Documents Reveal ADF Requested Anti

Documents left public on a Google Drive by anti-LGBTQ+ hate group American College of Pediatricians (ACPeds), first reported by WIRED, reveal nearly a decade of coordination between ACPeds and another hate group, Alliance Defending Freedom (ADF), to shore up anti-trans policy efforts and legal arguments with bespoke research.

Between Sept. 30 and Dec. 1, 2014, ADF sent letters to school boards in Minnesota, Rhode Island, Virginia and Wisconsin warning that they could be open to litigation for policies allowing transgender students to use appropriate facilities such as bathrooms and locker rooms. On Dec. 5, 2014, ADF sent an email with a similar message to school superintendents across the U.S. The letters and emails were signed by Jeremy D. Tedesco, then senior counsel at ADF, now vice president of corporate engagement, responsible for "efforts to combat corporate cancel culture."

In a November 2014 blog post decrying a transgender-inclusive nondiscrimination ordinance in Houston, Texas, then-ADF president Alan Sears highlighted the letters and ADF's campaign against LGBTQ+ nondiscrimination protections. Sears also repeated an anti-LGBTQ+ trope claiming that nondiscrimination protections put children at risk and the "safety implications" of LGBTQ+ nondiscrimination laws "are so obvious as to hardly need elaboration."

The only problem for Sears and Tedesco was a lack of evidence to support their claims; and, to make the claims stick, someone needed to elaborate. A new trove of internal documents from the American College of Pediatricians suggests ADF turned to the group known to traffic in anti-LGBTQ+ "junk science" to "substantiate" many of its anti-LGBTQ+ talking points and provide medical justification for interpreting Title IX to exclude gender-identity protections. Together, the documents offer insight into how the groups manufactured legislative, legal and public relations challenges to medical science and public policy throughout the 2010s that have resulted in a rollback of abortion rights and nearly unprecedented restrictions on bodily autonomy in the U.S.

ACPeds did not respond to a emailed request for comment on Hatewatch's findings.

Title IX of the Educational Amendments of 1972 is a federal civil rights law that prohibits sex-based discrimination in schools that receive federal funding. Restricting the interpretation of "sex-based discrimination" to apply only to straight, cisgender students has been one of the anti-LGBTQ+ movement's longstanding goals. As trans visibility has increased, hate groups have argued, without evidence, that trans people pose a threat to women and girls, and that trans-inclusive nondiscrimination protections under Title IX jeopardize the safety of cisgender girls in particular.

Before he sent the letters, Tedesco seemed to recognize the lack of scientific evidence supporting ADF's arguments against LGBTQ+ nondiscrimination laws, according to documents Hatewatch reviewed. Metadata associated with one document, a copy of an email titled "Transgender Research Requests," suggests the file originated with "JTEDESCO" at "ADF" on Aug. 11, 2014.

The message is addressed to Dr. Michelle Cretella, ACPeds’ executive director until 2021, and two others. It appears to be a follow-up to a previous call between Tedesco and the email recipients. The email asks for ACPeds to provide ADF with "white papers" on five topics related to LGBTQ+ children and healthcare. White papers are research reports that convey subject matter expertise, but are also used as marketing tools by corporations. The document from ADF to ACPeds even instructs the junk science organization on specifics, citing a 2013 Heritage Foundation article by Ryan Anderson arguing against same-sex marriage as an example of the "type of paper we have in mind."

ACPeds has a reputation within the anti-LGBTQ+ movement as an organization that attempts to obscure its anti-LGBTQ+ ideology and its connection to the religious right using medical pseudoscience. ACPeds was founded in 2002 after about 60 members broke away from the 60,000+ member medical association the American Academy of Pediatrics over its support for adoption by same-sex couples. ACPeds is now led by Jill Simons and reports more than 600 members, although the group allows members who are not physicians.

