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Hospitals and doctors across the country face harassment and even death threats for the medical care they provide to transgender children. In many cases, they have been the subject of posts from a Twitter account called Libs of TikTok, as well as stories in conservative media outlets that cast gender-affirming attention as child abuse and mutilation.
Which begs the question: where should social networks draw the line with accounts promoting narratives that trigger bullying campaigns on their platforms and beyond?
Children’s National Hospital in Washington, DC became the latest target this week when TikTok’s Libs posted an audio recording in which hospital staff appeared to say gender-affirming hysterectomies had been performed on minors. The hospital said the claim was incorrect and none of the people on record provide care to patients.
“The information on the recording is not accurate. We do not and have never performed gender-affirming hysterectomies for anyone under the age of 18,” Children’s National said in a statement to NPR. “The operator who spoke provided incorrect information.”
The statement continued: “Since the spread of misinformation on Twitter, we have been the target of a high volume of hostile and threatening phone calls and emails.”
Children’s hospitals in Boston, Seattle, Chicago and Portland, Oregon have also been targeted. In the past week, Boston Children’s Hospital warned that he was receiving “a high volume of hostile internet activity, harassing phone calls and emails, including threats of violence towards our doctors and staff” after false claims performs genital surgeries on minors.
The US Department of Justice even weighed in, with the US Attorney for Massachusetts calling the attacks “disturbing.”
False claims, videos out of context
These false narratives about gender-affirming pediatric care are rooted in fundamental “misperceptions,” said Dr. Angela Kade Goepferd, a pediatrician and director of the Gender Health Program at Children’s Minnesota.
“People have the misperception that we are doing surgery on young children. People have the misperception that we are changing children from boys to girls at a very young age,” they said.
They said care for transgender children is vast, from efforts to help children socially transition to puberty-blocking medications, and is carried out with input from pediatric psychologists, clinical social workers, experts in hormones and endocrinologists, as well as families. Gender-affirming surgeries are not a routine part of pediatric gender care, they said, and Children’s Minnesota does not perform any of those surgeries.
Some of the claims about Children’s National, Boston Children’s and other hospitals were fueled by the Libs of TikTok account, which regularly reposts videos and social media posts from LGBTQ people, teachers, schools and other institutions. The clips are sometimes taken out of context and framed to fuel outrage or ridicule for LGBTQ and anti-racist causes, in what the account owner has described as “exposures” of “the crazy ones.”
For example, a short clip on gender-affirming hysterectomies from a video originally posted by Boston Children’s that was reposted by Libs of TikTok does not mention the ages of the patients. But TikTok’s Libs tweeted along with the clip the false claim that the hospital offers the surgery “for girls.”
Libs of TikTok, run by a Brooklyn woman named Chaya Raichik, has 1.3 million followers on its biggest platform, Twitter. He has gained prominence and influence in right-wing circles over the past year as conservatives increasingly try to use anti-LGBTQ sentiment to rally support.
NPR contacted Raichik for this story. He initially responded and agreed to an interview, but did not respond to a follow-up message. Raichik frequently condemns criticism of his online activities as efforts to “cancel and silence her.” He has said that he too has been the subject of death threats.
Platforms fight against harassment networks
Twitter and Facebook prohibit bullying and harassment, coordinated mass attacks, and incitement to violence. Both companies prohibit the use of the word “groomer” as a slur against LGBTQ people under their rules against hate speech.
The platforms have removed some of the threats against hospitals. But it’s less clear how much liability companies can or will put on accounts that draw attention to targets who end up being harassed.
Twitter temporarily suspended TikTok Libs for breaking its rules. The company declined to comment on the account. Following threats reported by Boston Children’s Hospital, Libs of TikTok said Facebook had permanently suspended it for violating the platform’s community standards. But that was quickly reversed and the account reposted on Facebook, saying the social network had said it was a mistake. Facebook declined to comment on the suspension.
Libs of TikTok appears to have evaded outright bans by pushing the limits of the platforms’ rules, but not breaking them. The account does not explicitly encourage followers to threaten anyone and typically uses its target’s own words, sometimes without context, to hint at wrongdoing.
But while their individual posts may stick to the letter of the platforms’ rules, it’s their cumulative effect that worries researchers like Joan Donovan, who studies online extremism, media manipulation and disinformation at the Shorenstein Center. Media, Politics, and Public Policy at Harvard.
“We’ve reached this phase in social media where people know what to do when an account like Libs of TikTok calls another account or a person or institution,” he said. Complaints can trigger bullying campaigns known as “brigades,” in which commenters huddle together around a common goal.
In the case of children’s hospitals, “threats have gone from insulting specific people or accounts online to more direct threats,” Donovan said. “The online threat escalates very quickly to offline violence when we start to see these attack patterns.”
For social networks to deal with what Donovan calls “network incitement,” he says, effectively tracking those threats means looking beyond individual posts on specific platforms.
“Precipitating comments may not be as inflammatory, but if that creates an attack pattern that is recognizable, which is with an account like TikTok’s Libs, then these companies are well within their jurisdiction to warn and then ban the account.”
Right-wing groups target LGBTQ events, education and healthcare
Pediatricians and children’s hospitals are just the latest targets of right-wing outrage, in a new iteration of smears from decades ago of gay, lesbian and transgender people as pederasts or “groomers”.
“The Libs of TikTok account has been a major player in driving many of the harassment campaigns we’ve seen over the past year,” said Ari Drenn, director of the LGBTQ program at Media Matters for America, the liberal advocacy group.
In some cases, the events and figures published by TikTok Libs have been attacked offline by far-right extremists known for fighting.
On a single day this summer, for example, men with ties to the white nationalist group Patriot Front were arrested outside a Pride event in Coeur D’Alene, Idaho, and suspected members of the far-right Proud Boys stormed within an hour. of drag queen tales. in a library in San Lorenzo, California. TikTok’s Libs had tweeted about both events, although there is no conclusive link between the posts and the activities of extremist groups.
As the Washington Post reported In April, the account’s topics and posts are regularly featured and promoted by other conservative influencers and media figures, including podcaster Joe Rogan. Raichik has appeared on Tucker Carlson’s prime time Fox News show.
The growing stigmatization of transgender health care worries doctors.
“This is a developmentally appropriate team approach that gives children time to discover their identities,” said Dr. Goepferd of Children’s Minnesota.
Threats to hospitals are spreading, affecting not only hospital staff, but also patients and families seeking all kinds of care, as well as the long-term research needed in the field. “I am concerned that this kind of false narrative will make research institutions or funders nervous about funding more research to find out what is the best possible care we could provide at this time,” Goepferd said.
“The fact that the message has gotten out somewhere that it’s okay to attack doctors, pediatricians and children’s hospitals in this way is just a really disturbing social trend,” they said.
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