Is sex-change treatment Planned Parenthood's new moneymaker?

While pro-life legislation chips away at its taxpayer-based revenue, the nation’s leading abortion provider might have found a new cash cow.

At 32 of its centers in 10 states, Planned Parenthood now offers hormone replacement therapy (HRT) for clients wanting to change their gender expression. Despite the long-term physical and psychological risks associated with gender reassignment treatments, the abortion giant’s little-known but emerging enterprise hasn’t incited the same public backlash as another of its formerly hush-hush business practices—trafficking in aborted babies’ body parts.

Capitalizing on an upswing in the growing acceptance of transgender rights, Planned Parenthood is expanding its brand into a potentially lucrative market.

The cost for a complete gender reassignment—surgery, therapy, hormones, lab tests, and doctor visits—ranges from $20,000 to more than $100,000, depending mainly on the number and types of surgeries involved. Fewer than 500 of the nation’s 700,000 transgender individuals undergo gender reassignment surgery in any given year, and Planned Parenthood does not perform sex-change operations. But fees for office visits and drugs can be significant sources of revenue: $100 or more per appointment and anywhere from $360 to $1,500 per year for the drugs. Some health insurance plans cover gender reassignment treatment, as does Medicare.

Listed under “Other Services” in its annual report, Planned Parenthood’s transgender HRT business income presently accounts for less than 1 percent of the organization’s $1.3 billion annual revenue. But there is money to be made in supplying a full course of HRT, which may take two to three years. And the demand is growing. At Planned Parenthood’s center in Asheville, N.C., for example, the number of transgender clients rose from just a few people in 2013 to almost 60 in less than two years. Planned Parenthood of Kansas and Mid-Missouri last month added transgender services at all six of its centers.

Known primarily for its women’s health services, Planned Parenthood not only provides tablets and injections for women transitioning to men but also for men taking on female anatomical characteristics. A prospective client makes an initial consultation with an on-site “clinician” who takes blood for lab work, Katherine Simpson of Planned Parenthood’s Walnut Creek, Calif., affiliate told me. In the case of a male-to-female transition, Simpson said, the client then gets a four-week supply of testosterone-suppressing drugs. When he returns for a follow-up appointment, he undergoes more lab work to determine whether Planned Parenthood can prescribe a full regimen of HRT. Simpson said clients do not need a referral from a doctor to begin the hormone treatments.

That practice could put people at risk, said Peter Spriggs, senior fellow for policy studies at the Family Research Council.

“Planned Parenthood seems determined to streamline the process” of making hormones accessible to greater numbers of people, he said, adding the organization “appears to be evading even the Standards of Care recommended by the pro-transgender World Professional Association for Transgender Health. … Planned Parenthood’s ‘informed consent’ model skips over any requirement for a referral or for any substantial psychosocial assessment.”

As a result, “many more people could suffer the serious side effects that can result from” hormone therapy, he said.

Those serious side effects have many researchers questioning whether doctors should prescribe HRT at all. Not only have studies linked HRT to an increased risk of cancer, but gender reassignment treatments might be part of the reason why transgender men and women are killing themselves at a tragic rate.

A joint study from the National Gay and Lesbian Task Force and the National Center for Transgender Equality reports 41 percent of transgender individuals attempt suicide, compared to 1.6 percent in the general population. LGBT advocates blame the crisis on the current “social and legal convention in the United States” that fosters discrimination and ridicule of “gender non-conforming people.”

But studies published by the National Institute of Health suggest the source of emotional turmoil for transgender people, both before and after surgery, often comes from within. A large Dutch study, published in the American Journal of Psychiatry, found 61 percent of patients with “cross-gender identification” also suffered from other psychiatric disorders.

A long-term study in another socially liberal country, Sweden, uncovered a staggering suicide mortality rate: Individuals who had undergone sex reassignment surgery were 19 times more likely than a comparable non-transgender population to commit suicide.

HRT and other gender-bending treatments are misguided “medicine,” according to Paul McHugh, former psychiatrist-in-chief at Johns Hopkins Hospital.

“‘Sex change’ is biologically impossible,” McHugh wrote in The Wall Street Journal. “People who undergo sex-reassignment surgery do not change from men to women or vice versa. Rather, they become feminized men or masculinized women. Claiming that this is a civil-rights matter and encouraging surgical intervention is in reality to collaborate with and promote a mental disorder.”