don’t know for sure. But it’s certainly among the biggest, if not the biggest.”
What’s most striking about this dramatic increase is that Planned Parenthood offers hormone therapy on an informed-consent basis, meaning that no counseling or doctor’s note is required to begin taking hormones that, more likely than not, will have irreversible effects on a patient’s body.
According to Shrier’s interview with a source who was a Planned Parenthood “reproductive health assistant” for about 18 months from 2018 to 2020, her clinic had no doctors on staff. Instead, they employed a “gender counselor” with “no actual professional credentials or formal training” who was a “male-to-female transgender person.”
This counselor would speak to a potential hormone-therapy patient and send the notes from that meeting “to an actual licensed mental health professional somewhere off-site” who would then approve the “transition” hormones. “This is basically how they circumvented the requirement to speak to an actual counselor,” the employee added.
According to Shrier’s source, about one or two teenage girls would come to her clinic daily seeking testosterone, often accompanied by a group of friends — and, as far as she could recall, “none of the girls” were ever turned down.
That’s just one of hundreds of Planned Parenthood centers that now offer hormone therapy, with no counseling or doctors required. Judging from how Planned Parenthood portrays “gender affirming care” in its online material, it’s not hard to imagine this is routine practice.
“Congratulations on taking the first step of your decision to pursue hormone therapy! Planned Parenthood of Western PA is here for you every step of the way as you start or continue your journey of transition,” one homepage reads.
The website for Planned Parenthood’s Great Northwest, Hawaii, Alaska, Indiana, and Kentucky affiliate reassures patients: “You don’t need to participate in therapy or provide information from a mental health provider to receive hormone therapy.”
The same site — like many others operated by Planned Parenthood’s affiliates — offers videos showing patients “how to properly perform an intramuscular or subcutaneous self-injection.” The site divulges no possible risks of these hormones, only a section listing their “effects,” which mostly include results thought to be desirable for those who wish to transition.
Meanwhile, Planned Parenthood’s main website leaves no doubt as to whether the organization is all-in behind a “gender-affirming” model of care, which is far from the standard medical consensus for treating all gender-dysphoric patients.
Their page on “LGBTQ care” defines gender as “a social and legal status of male or female” and “a set of expectations from society about behaviors and characteristics.” The site describes transitioning as a “way to affirm your gender” and “the process of changing the way you look and how people see and treat you so that you become the gender you feel on the inside.”
“Gender identity,” meanwhile, “whether transgender or cisgender, is about who you ARE inside as male, female, both, or none of these.”
By all accounts, the organization appears to be gearing up to try the same strategy with hormone therapy that it mastered with abortion: cast a dubious procedure as essential health care and, rather than offer real counseling to desperate patients, convince them that risky and expensive “treatment” is the easiest option.
Alexandra DeSanctis is a staff writer for National Review and a visiting fellow at the Ethics and Public Policy Center.