“Do No Harm” — not so harmless

The US health care system* fails people of color on several metrics, including maternal and infant mortality, rates of chronic illness in youth and adulthood, and overall life expectancy. 

Some of this is driven by poverty and lack of health insurance, which disproportionately affect Black Americans. Some is a result of decisions made by medical professionals, who are less likely to take seriously the symptoms of Black patients, especially Black women. 

And some is attributable to the corrosive stress of dealing, day in and day out, with racism, in its individual and systemic manifestations.

Into the breach? “Do No Harm,” a lobbying group and think tank that’s been in the news lately for opposing gender-affirming care.

But only for trans people.

They have no beef with teenagers who get labioplasty, breast augmentation or reduction, tummy tucks and thigh lifts, chin and cheek implants, and botox: a quarter of a million procedures in 2023 (pdf: page 17). That’s in a year. 

But trans teenagers, 13,994 of whom had gender-affirming care of any kind in the five years from January 2019 through December 2023 are the victims of “extreme gender ideology.” 

As if the pressure to conform to gender norms isn’t ideology, or gendered.

“Do No Harm” was founded by a retired nephrologist, by the way. A kidney doctor. With an axe to grind, and no specialized training in psychology, social work, endocrinology, pediatrics, or any other profession devoted to the study of gender, or ideology, or young people.

Doctor Kidney’s mission: to drive “discrimination and division” out of health care — by opposing any initiatives to address gender and racial disparities in health care outcomes, clinical trials, medical school admissions, and hospital policies. Developing and supporting anti-trans legislation got added to the mix a year later.

Put another way: they want it to be illegal to think about including a diverse sample of the population in clinical studies. If women are excluded because “menstruation might mess up the results” or “they might be pregnant” — fine. If Black women are ignored in recruiting channels — fine.

Do No Harm claims its members “physicians, nurses, medical students, patients, and policymakers.” But the 21 members of the (all-white) team only include five with medical training, only one of whom is certified in psychiatry. 

The director of outreach is an RN with a background in cardiac health, the gender ideology specialist is an oncology nurse, and the director of eliminating DEI is distinguished for getting fired when she refused to participate in bias training; her nursing experience includes home health care, hospice nursing, and emergency department work.

Just to be clear: diversity and inclusion efforts opened doors for women, Jews, African-Americans, Hispanics, and other members of the not-white-male majority to enter medical school. 

They work to provide access to medical students from impoverished backgrounds: male or female, white or Black, and to make sure LGBTQ populations are comfortable accessing health care. 

They push for including elderly people in clinical trials, so your grandpa won’t die from a medication that was only ever studied in young adults. 

And they seek to analyze disparities in care that lead to dramatically distinct outcomes among different populations. Demographics, like those cited above, make clear the rationale for this. It’s not rocket science.

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Should you be tempted to check out the “Do No Harm” website, please note that it is full of misstatements and outright fabrications, including the claim that Europe limits gender-affirming care; their report doesn’t even mention Germany, which has explicit guidelines about caring for trans youth.

Also of interest: repeated warnings on the site that its contents “should not be interpreted as medical or professional advice.”

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*Health care in the US isn’t really a system; it’s a collection of often-competing, poorly integrated entities that individuals in need of care attempt to navigate at their peril. It’s three vulture capitalists in a trench coat fighting to extract every last penny from the business of selling drugs, diagnostic procedures, and doctors’ time.

The DOE Just Trumpeted Its True Colors

Here we go. The Trump Department of Education wants you to help it “end DEI” by informing (confidentially) on “illegal discriminatory practices at institutions of learning.”

This submission form is an outlet for students, parents, teachers, and the broader community to … identify potential areas for investigation.

Students can snitch on their teachers, parents on their kids’ teachers, teachers on each other. And you don’t have to have any connection to a school: anyone else in the community is welcome to use the form. 

The DOE press release announcing the portal quotes Tiffany Justice: “Parents, now is the time that you share the receipts of the betrayal that has happened in our public schools.”

Justice, co-founder of Moms for Liberty, claims the group is bipartisan though it has ties to the Proud Boys, promoted Florida’s “don’t say gay” laws, seeks bans on books with LGBTQ+ or Black characters or themes (and sexy seahorses) and is closely linked with Republican leaders. M4L members have suggested that LGBTQ+ students should be taught in separate classrooms from straight kids and students with disabilities should be de-mainstreamed, and called a Pride event “perverse.”

If you’re a school librarian, a teacher, an assistant principal, if you’re gay or trans, Jewish or Muslim, a second-generation immigrant or a Black person with generations in the United States behind you — or not! — whether a report is even valid is not the point. 

Being investigated is exhausting and demoralizing. Being investigated alone will make some people think you’ve done something wrong. Targeting individuals, claiming they’ve violated the nation’s new speech laws, makes it harder for others to dissent. 

That is the point.

Gestapo. Securitate. KGB. Frumentarii. Stasi. Secret Police. Whatever you call it, encouraging people to rat on their neighbors is a key feature of authoritarianism. 

A Moms for Life chapter newsletter opened with a quote from Hitler (the writer then apologized). In an interview with Forbes, Justice said it was a mistake for a chapter leader to open a newsletter with Nazi propaganda. But at a M4L conference, Justice said, “One of our moms … quotes Hitler.” Someone in the audience whooped. “I stand with that mom,” she added, to many more cheers. 

It’s not just about trans people. By foregrounding Moms for Liberty in its call for informers, the Trump Department of Education just told us that, loud and clear.