Exposing Planned Parenthood

Many know Planned Parenthood as the leading abortion provider in the country, or as one of the top left-wing political spenders each election cycle.

Fewer know that Planned Parenthood is now the nation’s leading provider of sex-change procedures for young adults, with astronomical growth from year to year. More Planned Parenthood clinics now provide gender treatments than chemical or surgical abortions.

Planned Parenthood reports providing puberty blockers, cross-sex hormones, and surgery referrals to adults and minors who identify as transgender.

Some affiliates offer other “gender-affirming” interventions for minors without parental consent.

At least 40,000 patients per year receive sex-change procedures at Planned Parenthood, according to The Free Press, and we estimate at least 100,000 visits are made to Planned Parenthood clinics annually for sex-change purposes. Data suggests that 1 in 6 teens and young adults who receive cross-sex hormones do so via Planned Parenthood.

Patients can receive hormones on their first visit, often without seeing a doctor, sometimes via telehealth or even over the phone. A referral letter or mental health evaluation is usually not required.

Planned Parenthood’s protocols for sexchange interventions are so lax that they have drawn condemnation from:

By our estimate, Planned Parenthood provides more abortion and sex-change services than all the following categories in their 2022- 2023 report, combined: primary care, STD treatments, UTI treatments, pap tests, HPV vaccines, other cervical cancer screening and prevention, mammograms, miscarriage care, prenatal services, adoption referrals, and sterilizations. Other services – such as pregnancy testing, contraceptive services, HIV and STD testing, and breast exams – are all significantly down compared to recent years, some by as much as 72 percent. Total health services and patients are also down.

The following report details the full scope of Planned Parenthood’s involvement in the lucrative sex-change business, as well as the ways they create a pipeline to that business through their numerous sex education programs nationwide, and their strategy for protecting this business through political activism.

As The Free Press reports, “in less than a decade, Planned Parenthood has “become the country’s leading provider of gender transition hormones for young adults, according to insurance claim data.” Planned Parenthood’s website proudly states that it provides puberty blockers, cross-sex hormones, and surgery referrals, among other “services,” to patients who identify as transgender, and that “most” of its clinics offer “gender affirming care.”

In its 2014-2015 annual report, Planned Parenthood reported that 26 of its centers were offering hormone treatments.

Now, according to our count, as well as indications from the Planned Parenthood website, more Planned Parenthood clinics offer sex change procedures than offer abortions.

As of April 2025, by our estimates, around 80 percent of Planned Parenthood clinics offer some form of “Gender Affirming Care,” while around 70 percent are advertised as offering abortions. Before the claim drew scrutiny from lawmakers, Planned Parenthood regularly bragged that it was the second-largest provider of cross-sex hormones in the country.

Planned Parenthood’s provision of sexchange services has grown dramatically over the years. According to an internal slide presentation reported on by The Free Press, between 2016 and 2021 the number of health centers offering “transgender and nonbinary hormone care” increased by more than 450 percent. Between 2019 and 2021, the number of patients for these services more than doubled.

Since then, their business has continued to explode. Between 2021 and 2022, for example, Planned Parenthood of Greater Ohio reported a 544% increase in “gender-affirming care” visits. Between then and their most recent report, the number tripled again.

Insurance claim data provided to The Free Press by The Manhattan Institute, which does not include those who pay out-of-pocket, suggests “that 1 in 6 U.S. teens and young adults who sought gender hormones last year were seen at Planned Parenthood. Between 2017 and 2023, affiliated clinics filed gender-related insurance claims for 12,000 youths aged 12–17.” The number of patients overall receiving sex-change procedures from Planned Parenthood in the insurance data “has risen tenfold since 2017. The largest proportion, about 40 percent, were 18- to 22-year-olds.”

One former Planned Parenthood employee recalls her clinic receiving 1-2 new teenage girls seeking testosterone every single day. None were turned down.

Insurance data probably understate the situation. Many affiliates report that about 20% or more of their clients pay out of pocket or are uninsured, and insurance coverage of sex-change procedures, especially for minors, varies across the country. According to a 2024 survey by the Kaiser Family Foundation, only about a quarter of large employers (200+ workers) and only half of very large employers (5,000+ workers) stated that their plans covered hormone therapy.

These may seem like simple requirements, but they are too much for Planned Parenthood. As we will outline below, Planned Parenthood regularly provides sex-change assistance to minors, regularly fails to inform its patients about potential side effects, regularly prescribes hormone treatments over the internet, often provides no mental health screening, and only involves actual medical doctors to a minimal degree.

