Despite the negative side effects of puberty blockers and hormone therapy, and lifelong consequences of “gender-affirming” surgery, the Biden administration is enthusiastic about “gender-affirming care” for minors. In March 2022, the Department of Health and Human Services issued a document promoting gender transitions for young people, including “puberty blockers” “during puberty”, “hormone therapy” from “early adolescence onward”, and “gender-affirming surgery” (such as removal of breasts and testicles) either in “adulthood or case-by-case in adolescence.”
Oddly, this HHS guidance document, titled “Gender Affirming Care in Young People,” was issued not by HHS agencies that have expertise in transgender issues (such as the Food and Drug Administration, which regulates drugs such as puberty blockers), but rather by the Office of Population Affairs, which deals with family planning, teenage pregnancy, and adoption. The FDA has warned that the puberty blockers used by minors in gender transitions can have dire side effects, such as brain swelling and permanent vision loss. Puberty blockers can also lead to conditions like osteoporosis. As the New York Times notes, puberty blockers have “long-term physical effects,” and may “lead to heightened risk of debilitating fractures.”
In a Freedom of Information Act lawsuit, HHS produced documents indicating that its “Gender Affirming Care” recommendations were drafted without the FDA’s input. Instead, they were posted and publicized by Child Trends, a non-profit that receives funding from progressive LGBTQ advocacy foundations to promote “social justice” (one of its funders does so to “Push Boundaries, Make Change”).
Was the use of Child Trends a sign of the politicization of HHS? Or just the outsourcing of government work to an established contractor?
It seems to be the latter. The records at this link — produced in response to a Freedom of Information Act lawsuit — show that Child Trends had received over $900,000 for specific prior contract work, performed during both the Biden and Trump administrations. (See pages 5-6 of the records produced on May 31, 2024 in Bader Family Foundation v. U.S. Department of Health and Human Services, Civil Case #23-3546).
Child Trends had received favorable reviews for three contracts: for “Innovations in Family Planning Clinical Service Delivery for Hard to Reach School-Based Populations” (performed from 2019-2022), “Examining Responsible Fatherhood Program’s Approaches to Coparenting and Healthy Marriage and Relationship Services” (performed from 2018-2022), and “Comprehensive Communications Services and Support to Advance and Promote the Vision, Strategic Priorities, Goals, and Objectives of OPA” (performed from 2018-2023). Those favorable reviews are at this link — a “past performance questionnaire” for each contract. (See pages 364-389 of the records produced on May 31, 2024 in Bader Family Foundation v. U.S. Department of Health and Human Services, Civil Case #23-3546). Child Trends was rated “exceptional” in five out of six categories for the family-planning contract, four out of six categories for the fatherhood contract, and six of six categories for the communications services contract. In each “past performance questionnaire,” the evaluator said that “Given what I know about the contractor’s ability to execute what he promised in his proposal, I [“Definitely Would”] award to him today given that I had a choice.”
So even if Child Trends disseminated a slanted guidance document, it may simply have been doing what the agency wanted, or promoted views widely shared in its ideological bubble. Moreover, its own progressive tinge is shared by other contractors that competed with it for contracts covered by the FOIA request. HHS contractors, like government employees, are commonly progressive. Other contractors’ contract proposals reveal that their staff have histories of progressive publications, and the competing contractors’ proposals make diversity-based appeals touting the race and gender of the people who would perform the contract if it were awarded to the contractor. For example, a subcontractor touts it is a “women of color-led organization” in the attached page. (See this link, page 202 of the records produced on May 31, 2024). And another contractor submitting a proposal touts the fact that a”‘women-owned, minority-owned small business” will be working with it as its partner in performing the contract, if it receives it. (See this link, page 138 of the records produced on May 31, 2024).
There does seem to be a lack of evidence supporting the “Gender-Affirming Care and Young People” document generated by Child Trends, though. As the Daily Wire reported this year:
The Department of Health and Human Services said it has only two pages of literature supporting Assistant Secretary Rachel Levine’s assessment that “gender-affirming care” is “necessary” for transgender youth, prompting allegations that the transgender-identifying Biden administration official has violated the Department’s scientific integrity policies by baselessly claiming it’s settled science.
Protect the Public’s Trust (PPT), a nonprofit watchdog, filed a Freedom of Information Act request for “records of scientific evidence, studies, and/or data to support the Assistant Secretary’s claim that ‘gender-affirming care is medically necessary, safe, and effective for trans and non-binary youth,’” as well as for “records of surveys of medical professionals regarding the value and importance of ‘gender-affirming care’ for minor children.”
