New Human Rights Campaign Foundation Report: Online Hate & Real World Violence Are Inextricably Linked

The Human Rights Campaign Foundation – the educational arm of the nation’s largest lesbian, gay, bisexual, transgender, and queer (LGBTQ+) civil rights organization – released Online Harassment, Offline Violence: Unchecked Harassment of Gender-Affirming Care Providers and Children’s Hospitals on Social Media, and its Offline Violent Consequences, a report showing how anti-equality, online extremists are leading a proactive and coordinated campaign of hate against hospitals and medical providers who offer gender-affirming care for transgender, non-binary and questioning youth. According to this new research, accounts like LibsOfTikTok and individuals like Matt Walsh are leading a highly-organized attack campaign; HRC Foundation researchers identified online harassment campaigns against 24 different hospitals and health care providers, across 21 states, between August and November alone. In addition to the report, HRC released a video featuring Dr. Angela Goepferd of Children’s Minnesota, discussing the attacks on medical providers.

These accounts are spreading falsehoods about gender-affirming care and using violent rhetoric to encourage targeted attacks on providers, including harassing phone calls, death threats and bomb threats to hospitals. The spread of disinformation online is directly correlated to the real-life violence happening across the country, such as recent bomb threats on Boston Children’s Hospital; as the report concludes, without intervention from social media platforms like Facebook, Instagram, TikTok and Twitter, this cycle will viciously continue.


As threats against the transgender community continue to rise – especially impacting Black, Brown and young transgender people – it is crucial that we look at who are the major players fueling this campaign of hatred. This report confirms what we have suspected for some time: these dangerous accounts are playing a major role in causing harm to healthcare providers and patients. They are no longer just making the internet an unsafe place for transgender people and allies. The ruthlessness and the vitriol has long ago expanded beyond the confines of the screen to spawn threats of physical harm on people.”

Kelley Robinson, President of the Human Rights Campaign

HRC identified a five-part cycle of violence:

  1. Hate speech accounts such as Libs of TikTok or Matt Walsh, a known anti-trans extremist at the alt-right news site The Daily Wire, post an inflammatory message full of disinformation about gender affirming care and call out a specific hospital or doctor by name.

  2. The doctor and hospital almost immediately begin receiving a barrage of harassing and threatening messages online.

  3. Offline, doctors and hospitals named in social media harassment campaigns face harassment and threats at their homes and workplaces. In the most extreme examples, doctors face death threats and hospitals face bomb threats, halting care for all patients.

  4. Extremist politicians looking to rile up the most extreme members of their base join in spreading the same transphobic rhetoric from their platforms, in some cases going so far as to introduce legislation to regulate children’s hospitals and gender-affirming care providers.

  5. Hospitals halt gender-affirming services or remove online resources and websites in order to protect the safety of their patients and staff.

HRC’s report documents dozens of instances where posts have led to violence and prevented patients from receiving the healthcare they need at places like Boston Children’s Hospital, Children’s Hospital of Pittsburgh, Vanderbilt University, and the University of Wisconsin. In other instances, online campaigns have been taken up by extremist politicians to justify investigations and legislation to block or pressure hospitals and doctors into ceasing providing gender-affirming care. One such incident happened on September 21, 2022, when Tennessee Governor Bill Lee and Attorney General Jonathan Skrmetti called for an investigation into Vanderbilt University’s Transgender Health Clinic just 24 hours after Matt Walsh, a known far-right ideologue working for the alt-right media company The Daily Wire, tweeted that the clinic would “castrate, sterilize, and mutilate minors.” Vanderbilt health providers also received death threats, according to the report.

The damage isn’t limited to doctors, administrators, and patients receiving gender-affirming care – it impacts all patients and families who visit these hospitals and clinics. The report notes that when hospitals are forced to go into lockdown and hire extra security, it impacts access to care for everyone. As stated in a letter sent to the DOJ from the American Medical Association (AMA), American Academy of Pediatrics (AAP), and Children’s Hospital Association (CHA), “In one hospital, a new mother was prevented from being with her preterm infant because the hospital’s Neonatal Intensive Care Unit was on lockdown due to a bomb threat.”

Even though some social media platforms have policies banning such dangerous disinformation and violent threats, the enforcement is inconsistent, and this kind of rhetoric continues to thrive online. Despite occasional bans or suspensions, accounts are routinely reinstated and their posts remain available to incite viciousness. HRC demands social media platforms take meaningful action before even more harm is done.

Best-practice, age-appropriate care for young transgender people — as supported by the AMA, APA and other bodies representing millions of doctors across the country — can be lifesaving and, in many cases, can be as simple as changing hairstyle or clothing. Every credible medical organization — representing over 1.3 million doctors in the United States — calls for age-appropriate gender-affirming care for transgender and non-binary people. Learn more in our gender-affirming care fact sheet, or in our gender-affirming care explainer video. When reporting on issues pertaining to transgender and non-binary people, please consult our brief guide on getting transgender coverage right.

For more information on the HRC Foundation’s Public Education and Research Program, visit

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