Affiliates brag that “[i]n most cases your clinician will be able to prescribe hormones the same day as your first visit. No letter from a mental health provider is required.” Reports from whistleblowers and detransitioners generally describe initial visits for cross-sex hormones as taking around half an hour or less.

It is not uncommon for cross-sex hormones to be administered by non-doctors. Prior to Florida’s law, one source noted, around 80 percent of patients receiving “gender affirming care” in the state were receiving it from nurses and physician assistants.

Planned Parenthood is no exception. One detransitioner reported that she was prescribed an alarmingly high dose of testosterone at Planned Parenthood after brief interactions with a nurse practitioner and a social worker, who waived their usual requirement that blood work be done because she seemed “so sure,” despite her having just turned 18.

Another whistleblower, whose previous employment with Planned Parenthood was confirmed by Abigail Shrier, claimed a similar pattern:

At some affiliates, Planned Parenthood employees seem barely involved – they direct patients to take blood pressure readings themselves prior to an initial online meeting, meet for an initial visit online (with a “clinician” involved at some point), send patients to a LabCorp location if any lab work needs to be done, and then prescribe. Even scheduling followup appointments is the patient’s responsibility. One affiliate reports the majority of their gender visits now occur over the Internet. According to the former employee: “‘The extent of our intervention’ was to grant ‘their requests to start the hormone therapy.’”

Planned Parenthood makes it incredibly easy to obtain sex-change services. Affiliates generally operate under an “informed consent” model, meaning that patients do not need any psychological screening or letter of reference from a doctor before prescribing hormones.

Planned Parenthood defends this model. As the associate medical director of one affiliate told The Free Press: “Gatekeeping is not necessary. People are the experts of their own body and of their own journey, and as long as they can make decisions, they should be the agent of their own healthcare.”

If patients show up, it seems that the common practice is to just assume a hormone prescription is necessary. According to the whistleblow-er interviewed by Shrier, “The questions that we asked were like, very closed ended…It would be, ‘you know, at what age did this start’? Boom that is it. ‘What kinds of dysphoria do you feel’? Boom that’s it, you know? ‘What do you want out of your transition’? ‘Do you want top surgery?’ ‘Do you want bottom surgery’?”

While she said that patients were technically given a document outlining some potential side effects, “I can say anecdotally that I never saw anybody read it.”

Many supporters of Planned Parenthood’s overall agenda, and of sex-change procedures in general, find Planned Parenthood’s practices in this area alarming.

Shrier’s whistleblower made clear that she supported what she believes to be Planned Parenthood’s core mission, including abortion, but said that “their recent roles in trans activism are abhorrent, and they’re digging their own grave.”

And The Free Press reports speaking with “a former Planned Parenthood clinic employee who, trans-identified himself, has been taking testosterone for nearly a decade and knows its effects intimately. He became concerned that the information wasn’t being shared with new patients, and asked the chief medical officer why.

He was told that protocols were set by the national office, and in any case, informing patients of lesser-known side effects ‘would scare them.’ He has since obtained legal whistleblower protection.”

Dr. Edwards-Leeper’s opinion of Planned Parenthood’s sex-change practice is dim overall:

“I have always been a very strong supporter of Planned Parenthood and am pro-choice. [...] But they have taken on something that they are not equipped to handle.”

The Washington Free Beacon reports on one young man on the autism spectrum, who struggled with depression and anxiety, and “was expelled from three different special-needs schools due to behavioral problems[.]” His parents intended to take him to a gender clinic they hoped could provide a more rigorous and in-depth mental assessment and screening. But when he became frustrated with how long this would take, the high school student simply went to a Planned Parenthood instead, which prescribed him estrogen within a little over half an hour.

Erica Anderson describes this dynamic as having an effect on the transgender industry as a whole. Afraid of losing patients to Planned Parenthood, the Washington Free Beacon paraphrases, there is a general “race to the bottom that pulls all providers, no matter their philosophy, toward the informed consent model adopted by Planned Parenthood, which doles out life-altering drugs to almost anyone who requests them.”

The whistleblower who spoke to Shrier said that she never saw a single girl seeking testosterone turned down or referred for psychiatric evaluation.

These practices are disturbing in general, but especially so when minors are involved.

It is not always easy to determine which affiliates cover which procedures for minors, and policies vary across the country. Some affiliates have provided cross-sex hormones to patients as young as 14, while others nominally limit their procedures to 16 years and to emancipated minors or those with parental consent. Some state that they are only able to treat adults, sometimes due to local laws and regulations.

Many clinics declare, more vaguely, that Planned Parenthood will “provide gender-affirming care whenever and however we can under the law.”

