Fred was diagnosed with ADHD with autistic traits at age 4 and struggled with depression and anxiety as he got older. He was expelled from three different special-needs schools due to behavior problems and is now an 18-year-old New Jersey high school student who lives with his parents.

Last December, Fred announced that he was a transgender woman, a few months after his best friend, who is also autistic, began identifying as transgender.

Fred's parents — who asked The Washington Free Beacon to withhold his real name — tried to enroll him in the Gender and Autism Program at Children's National Hospital, which is the only gender clinic in the country that specializes in treating autistic youth.

Fred had resolved to take hormones; but before he did, his parents wanted to make sure that his dysphoria wasn't temporary or influenced by his friend's condition. In March, the program informed them the waiting list was a year long.

Unwilling to wait and now 18, Fred turned to Planned Parenthood for hormones while his parents were out of town in late July. The abortion provider reportedly prescribes hormones to any legal adult without a formal diagnosis of gender dysphoria or a letter from a therapist and requires only a brief consultation about the drugs' effects, which include permanent infertility.

According to phone tracking data his parents made available to the Free Beacon, Fred arrived at his local Planned Parenthood clinic in Montclair, New Jersey, around 11 a.m. and by 11:39 a.m. they received a text message from CVS that Fred's estrogen prescription was being processed.

"It’s criminal what Planned Parenthoods all over the country are doing," Fred's mother, a New Jersey pediatrician, told the Free Beacon. "And most people have no idea this is happening."

Amid growing concern about the dangers of rapid gender transition and with waitlists at clinics like Children's National monthslong, if not yearslong, many young people are using Planned Parenthood to speed up the process and get around the safeguards.

"I have always been a very strong supporter of Planned Parenthood and am pro-choice, but they have taken on something that they are not equipped to handle," Laura Edwards-Leeper told the Free Beacon. Edwards-Leeper co-founded the nation's first pediatric gender clinic, at Boston Children's Hospital, in 2007.

Planned Parenthood is one of the largest and fastest-growing providers of transgender hormone therapy in the United States. Between 2021 and 2022, clinics in the greater area of Portland, Oregon, saw nearly a 400% increase in gender-transition care visits, according to annual reports. Affiliates in Ohio observed a 544% increase during the same time frame.

A Reuters investigation last year found that some pediatric gender clinics are prescribing hormones on the first visit, whereas they previously waited months to conduct in-depth assessments before reaching for the prescription pad.

Alarmed by Planned Parenthood's informed consent model, Edwards-Leeper told the Free Beacon that some 18-year-olds, especially special-needs individuals, require extensive counseling before they can meaningfully consent to taking hormones.

"There are 15-year-olds I work with who are much more mature than average and can make these kinds of decisions," she said. "But there are also 20-year-olds who are struggling in various ways that make them less able to give informed consent."

Guidelines published in The Journal of Clinical Child and Adolescent Psychiatry state: "Because it is often harder for an adolescent with [autism] to comprehend the long-term risks and implications of gender-related medical interventions, consenting for treatment may be more complex in this population."

The World Professional Association of Transgender Health (WPATH), also notes in its guidelines that "it is critical to differentiate gender incongruence" from autistic "obsessions" and "rigid thinking."

"Some young adults are developmentally more like adolescents," Edwards-Leeper, who helped draft the WPATH minor guidelines, told the Free Beacon. "Planned Parenthood really isn't following the standard of care if they don't take that into account."

Fred's parents filed a complaint against Planned Parenthood with New Jersey's nursing and medical boards in July, arguing that it violated the standards of care by prescribing their son estrogen without a psychiatric assessment. They also stated that his ability to consent was inhibited by his autistic traits.

"The New Jersey State Medical Board has an obligation to protect children and young adults, especially those with special needs," the complaint said. "This type of shoddy (and irreversible) medical practice is a threat to all of them."

Information from Reuters was used in this report.

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