Meet the influential new player on transgender health bills

Do No Harm, a nonprofit that launched last year to oppose diversity initiatives in medicine, has evolved into a significant leader in statehouses seeking to ban gender-affirming care for transgender youths, producing model legislation that an Associated Press analysis found has been used in at least three states.

The nonprofit, not widely known outside conservative medical and political circles, describes itself on its website as a collection of doctors and others uniting to "protect healthcare from a radical, divisive, and discriminatory ideology."

Representatives of Do No Harm turned down opportunities to talk with The Associated Press and emailed a statement explaining the group's position.

WHO IS BEHIND DO NO HARM?

Founder Dr. Stanley Goldfarb is a kidney specialist and a professor emeritus and former associate dean at the University of Pennsylvania's medical school. Goldfarb retired in 2021 and incorporated Do No Harm in January 2022.

Chloe Cole, center, is recognized by Florida Gov. Ron DeSantis during a joint session for his State of the State speech March 7 at the Capitol in Tallahassee. At left is Florida first lady Casey DeSantis. Cole received puberty blockers when she was 13, and underwent a double mastectomy at 16. Now she is an advocate against allowing those procedures on children.Phil Sears ~ Associated Press, file

Chloe Cole, center, is recognized by Florida Gov. Ron DeSantis during a joint session for his State of the State speech March 7 at the Capitol in Tallahassee. At left is Florida first lady Casey DeSantis. Cole received puberty blockers when she was 13, and underwent a double mastectomy at 16. Now she is an advocate against allowing those procedures on children.Phil Sears ~ Associated Press, file

Do No Harm initially focused on race in medical education and hiring. "The same radical movement behind 'Critical Race Theory' in the classroom and 'Defund the Police' is coming after healthcare, but hardly anyone knows it," it warns on its website.

Goldfarb declined to be interviewed by The Associated Press but said in an email that "Do No Harm works to protect children from extreme gender ideology through original research, coalition-building, testimonials from parents and patients who've lived through deeply troubling experiences, and advocacy for the rigorous, apolitical study of gender dysphoria."

Goldfarb has published a book, "Take Two Aspirin and Call Me By My Pronouns: Why Turning Doctors into Social Justice Warriors is Destroying American Medicine," along with a similar op-ed in the Wall Street Journal.

He told the New York Post in September 2022: "This focus on diversity means we're going to take someone with a certain skin color because we think they're OK, that they can do the work. But we're not going to look for the best and the brightest. We're going to look for people who are just OK to make sure we have the right mixture of ethnic groups in our medical schools."

The organization supported a civil rights lawsuit brought by two doctors and several states that challenged a federal rule allowing higher compensation for doctors who adopt an "anti-racism" plan. The lawsuit remains ongoing.

The organization's executive director, Kristina Rasmussen, previously was chief of staff to former Illinois Gov. Bruce Rauner, a Republican, and served as president of the Illinois Policy Institute, a conservative think tank, according to her LinkedIn profile.

WHERE IS DO NO HARM WORKING?

An AP analysis of statehouse bills to restrict gender-affirming care for youths found passages identical or nearly identical to Do No Harm's model legislation in Montana, Arkansas and Iowa.

The organization had lobbyists registered in 2022 in at least three states -- Kansas, Missouri and Tennessee -- and in Florida in 2023. People associated with the group have appeared as witnesses in statehouses, including Chloe Cole, 18, listed on its website as a "patient advocate" who has spoken to lawmakers about her gender-transition reversal.

In states including Idaho, New Hampshire, Tennessee and Ohio, Cole described her transition beginning at age 13, surgery to remove her breasts at 15, and stopping her transition a year later saying it was a mistake. Republican supporters of bills restricting or banning gender-affirming care often cite Cole's story.

Cole told the Kansas news outlet The Reflector this year that Do No Harm was reimbursing her travel expenses as she testified before state lawmakers. She and her lawyer did not respond to requests for comment from the AP.

IS DO NO HARM A LOBBYING GROUP?

Do No Harm originally organized as a charitable organization whose tax-exempt status would be endangered by substantial lobbying.

On March 9 this year, after the group had already made significant inroads in legislatures with its model bill, lobbyists and hearing witnesses, it incorporated Do No Harm Action as a separate nonprofit with a tax status that allows for more lobbying, according to records obtained from the Virginia Office of Charitable and Regulatory Programs.

Goldfarb did not respond directly to questions about Do No Harm's lobbying, nor did another representative for the organization.

In the application for nonprofit status obtained from the Virginia agency, Do No Harm projected revenues of $910,000 in 2022, more than $1.1 million in 2023 and over $1.5 million in 2024.

The organization is so new that federal tax forms that typically reveal nonprofits' spending details have been either not received or not processed.

It won a $250,000 award last year called the Gregor Peterson Prize. Its previous recipients include the Center for American Liberty, led by Harmeet Dhillon, a lawyer who advised former President Donald Trump's 2020 reelection campaign and who is representing Cole in her lawsuit against Kaiser Permanente over gender-transition treatments she now says she regrets. The prize was announced in December at a summit held by the American Legislative Exchange Council, a prominent provider of conservative model legislation.

HOW IS THE GROUP'S WORK RECEIVED?

More than 150 Penn medical school alumni signed a letter criticizing Goldfarb in 2019 for his Wall Street Journal op-ed. And last year, he was the target of an online petition after he reacted to an article in a scientific journal about the academic success rates of medical residency students of color at several institutions by suggesting in a tweet that "Could it be they were just less good at being residents?"

Cole's testimony at the Tennessee statehouse was praised by House Majority Leader Lamberth, who said she "described much better than I can on why no child should be put through this." Lamberth, who sponsored the state's ban on gender-affirming care for minors, also thanked Cole for sharing "the most private things that can ever happen to somebody."

Its model legislation on gender-affirming care has been criticized for using technical medical terminology as political rhetoric to scare people.

"Every single line of this contains some sort of falsehood," said Dr. Meredithe McNamara, an assistant professor of pediatrics at the Yale School of Medicine.

"My overall takeaway from this is that there are a lot of recycled false claims about gender dysphoria, standards of care, safety, evidence and medical authority which seems like it's right out of the disinformation playbook."

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Associated Press writers Kavish Harjai and Amy Beth Hanson, along with AP News Researcher Rhonda Shafner, contributed to this report. Harjai is a corps member of the Associated Press/Report for America Statehouse News Initiative. Report for America is a nonprofit national service program that places journalists in local newsrooms to report on undercovered issues.