Several affiliates and clinics, as well as Planned Parenthood’s national website, state openly that they prescribe puberty blockers for transgender-identifying children. According to their national education materials, Planned Parenthood views puberty blockers as an advisable course of action for “transgender or nonbinary” children who are finding puberty “uncomfortable, scary, or stressful[.]”

All in all, according to The Free Press, Planned Parenthood clinics filed “gender-related insurance” claims for 12,000 children between 2017 and 2023. This is likely an undercount. One study from 2019 on health insurance coverage of “gender-affirming health care services” for children found that nearly 70 percent of insurance plans they reviewed did not cover puberty-blocking medication, and more than 80 percent did not cover cross-sex hormones.

Because of the ubiquity of telehealth services, patients may be able to access services from more permissive affiliates, even if their local clinic will not see them. Some clinics expressly limit telehealth to patients currently within their state, but this is not universal. And there are indications that some affiliates may be providing telehealth across state lines. In 2023, Planned Parenthood of Tennessee and North Mississippi reported that their “gender affirming healthcare” program – 1,086 in-person visits and 918 telehealth – served 167 zip codes “across Tennessee and 5 neighboring states.” Many states have laws protecting providers of cross-sex hormones from out-ofstate investigations or lawsuits categorically.

In Missouri, Planned Parenthood is under investigation by Attorney General Andrew Bailey as part of an inquiry into “how this clandestine network of clinics has subjected children to puberty blockers and irreversible surgery, often without parental consent.” Planned Parenthood is separately under investigation in the state after videos emerged in which “Planned Parenthood staff admitted they traffic minors across state lines to perform abortions without parental consent.”

Planned Parenthood bills itself as “the single largest provider of sex education in the United States,” with a focus on advancing “equity” (including for the “Latinx” community) and being “LGBTQ-inclusive.” Many affiliates partner with local schools, foster care systems, criminal justice facilities, and libraries to spread their “educational materials.”

According to a report from The Claremont Institute, “Planned Parenthood and its allies won 80 percent of all sex education grant money between 2020 and 2023. [...] Planned Parenthood and its affiliates write the standards and create, deliver, or endorse the majority of curricula used by federal grantees.”

They want this “education” to start extremely young. According to a recent “Call to Action” from Planned Parenthood and other groups: “Comprehensive sex education delivered in schools from kindergarten through 12th grade is the best way to provide truly LGBTQ-inclusive sex education and ensure positive sexual health outcomes for all youth.” After all, as another Planned Parenthood guide declares, “sexuality is a part of life through all the ages and stages. Babies, elders, and everyone in between can experience sexuality.” And “[m]any people,” the national website proclaims, “know their gender identity as young as age 2[.]”

They follow their own advice. Planned Parenthood’s national site provides resources for teaching transgenderism to pre-schoolers. A curated playlist of videos from Planned Parenthood Arizona, Inc., includes an animated video for preschoolers about gender identity – “Sex is what you are labeled when you are born [...] Your gender identity is about how you feel on the inside – like a boy, girl, both, or neither.” In the video – complete with its own song – animated penguin “Charles” becomes “Charlotte,” “Darla” becomes “Darren,” and “Skyler” becomes “gender-fluid.” After each of these transitions, the penguins post pictures of themselves on a fake version of Instagram and rack up hundreds of likes.

Another video series endorsed by the affiliate, this one for 9-12 year olds, features drag queens, lessons on gender and sexual orientation, tours of the “Cabbagetown” abortion clinic, “a rousing game of Scrotum Ball,” and various “gender-flexible dolls.”

Gender, according to Planned Parenthood, can be very flexible. Their social media declares that it’s “totally normal and OK” to feel like you are “more than one gender at the same time,” “different genders in different situations,” “different genders at different times,”

“bigender (2 genders), trigender (3 genders), poly gender (many genders), and pangender (all genders)” – or even to change gender identity “day-to-day.”

Another affiliate released an Activity Book as part of their sex ed programming, including a gender-identity word match, coloring pages depicting genitalia, a section on “The Gender Unicorn,” and an exercise filling in “flower petals” to help understand one’s intersectional “social identities [...] such as race, ethnicity, gender, sexual orientation, socioeconomic status, ability, first language, and religion.”

One Planned Parenthood “sex educator” on TikTok reportedly advised minors on how to get “spicy toys” without their parents’ knowledge over the Internet, or otherwise substitute with vegetables.

Some of Planned Parenthood’s curricula are developed using federal dollars, such as “Get Real,” which received $1 million in annual funding under HHS’ Teen Pregnancy Prevention Program.