The group claims to be above the influence of "the politically driven pronouncements of the day," but the circumstances of ACPeds’ founding and its entrenchment within anti-LGBTQ+ policy networks make clear its primary purpose – to restrict LGBTQ+ rights. For example, an earlier document leak in 2023 that exposed emails between South Dakota, Idaho and Florida lawmakers and a network of anti-LGBTQ+ activists showed the influence of the group's former president Dr. Quentin Van Meter, Cretella and the co-chair of ACPeds’ Committee on Adolescent Sexuality, Dr. Andre Van Mol, on the development and adoption of legislation banning gender-affirming healthcare across the country between 2018 and 2020.

A recent report by Kit O’Connell and Steven Monacelli at the Texas Observer details ACPeds’ admiration for conservative megadonor Monty Bennett's successful campaign to shut down the Gender Education and Care, Interdisciplinary Support (GENECIS) program at Children's Medical Center Dallas in late 2021 because the hospital provides gender-affirming care.

The new documents seem to confirm the national reach of ACPeds and its focus on restricting LGBTQ+ rights. In a Jan. 21, 2020, board conference call, the group discussed so-called "Vulnerable Child Protection Acts" that ban gender-affirming healthcare for young people, noting the laws were "drafted by ADF [Alliance Defending Freedom]/LC [Liberty Counsel] & ACPeds" and "are being introduced around the country." The minutes indicate that to that point, "ACPeds members have been recruited to testify on behalf of these bills in GA, AL, KY and OH."

The trove of internal documents also shows the group's leadership has, for years, disregarded questions about its credibility, and even Cretella's own qualifications for treating transgender people, in favor of anti-LGBTQ+ advocacy. In an email from Cretella dated Aug. 28, 2017, the former executive director says, "In the past I’ve been told by lawyers on our side that I do not qualify as an expert witness because I am not an academic and do not have experience caring for children with gender identity disorder." The same year, Cretella authored dozens of letters to elected officials opposing gender-affirming healthcare and LGBTQ+ nondiscrimination policies.

In 2020, then-ACPeds president Quentin Van Meter was "discredited as an expert" on hormone treatment in a Texas court, but regularly appears before state lawmakers advocating against gender-affirming healthcare. ACPeds also regularly issues policy statements, amicus curiae ("friend of the court") briefs, domestically and internationally, and promotes appearances by its leadership in conservative media, disguising itself as a medical authority while spreading anti-LGBTQ+ "junk science."

In 2017, Hatewatch reported on ADF's "stable" of purported "expert" witnesses, including Dr. Paul Hruz and Dr. Allan Josephson, who were called to help defend discrimination against transgender students. Although both hold medical degrees, Hruz and Josephson were at odds with their professional organizations’ official positions on gender-affirming care and, like Cretella, reported never treating patients with gender dysphoria. What the witnesses held in common were anti-LGBTQ+ beliefs and a relationship to ADF, who sponsored a conference where the two met.

The new documents suggest that ADF's recruitment of dubious "experts" began earlier than previously reported and, to an extent, anticipated the fight to interpret Title IX to include protections for transgender students. The documents also show that ACPeds appears to have recognized the request and eventually responded with a public statement and letter-writing campaign of its own, following ADF's lead on messaging. Importantly, ACPeds purportedly offered a medical justification for an exclusionary interpretation of Title IX in accordance with ADF's request.

In the 2014 "Transgender Research Request" message, ADF asks ACPeds for several policy statements that "substantiate" the claim that "psychological harm" especially "befall[s] girls/women" when their "privacy" is "invaded by males," and "substantiate" the idea that being transgender is a "phase" and that "interpreting this common stage as gender identity confusion warrants treating a child as the opposite sex … and pursuing more drastic measures like … genital change surgery."

The request is consistent with both ADF's anti-trans political messaging at the time and its legal needs. In addition to leading a case brought by some conservative ministers campaigning against a trans-inclusive nondiscrimination law in Houston, Texas, ADF was leading the charge against gender-inclusive school nondiscrimination policies, helping challenge one as early as 2013. ADF attorneys would go on to testify and file amicus briefs, and ADF would file its own cases against LGBTQ+ nondiscrimination laws in public school districts throughout 2015-17. ADF would also author model legislation banning trans students from school sports in dozens of states.

