
Like many of you, I’m devastated about the overturning of Roe v. Wade. Clearly it was a flawed decision in the first place, and the Democrats made mistakes that Republicans—or rather, the extremists on the Supreme Court—took advantage of. But it was necessary for women to have equality with men. I am willing to concede that abortion is a murky and complicated issue, and have written about how the left wing’s discourse on it rendered me unprepared for the reality of the actual procedure. I was in the “safe, legal and rare” camp, and was perfectly comfortable with certain restrictions. Apparently I am a moderate? Or perhaps I became one once the rest of the party veered hard to the left.
Abortion rights and access to gender-affirming care are often linked in the left press, using the same language of bodily autonomy; in fact, I’ve heard employees at Planned Parenthood use this phrase to justify PP’s expansion to become one of the largest purveyors of cross-sex hormones in the country in the last decade, with few restrictions on who can access them, and little physical or mental evaluation before dispensing them. As a detransitioned woman named Helena Kerschner explained, she was able to get hormones on her first trip to a Planned Parenthood clinic with no bloodwork or physical workup, the minute she turned 18. Kerschner told the nurse that she thought she might have extra estrogens because her thighs were so thick. She asked for the maximum dose, four times the normal starting amount. The practitioner complied.
The comparisons between, say, my abortion and Kerchner’s obtaining of testosterone are deeply flawed. For one thing, those arguing to remove “gatekeeping”—that is, evaluations for young people before they suppress puberty, inject cross-sex hormones or have body parts removed (or added)—aren’t suggesting these interventions should be safe, legal and rare. They are suggesting that anyone who wants these procedures or drugs get immediate access to them.
If it were true that these interventions were proven to be safe and effective, that would make sense. But a recent nonpartisan evidence review—our country’s first!—noted: “Studies presenting the benefits to mental health, including those claiming that the services prevent suicide, are either low or very low quality and rely on unreliable methods such as surveys and retrospective analyses, both of which are cross-sectional and highly biased.” And: “Available medical literature provides insufficient evidence that sex reassignment through medical intervention is a safe and effective treatment for gender dysphoria.”
Meanwhile, with more detransitioners speaking up every day, and many people seeking interventions not because of an internal sense of strife but because of an ideology romanticized on social media, it’s getting increasingly hard to argue that affirmation-only and interventions-on-demand are the appropriate models of care—not that those arguments aren’t being made daily, and in fact proposed as law.
Another difference: abortion is not pitched to distressed young people as a panacea; it’s something you generally try to avoid, but is an important last resort so that women are not forced to carry and give birth to children, which, research shows, has much more lasting implications for women economically and emotionally than abortion does.
I want abortion to be a right, but I also hope it’s a right most women are lucky enough to avoid exercising. I’ve heard many adult trans people, and some detransitioners, use similar language to describe transition: I’m glad I did it but if you have a way of getting through this without medicalizing, please do. Or: I regret it. (My suspicion is that for some autogynephiles, transition is the only relief, but clearly for many in the group once thought of as the “homosexual transexual,” transition is increasingly being seen as a mistake.)
I believe that Planned Parenthood itself has participated in the selling of cross-sex hormones as not only a right rooted in bodily autonomy but an appropriate treatment either for gender dysphoria or for anyone identifying as trans.
Earlier this year, Planned Parenthood sent out an internal memo about new research on puberty blockers and cross-sex hormones. It was titled “THE POSITIVE EFFECTS OF HORMONE THERAPY FOR TRANS YOUTH” and it read:
Amid an onslaught of recent anti-transgender legislation, a new study by The Trevor Project has confirmed that gender-affirming hormone therapy improves mental health outcomes for trans and nonbinary youth. The study — which surveyed 9,000 young people between 13 and 24 years old — found that youth reported a lower likelihood of depression and suicidality, compared to those who wanted treatment but were unable to access care. Parental support for their kids’ gender identities played a huge role in access to hormone therapy. Dr. Amy Green, VP of Research at The Trevor Project, stressed the need to expand access to trans-affirming medical care across the country:
“This study emphasizes the potential benefits of gender-affirming hormone therapy as a mechanism to reduce feelings of gender dysphoria and minority stress among transgender and nonbinary youth — thereby working to improve mental health outcomes and prevent suicide.
These data should serve as a call to action to resist blanket bans on gender-affirming medical care and to invest in more research on this topic so that youth and their families can make evidence-informed decisions regarding care.”
I’m told this memo came from the medical director of Planned Parenthood though I haven’t verified it. Look at the language they use—“confirmed that gender-affirming hormone therapy improves mental health outcomes for trans and nonbinary youth” versus the language of the actual study: “was associated with lower odds of recent depression.” [Emphasis mine both times.] This is the same research being classified as so low-quality that it can’t support its own claims, yet Planned Parenthood cites it as proof that they’re doing good work.
Perhaps the most troubling aspect of Planned Parenthood’s ascendance to top dispenser of cross-sex hormones for young people is that such medications very well may remove those young people’s chance to procreate, unless they are lucky enough to be able to engage in “fertility preservation.” The organization apparently sees no conflict between fighting for reproductive rights and offering treatments, with no mental health evaluation, that may lead to sterilization.

Last week, a new study came out, noting that there’s been an 800% increase in prescriptions for cross-sex hormones between 2013 and 2019. Some people are celebrating this, seeing it as confirmation that trans people are a large and diverse group, finally able to be themselves and get the interventions they want. Others see it as confirmation that there is an epidemic of young people feeling deep distress about their bodies or gender roles in ways never before seen, and resorting to serious, and possibly inappropriate, medical interventions to attend to that distress.
Either way, it’s great news for insurance companies and nonprofits like Planned Parenthood, for if it’s going to be much harder to make money off abortion care, it looks like it’s going to be far easier to profit off hormones.
(Sorry for the note of cynicism; it’s what happens when you lose faith in your most trusted institutions.)
Alternatives to Planned Parenthood, if you want to donate to abortion care—please leave other suggestions in comments!
National Network of Abortion Funds
Brigid Alliance
National Advocates for Pregnant Women
Keep Our Clinics
Access Reproductive Care-Southeast or (ARC Southeast)
Indigenous Women Rising
I want to be open minded about the world of Trans but I keep getting the feeling that it is the new: dye your hair pink, get a nose piercing, a tattoo, a nipple ring, become a Goth or an Emo….. is this part of a huge social contagion? They write about the Tik Tok Tourette’s social contagion but what about the non binary and Trans social contagion?
We want to be compassionate about trans youth but we don’t want to be stupid about young people making these decisions when they’re in the throes of adolescent confusion and misery.
Thank you again for urging us to think about these issues.
Great article! I noticed a typo though, "body parents" instead of "body parts"? After further reading... you have it! I was perplexed at the connection between Planned Parenthood and the championing of trans "health care" and thought it must be on account of some sort of behind the scenes funding by the trans lobby. Now you've clearly shown the ideological connection to "bodily autonomy" and how flawed it is to conflate abortion rights with a "trans" child's or young person's "right" to irrevocably medically harm their own body. PP's stance also seems like another example of the "unembodied principle" Andrea Dworkin wrote about years ago in her critique of the ACLU, which of course applies even more these days to the ACLU's stance on trans rights ideology. Thank you for your article and other writings!