“Joe Biden and the New Left even promote surgery on teenagers and young adults, removing breasts and genitalia.”
America’s first legal radio ad, October 9, 2022
A radio ad targeting care for transgender youth began airing in cities across the country this fall — from a Spanish-language station in Corpus Christi, Texas, to a sports talk show in Tennessee to pop radio in Detroit. The ads, paid for by a political advocacy group founded by Stephen Miller, a longtime speechwriter and senior adviser to former President Donald Trump, were deemed so inflammatory by a radio station owner that they were pulled in major markets.
The minute-long script from America First Legal, titled “No More,” accuses President Joe Biden of “pushing radical gender experiments” along with hormone therapy.
“Joe Biden and the New Left even promote surgery on teenagers and young adults, removing breasts and genitalia,” the ad claims.
With a man’s voice playing ominous music, the ad says the White House is pushing boys to look more feminine by taking estrogen and girls to grow facial hair by taking testosterone. The ad also suggests that Democrats are pushing puberty blockers to “prevent children from developing into normal men and women.”
In August, PolitiFact rated a similar statement by Florida Governor Ron DeSantis as “mostly false.” In early November, state medical boards appointed by DeSantis banned hormone treatment and surgery for minors. But since the America First Legal ad takes direct aim at the policies of the Biden administration and highlights what has become a hot topic ahead of the midterm elections and in the broader cultural debate, we decided to investigate further.
First, we checked with America First Legal about the basis for its statements. The group did not respond to repeated emails and phone calls. But its general counsel, Gene Hamilton, released a statement to Politico regarding a news report about the ad: “We believe in biology and we believe that confused children should not be permanently harmed by people with radical agendas.”
A document by America First Legal that was filed with the Federal Communications Commission by Detroit radio station WDRQ-FM and obtained by KHN and PolitiFact lays out a more specific justification for the advertising claims.
It cites a two-page explainer published by the Department of Health and Human Services’ Office of Population Affairs in March 2022. The first two paragraphs explain that gender-affirming care “comprises a range of services that may include medical, surgical, mental health, and non-medical services” for transgender people, and that “primary gender-affirming care is for overall health and well-being. Very important because it allows children or adolescents to focus on social change.”
The document appears to communicate that gender-affirming care is important for transgender and non-binary children but makes no specific endorsement of surgery.
What exactly is White House policy?
The Biden administration was asked about the ad at a White House briefing, and spokeswoman Karin Jean-Pierre said simply: “Transgender rights are indeed human rights.”
HHS declined to explain its position on gender-affirming surgery but released a statement to KHN that described what spokesman Adam Sarvana called “a disturbing wave of radical attacks on some of our nation’s most vulnerable children.”
“The Biden-Harris administration believes in parents, but we’re unfortunately seeing interference in people’s medical decisions that jeopardize potentially life-saving care,” he said.
The message suggests unequivocal support for gender-affirming care, particularly to address the high rate of suicide among trans adolescents. A White House fact sheet said the administration is “confirming the positive impact of gender affirming care on youth mental health.” The White House frames access to care as a civil rights issue for transgender people.
The White House’s statements largely echo those of leading medical groups, including the American Academy of Pediatrics. The professional association representing 67,000 pediatricians has similarly been accused of gender-affirming care, but AAP president Dr Moira Szilagyi is defending it from what she calls “extremism”.
“Critics of our gender-affirming care policy mischaracterize it as pushing medical or surgical treatment on young men; In fact, the principle calls for the opposite: a holistic, collaborative, compassionate approach to care with no end goal or agenda,” he wrote in an August blog post.
What about guidelines?
America First Legal ads specifically target teenagers and young adults with surgery. This, in itself, is complicated.
The World Professional Association of Transgender Health guidelines were updated in September, and they expand allowances for genital surgery for minors. But this type of surgery is rare. Vanderbilt University Medical Center, which has been at the center of a firestorm over its pediatric transgender care clinic, said it had never performed genital surgery on a minor.
