The man behind the effort to limit gender care

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Jul 15, 2024 View in browser   By Ben Leonard and Chelsea Cirruzzo Presented by  With David Lim  Driving The Day Dr. Stanley Goldfarb (center), founder of the group, Do No Harm, wants lawmakers to ban gender-affirming care for kids. | Do No Harm handout ‘OUR GOAL WAS TO … HAVE AN EFFECT’ — A wave of Republican-led states have restricted care for children with gender dysphoria, and they’re turning to Dr. Stanley Goldfarb and his organization, Do No Harm, for legislative strategy and hand-picked medical experts, POLITICO’s Daniel Payne reports. Goldfarb, a former dean at the University of Pennsylvania’s medical school and a retired kidney doctor, has become a go-to source of medical information in making the case to restrict gender-affirming care. The group has argued that puberty blockers, rare surgeries and hormone treatments are medically harmful. Half of states have enacted laws restricting access to such care. “Our goal right from the beginning was to have an effect,” Goldfarb, who has raised millions for the cause since he founded the group in 2022, told POLITICO. “We’ve done that.” Goldfarb and his group have bucked the medical consensus from established organizations like the American Medical Association and the American Academy of Pediatrics, which have published policies backed with research to show that gender-affirming care is safe and necessary for patients’ health. Goldfarb accuses the establishment of putting ideology ahead of good medicine. The pushback: Goldfarb, who acknowledges his training as a kidney doctor means he’s no expert in gender care, and his work with the right have caught the eye of doctors leading established groups. Dr. Marci Bowers, president of the World Professional Association for Transgender Health who provides gender-affirming care to others, calls Goldfarb “pompous” and compares his crusade against the care to Nazi eugenics experiments. Goldfarb called Bowers’ broadside, or any name-calling in the debate over transgender care, “the last refuge of the scoundrel.” Lobbyists for mainstream health care organizations are worried about the group's influence among the GOP and believe his lobbying on gender-affirming care is putting patients at risk. “Banning things rarely ends well,” said Dr. Deborah Greenhouse, a pediatrician who works in South Carolina, which has barred patients under 18 from getting medical care for gender transition. What’s else is ahead: Goldfarb’s ambitions go beyond gender-affirming care, eyeing rooting out diversity, equity and inclusion efforts in medical education. Without Goldfarb, Rep. Greg Murphy (R-N.C.) said, the lawmakers “would not have made any significant progress” on his bill pending before the House Committee on Education and the Workforce. Whether Congress passes a bill or not, Goldfarb sees DEI as a ripe target after the Supreme Court banned affirmative action in college admissions last year. WELCOME TO MONDAY PULSE. Our politics team has the latest coverage on the Trump assassination attempt at politico.com. Send your tips, scoops and feedback to bleonard@politico.com and ccirruzzo@politico.com and follow along @_BenLeonard_ and @ChelseaCirruzzo. A message from HCA Healthcare: At HCA Healthcare, we show up to invest in and develop the next generation of healthcare leaders and professionals. Over the next three years, the HCA Healthcare Foundation will donate $1 million to the Consortium of Florida Education Foundations to help fund its Career Pathways to a Healthier Florida program, aiming to create and expand healthcare career pathways for underserved high school students across the state. Learn more about our dedication to education and our communities.   BIRD FLU Three cases of possible bird flu have been reported among poultry workers in Colorado. | Farjana K. Godhuly/AFP via Getty Images MORE BIRD FLU CASES — Three workers in Colorado who responded to an avian flu outbreak at a commercial egg-laying farm presumptively tested positive for the virus, the CDC reported late Friday. None of the individuals — who experienced mild symptoms including pink eye and common respiratory infection symptoms — were hospitalized. The Colorado State Public Health Laboratory has sent samples to the CDC for confirmatory testing. “This is another highly unfortunate reminder that the H5N1 virus poses a clear and present threat to farm workers,” said Jennifer Nuzzo, director of the Pandemic Center at the Brown University School of Public Health. “We need better strategies to prevent farmworkers from contracting this virus.” What’s next: The CDC is sending staff to Colorado to help the state’s ongoing investigation into the infections. The three workers were involved in culling poultry at the northeast Colorado farm. “State public health officials have collected additional samples from symptomatic workers, which will be tested this weekend,” the Colorado Department of Public Health and Environment said in a press release. “State epidemiologists suspect the poultry workers’ cases are a result of working directly with infected poultry.” The CDC said the risk to the general public from avian flu remains low. But the agency added that the investigation results “will inform whether guidance changes are needed.” Public health investigators seek information on the workers’ use of personal protective equipment. Sequencing virus samples from the outbreak is also an important step “to determine if a change in the risk assessment is warranted,” according to the CDC.   