At least 24 hospitals, providers have been targeted online and offline over gender-affirming care, report says

At least 24 hospitals or healthcare providers across 21 states “were directly attacked online” in the wake of social media posts from influential accounts regarding gender-affirming care, according to a new report from LGBTQ+ civil rights organization the Human Rights Campaign (HRC).

The tally represents “an informal exploration” across two social media platforms, Facebook and Twitter, from August to November.

The count accompanies a five-step outline of how online posts from high-profile “hate speech accounts” escalate into offline threats, introduced legislation and, in many of the 24 cases, the removal of online gender-affirming care resources or halted services.

The HRC’s report supports this so-called “cycle of online hate and stigma” with screenshots and media reports detailing each step as it impacted workers at major provider organizations including Boston Children’s Hospital, Children’s Hospital of Pittsburgh, Vanderbilt University and the University of Wisconsin.

The five steps of the harassment campaigns, according to the HRC report (PDF), are:

  • An “inflammatory” online post from high-traffic social media accounts that names specific hospitals or doctors alongside misinformation about their services
  • A “barrage of harassing and threatening messages” sent to the hospital or doctor
  • Offline harassment and threats directed at the provider’s home or workplace, including death and bomb threats
  • Amplification of the messaging by “extremist politicians” who “in some cases [go] so far as to introduce legislation to regulate children’s hospitals and gender-affirming care providers”
  • Hospitals and providers either remove online resources or halt gender-affirming care services “in order to protect the safety of their patients and staff”

“As threats against the transgender community continue to rise—especially impacting Black, Brown and young transgender people—it is crucial that we look at who are the major players fueling this campaign of hatred,” Kelley Robinson, president of the HRC, said in a release. “This report confirms what we have suspected for some time: these dangerous accounts are playing a major role in causing harm to healthcare providers and patients. They are no longer just making the internet an unsafe place for transgender people and allies.”

Medical groups have called on federal law enforcement to take a harsh stance on harassment campaigns targeting gender-affirming care providers and staff. An October letter to Attorney General Merrick Garland from the American Academy of Pediatrics, the American Medical Association and others highlighted organizationwide disruptions in care and increased provider stress directly caused by an “intentional campaign of disinformation.”

"In one hospital, a new mother was prevented from being with her preterm infant because the hospital’s Neonatal Intensive Care Unit was on lockdown due to a bomb threat," the provider organizations wrote in their October letter. "These coordinated attacks threaten federally protected rights to healthcare for patients and their families."

Disagreements over gender-affirming care services continue to play out in Congress and the courts.

In July, the Biden administration issued a proposed rule restoring Obama-era nondiscrimination protections for transgender individuals, which the Department of Health and Human Services aimed to have in place by 2023. That mandate has since been struck down by a federal appeals court that ruled the administration cannot force religious healthcare providers to perform or pay for transition surgeries.