“Get Real” is shocking – according to the Massachusetts Family Institute, it teaches children as young as 11 “how to enthusiastically consent to sexual activity, promotes solo and mutual masturbation, directs teachers to lead children through inappropriate sexual role-playing scenarios, and more.” As the Daily Caller reports, Get Real “encouraged sixth graders to prepare for sex by including material on proper condom usage for vaginal, oral or anal sex and recommending other non-traditional contraception methods, like non-microwavable saran wrap.”

Sixth graders are asked to identify where people “their age” can get condoms.

Each election cycle, Planned Parenthood proudly announces plans to spend tens of millions of dollars defeating Republican politicians and policies – $20 million in 2016, $24.5 million in 2017-2018, $45 million in 2020, $50 million in 2022, and $40 million in 2024.

Planned Parenthood’s intense involvement has led some to wonder what exactly the main purpose of the organization is. As The New York Times put it, one of the “central tensions” of Planned Parenthood, and the source of “internal turmoil” in recent years, has been the question of whether it is “a political organization or a health organization first[.]” It’s hard to imagine the same question even being asked of any other serious health network, let alone being so difficult to answer.

Planned Parenthood’s national rules seem to suggest that politics, not healthcare, is the main priority.

Again, according to The New York Times, while Planned Parenthood has raked in as much as $498 million in annual donations recently, “little” of that money actually goes towards providing health care at actual clinics. “Instead, under the national bylaws, the majority of the money is spent on the legal and political fight to maintain abortion rights.”

The types of medical services Planned Parenthood prioritizes are highly politicized. Regular run-of-the-mill care is de-emphasized, while woke priorities like abortion and sex-change procedures have become a larger and larger focus.

When choices have to be made between politics and health care, legitimate medical services are often the first to go. As The New York Times reported, “Planned Parenthood of Northern California made a hard funding choice last March when it ended a prenatal care program that served 200 to 250 low-income women a month.” That same fiscal year, the affiliate reported more than 17,000 “gender-affirming hormone therapy” visits, up 12 percent compared to two years prior.

Other affiliates note that while they will happily provide cross-sex hormones to those with gender dysphoria, they are not equipped to provide samesex hormones such as “menopause care.”

These priorities make a certain amount of financial sense. Sex-change procedures are especially good for Planned Parenthood’s business. As one whistleblower notes, while abortions were her clinic’s “bread and butter,” “trans identifying kids are cash cows, and they are kept on the hook for the foreseeable future in terms of follow-up appointments, bloodwork, meetings, etc., whereas abortions are (hopefully) a one-and-done situation.”

This logic has led sex-changes and abortions to become an outsized part of Planned Parenthood’s medical activities. Judging by our estimates and Planned Parenthood Federation of America’s 2023-2024 report, it would appear that abortions (402,230) and sex-change visits (100,000+) are a larger part of Planned Parenthood’s business than all the following categories in the 2023 report combined:

The vast majority of Planned Parenthood’s remaining “services” are low-complexity, quick interventions that are readily and cheaply available at thousands of other health clinics, doctors’ offices, pregnancy centers, pharmacies, and elsewhere – for example, condoms and other contraception, contraceptive “counseling,” Plan B, non-mammogram breast exams, pregnancy tests, and STD or HIV tests.

Planned Parenthood’s “services” are low-complexity by design. Planned Parenthood directs its employees to try to see at least four patients per hour, and to keep appointments to about 10 minutes long.

Many of these services require nothing more medically intensive than a blood draw. But even here, Planned Parenthood cuts corners. According to The New York Times, blood draws at Planned Parenthood are regularly done by medical assistants “who are not required to have medical training,” draw blood from patients after “an hour or so” of training, and who often run into problems they are not equipped to handle.

These services, even such as they are, have become a smaller and smaller portion of Planned Parenthood’s business over the years. Since 2010, breast exams at Planned Parenthood are down 74 percent, pap tests are down 77 percent, and contraceptive services are down nearly 40 percent.

Looking further, emergency contraception kits are down 64 percent since 2009, and pregnancy testing is down nearly 20 percent from its recent peak in the 2014-2015 report. STI and HIV tests are down more than 5 percent compared to the 2019-2020 report. Reproductive “Preventive Care Visits” – which seem to have been labelled “Well-Woman Exams” before Planned Parenthood started excising the word “woman” from its reports – were down 31 percent relative to two years ago, to a little less than 130,000. Sex-change visits may outnumber this category in the very near future, if they don’t already.

This shift in focus towards political activism is intentional. When Planned Parenthood’s previous president, Dr. Leana Wen (the first doctor to run the organization in nearly half a century), tried to re-emphasize health care as opposed to political activism, she was unceremoniously terminated by the board after just 8 months. She was quickly replaced by a political science professor and activist whose previous experience included designing mandatory unconscious-bias training for Starbucks employees.

Among Dr.