Understand 2024’s big impacts with Pro’s extensive Campaign Races Dashboard, exclusive insights, and key coverage of federal- and state-level debates. Focus on policy. Learn more.     Antitrust FTC EYES DIALYSIS FIRMS — The FTC is probing the nation’s two biggest dialysis providers, DaVita and Fresenius Medical Care, over alleged practices stifling competition with smaller companies, three people with knowledge of the probe told POLITICO’s Josh Sisco. The investigation focuses partly on how the companies make it difficult for their doctors to leave for rivals and start new businesses, said the three people, who were granted anonymity to speak about a confidential matter. The agency is investigating whether noncompete agreements the companies require doctors to sign snarl efforts by rivals that want to make it easier for dialysis patients to be treated at home. DaVita and Fresenius control at least 70 percent of outpatient clinics. It’s the latest move in health care from the FTC, which is expected to sue three companies over rising insulin costs and has scrutinized a large anesthesiologist group over monopolization allegations in Texas. The response: DaVita spokesperson Karen Modlin said the group is cooperating with the FTC and “demonstrate the advantages of our structure in serving the kidney care community.” Spokespeople for the FTC and Fresenius declined to comment.   A message from HCA Healthcare:   In Congress STILLBIRTH BILL IS LAW — President Joe Biden signed legislation clarifying that federal funds can be used for stillbirth prevention. The legislation from Sens. Jeff Merkley (D-Ore.) and Bill Cassidy (R-La.) and Reps. Ashley Hinson (R-Iowa) and Alma Adams (D-N.C.) passed the Senate by unanimous consent and the House 408-3 before Biden signed it Friday. The legislation encourages more research and programs to prevent stillbirth, including monitoring fetal movements, improving birth timing for pregnancies with risk factors and smoking cessation efforts during pregnancy. About 21,000 babies — 1 in 175 births — are stillborn annually in the U.S.   Understand 2024’s big impacts with Pro’s extensive Campaign Races Dashboard, exclusive insights, and key coverage of federal- and state-level debates. Focus on policy. Learn more.     Names in the News The American Telemedicine Association has launched a new leadership council. Eric Batch is now national advocacy vice president for outreach and partnerships at the American Heart Association. He previously led advocacy for Western states for the organization. WHAT WE'RE READING The Wall Street Journal reports on energy drinks becoming a “go-to” for teenage girls and young women with eating disorders. Reuters reports on Novo Nordisk getting scrutiny from Congress over a move to stop selling one of its insulin products in the U.S. A message from HCA Healthcare: Every day, HCA Healthcare serves patients across our 188 hospitals and approximately 2,400 sites of care in 20 states. To develop a strong workforce that reflects the patients we serve, we partner with local organizations, colleges and universities to create opportunities for future healthcare leaders to learn and confidently serve in their communities. Over the next three years, the HCA Healthcare Foundation will donate $1 million to the Consortium of Florida Education Foundations to help create and expand healthcare career pathways for underserved high school students across the state. In addition, as part of our commitment to invest $10 million in partnerships with Historically Black Colleges and Universities and Hispanic-Serving Institutions to advance diversity in healthcare, HCA Healthcare will gift $650,000 to Savannah State University and $200,000 to St. Mary’s University’s Greehey School of Business. Read more about our commitment to investing in education and our communities.     Follow us on Twitter Dan Goldberg @dancgoldberg Chelsea Cirruzzo @chelseacirruzzo Lauren Gardner @Gardner_LM Sophie Gardner @sophie_gardnerj Kelly Hooper @kelhoops Robert King @rking_19 Ben Leonard @_BenLeonard_ David Lim @davidalim Megan Messerly @meganmesserly Alice Miranda Ollstein @aliceollstein Carmen Paun @carmenpaun Daniel Payne @_daniel_payne Ruth Reader @RuthReader Erin Schumaker @erinlschumaker   Follow us

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