In response, HHS produced only a single document—a two-page PDF called “Gender-Affirming Care and Young People.” The document is also on HHS’ website and is not a scientific study, but rather a brochure that declares that “research demonstrates that gender-affirming care improves the mental health and overall well-being of gender-diverse children.”
At this link are the first hundred pages of the records produced on May 31, 2024 in response to the Freedom of Information Act lawsuit in Bader Family Foundation v. U.S. Department of Health & Human Services.
Many government contractors, like Child Trends, are nonprofits. Non-profits are not purer or better than for-profit entities. They also have an incentive to pay their employees well and build up big financial reserves at taxpayers’ expense.
Indeed, San Francisco is one of America’s most poorly-run cities, partly because it has outsourced so many government functions to nonprofits that are far greedier and less efficient and less accountable than the typical government employee. That is chronicled in disturbing detail in “The Nonprofit Industrial Complex and the Corruption of the American City,” in the American Affairs journal. That article describes how San Francisco bankrolled an “affordable-housing” nonprofit that successfully blocked the construction of thousands of units of affordable housing, relying on a bogus rationale — increasing its own wealth in the process. San Francisco also subsidizes non-profits that spawn homelessness and crime, while purporting to fight homelessness and prevent crime:
Nonprofits that self-righteously declare themselves providers of homeless services actively lobby to make homelessness worse in order to increase their own funding; nonprofit organizations hire convicted felons—including murderers, gang leaders, sex offenders, and rapists—who go on to commit more felonies while receiving hundreds of thousands of dollars in government contracts; and the executives of nonprofits, the very people in charge of institutions whose stated purpose is not to make money, earn millions of dollars while catastrophically failing to deliver the public services we are paying them to provide.
Moreover, it notes,
Although San Francisco is one of the worst cities when it comes to nonprofits behaving badly, these same problems exist in every city that makes excessive use of the nonprofit sector. Seattle, in particular, has a rather distressing tendency to give exorbitant sums of taxpayer money to convicted felons, up to and including violent criminals and registered sex offenders. In 2001, a man named Khalid Adams was convicted of first degree theft in an incident in which he allegedly groped his victim while shouting racial slurs; two years later Adams was convicted again, this time of first degree robbery and unlawful possession of a firearm. Adams’s third—but not final—conviction came in 2021 when he pled guilty to unlawful possession of a firearm by a previously convicted felon.
Only a year after Adams’s third conviction, however, he was hired to work as a “violence interrupter” by a government-funded Seattle-area nonprofit called Community Passageways. In November 2022, while receiving a salary from King County taxpayers to prevent gun violence, Adams broke into his ex-girlfriend’s apartment, held her new boyfriend at gunpoint, and was subsequently shot by the ex’s eighteen-year-old cousin. Adding a surreal element to this already incredible story, Savior Wheeler, the young cousin who shot Khalid Adams, was a client of Community Passageways, one of the same at-risk young people that Adams was supposed to keep away from gun violence. A Seattle nonprofit therefore hired a three-time convicted felon who was fresh out of prison to work as a mentor for at-risk youths, and he was subsequently shot by one of those very at-risk youths while threatening an ex-girlfriend at gunpoint.
This is a surprisingly common occurrence in Seattle. In 2022, the city gave $260,000 dollars to a registered sex offender who was operating under a fake name and credentials to mentor at-risk young people. In 2020, they gave a $3 million no-bid contract—one of the largest grants in city history—to a nonprofit called Freedom Project to run a “racial equity study.” Freedom Project’s executive director at the time was David Heppard who was convicted as a teenager for taking part in the gang rape of a pregnant seventeen-year-old. Freedom Project’s finance director, Quddafi Howell, once shot up a man’s house as an intimidation tactic to prevent him from snitching on Howell’s drug dealing.
One area that is typically done better by non-profits than by the government is schooling for kids. That is because, economically speaking, education is a private good, not a public good. And because parents of children in private schools closely monitor the quality of education their kids are receiving, even when their kids are receiving taxpayer-funded school vouchers. America was already one of the most literate countries in the world, before the public school system was even created. As the Independent Institute notes, “Between 1800 and 1840 literacy in the North rose from 75 percent to between 91 and 97 percent. In the South the rate grew from about 55 percent to 81 percent.” Thus, most Americans could read and write, even before the public school system existed.
Private schools are more economical than public schools, spending less per pupil, and maintaining their physical plant in better condition for less money. As education expert Andrew Coulson noted, “public schools were four times more likely than AZ private schools to have a building in ‘less than adequate’ condition, despite the fact that public schools spent one‐and‐a‐half times as much per pupil.”
