For Cristina Hineman, the situation felt urgent: the 17-year-old needed treatment at Planned Parenthood, where she knew she wouldn’t be subjected to humiliating questions, or an unnecessary waiting period, or lectures, or prying about her certainty. But it wasn’t an abortion she sought. It was testosterone.
Planned Parenthood was founded a century ago to promote birth control. Today, its nearly 600 clinics nationwide make it the largest single provider of abortion, contraception, reproductive care, and sex education in the U.S.
It has also, in less than a decade, become the country’s leading provider of gender transition hormones for young adults, according to insurance claim data. In 2015, around two dozen of their clinics began offering this service. Now it’s available at nearly 450 locations. Insurance claim information provided to The Free Press by the Manhattan Institute shows that at least 40,000 patients went to Planned Parenthood for this purpose last year alone, a number that has risen tenfold since 2017. The largest proportion, about 40 percent, were 18- to 22-year-olds.
Faced with her parents’ skepticism, Hineman waited to make an appointment for just after her 18th birthday in November 2021 at the Planned Parenthood in Hudson, NY. Some clinics offer hormones starting at age 16 with parental approval, but as a legal adult Hineman wouldn’t need their consent.
After she filled out forms in the Planned Parenthood waiting room, a nurse led her to an exam room and handed her a consent form for “masculinizing hormone therapy.”
Records show that a nurse practitioner asked about Hineman’s identity and desires; she noted that “patient has consulted with a mental health provider”—meaning Hineman had previously talked to therapists. The two discussed the “expected changes” related to testosterone—growing a beard and body hair, deepening voice, and that “changes to fertility may be permanent or reversible.”
Then the first nurse took Hineman’s blood, and she was given a prescription for testosterone gel. She remembers all this taking under 30 minutes.
Like many others in the rising wave of female teens seeking to masculinize, she had been battling a cluster of mental health problems: self-harm, depression, and anxiety. Also like many of these teens, Hineman has autism. The Covid lockdown exacerbated her troubles. She told me, “I couldn’t see my friends, I couldn’t see my girlfriend. I was depressed and scared, in my room ruminating all the time.”
The viral YouTubers she was watching convinced her that gender was the problem. “I was like, oh my god, trans includes all the things I’ve been feeling—my discomfort with my chest, my discomfort with being called ‘young woman,’ not being sure of who I was or what I wanted to be,” she said.
Just over a year into treatment, Hineman realized she had made a terrible mistake, and that gender was not the source of her problems. “I was brainwashed,” she says now. “A lot of people say that adults should be able to do whatever they want. But if you have mental illness that’s clouding your view, or you’re so misinformed about what gender dysphoria even means, then you cannot consent to such invasive treatments.”
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