Breast removal is more acceptable for older teens under the new WPATH guidelines. The number has increased in recent years but remains relatively small compared to hormone therapy, a much more common treatment for adolescents. A Reuters analysis of insurance claims data found “top surgery” – which refers to breast removal – is increasing each year, but fewer than 300 minors are operated on a year.
Dr. Michelle Hutchison, chief of pediatric endocrinology at the University of New Mexico Health Sciences Center, laughed off the idea that the Biden administration was pushing for such surgery.
“The only people I’ve ever met push patients,” said Hutchison, who also cares for transgender youth in Arkansas. “If anything, it’s usually us, as medical professionals, saying, ‘Hey, let’s take a beating. Let’s stop and think about it.’
Hutchison said he has never recommended genital surgery for a minor.
Is the policy equal promotion?
The veracity of the ad depends on whether the White House is promoting or emphasizing gender-affirming care. Dr. Michael O’Brien, a pediatrician in South Carolina and an LGBTQ+ advocate, said what’s troubling is that the materials used to justify the ad read like “objective facts.”
“The HHS document doesn’t promote or push a treatment so much as it describes it in technical terms,” he said.
Even leaders at the Society for Evidence-Based Gender Medicine, who are skeptical of the rush to gender-affirming care, said “it’s not right to say that the Biden administration is forcing these interventions on children.”
“Perhaps, children do not read the administration’s statement endorsing gender-affirming care,” said a society spokesperson. “We find the politicization of transgender health deeply problematic and unhelpful. Unfortunately, much of the United States has taken a political approach on both sides of the debate.”
The ad says: “Joe Biden and the New Left even promote surgery on teenagers and young adults, removing breasts and genitalia.” Experts in the field, LGBTQ+ advocates and even critics of gender-affirming care say they find the message misleading.
Some media outlets, such as Florida-based Beasley Media Group, pulled the ad, citing internal emails disclosed in FCC filings that company attorneys said the evidence was “insufficient to support the claims” and that the spot was “not in” the best interests of our company and or audiences.” The spot also pulled Pittsburgh’s iHeartMedia stations
The Biden policy specifically lists surgery among the “array of services” that should be available and notes that “primary gender-affirming care is critical.” But the ad leaves out other types of care — such as mental health services — that are considered the starting point for caring for this vulnerable population.
The main real problem with advertising is the use of the words “promote” and “push”. Making sure a treatment option is available doesn’t mean pushing it and casting it is hyperbolic.
We rate this claim as false.
Federal Communications Commission/Katz Media Group, Filing Containing Advertising Justification from America First Legal, accessed October 27, 2022
Federal Communications Commission/Katz Media Group, Filings Regarding Ad Cancellations in Philadelphia and Detroit, accessed October 27, 2022
Office of Population Affairs and US Department of Health and Human Services, “Gender-Affirming Care and Young People” Guidance, March 2022
Phone interview, Dr. Michelle Hutchison, Chief of Endocrinology, University of New Mexico Health Sciences Center, October 27, 2022
Direct-message interview with Dr. Michael O’Brien, a pediatrician in training at the Medical University of South Carolina, November 3, 2022
Phone interview, LGBTQ+ advocacy group COLOR Latina Aurea Bolaños Perea in Colorado, October 27, 2022
American Academy of Pediatrics President Moira Szilagyi blog post, August 10, 2022
October 27, 2022 email statement from Adam Servana, director of communications for the Secretary of Health with HHS
PolitiFact, “‘They’re Literally Cutting Off Little Kids’ Private Parts,'” 10 Aug. 2022
Endocrine Society, “Gender Dysphoria/Gender Nonconformity Guidelines Resource,” September 1, 2017
World Professional Association for Transgender Health, Standards of Care, 2022
Email response, Society for Evidence-Based Gender Medicine, October 24, 2022