Reflecting this context and ADF's impending letters to school districts warning of potential litigation, the research requests asks if there is "any way to get the papers completed … by mid-November" [2014], but it would be "even better" if they could be done earlier.

The request also foreshadowed the direction of ADF's legislative and legal strategy when it asked for policy statements to "substantiate" the claim that it is "inappropriate" and "could have harms" to treat gender dysphoria in children with affirmation, and caregivers should instead ignore it as "a phase." A document from a professional organization that reaches these conclusions, the request suggests, would help ADF "make the point that interpreting Title IX to include protections for ‘gender identity’ [sic] will harm girls."

Throughout 2015 and 2016, ADF continued to send letters to and testify before local school districts warning "no court" had interpreted Title IX to include gender identity, and that school districts with nondiscrimination policies that included gender identity could open themselves to litigation. The group also took on clients to challenge local school districts’ adoption of trans-inclusive policies and challenged the Obama administration's guidance for schools that included gender-identity protections under Title IX after it was announced in May 2016.

A review of ACPeds executive committee meeting minutes shows that at the fall 2014 board meeting, held Oct. 3-4 in Atlanta, Georgia, Dr. Cretella was assigned an "action item" to "cooperate with Alliance Defending Freedom (ADF) on joint statement concerning transgender use of restrooms in schools." A statement titled "Sex-Segregated Bathroom and Locker Room Access is Best for Children" eventually appeared on ACPeds’ website in the spring of 2016. In the short statement, however, ACPeds offered no medical evidence for why transgender people should be barred from using bathrooms that match their gender identity.

At the February 2016 board meeting in Houston, Texas, the minutes note the organization sent letters and a fact sheet about gender dysphoria to state legislatures, school districts and "several grassroots organizations" in Alabama, Illinois, Massachusetts, Minnesota and Virginia.

In a publicly available version of a letter titled "A Medical Response to DOE & DOJ Guidance for Schools" and dated after the Obama administration issued Title IX guidance, Cretella cites Dr. Kenneth Zucker and controversial sexologist J. Michael Bailey to argue that neither gender-affirming care nor claiming "gender identity is the equivalent of sex as codified in Title IX" have any "basis in science." "Human sexuality is binary by design," the letter claims, while "all medically identifiable deviations from the sexual binary norm … are rightly recognized as disorders of human design." Gender identity, ACPeds insists, does not "comprise a third sex" and is, therefore, not protected under Title IX.

One case, known as Doe v. Boyertown Area School District, illustrates how ADF's request for research and ACPeds’ production of that research are packaged as part of ADF's legal campaign against LGBTQ+ rights. The Boyertown case began in August 2016, when ‘Joel Doe’ started high school in the Boyertown, Pennsylvania, school district. Because the district previously adopted a "narrow" policy – consistent with recommendations from the American Academy of Pediatrics – to allow trans students to use restrooms and locker rooms consistent with their gender identity, ADF and the Independence Law Center filed suit on behalf of Doe to block the policy.

Among other claims, ADF's suit argued that Title IX "explicitly emphasizes the binary view of sex, not ‘gender identity,’ [sic] which is nonbinary" to support its assertion that Title IX should not be interpreted to protect trans students. ADF lost the case, although the group appealed all the way to the U.S. Supreme Court, which declined to review a lower court ruling, leaving the policy in place.

As the case made its way to the Supreme Court, ACPeds leaders including Van Meter and Van Mol filed an amicus brief in support of Doe and ADF's legal theory. The brief cites other ACPeds thought leaders including Cretella and Zucker and claims "gender affirming policies generally harm, rather than help, gender dysphoric children." The brief repeats characterizations from ADF's 2014 request by equating transgender identity to "a bit of play-acting," claiming that transgender people are "impersonating" the opposite sex, and insinuating that nondiscrimination policies will result in a rash of transgender kids pursuing "drastic medical courses" like "surgical interventions."

Van Meter and Van Mol's 2018 amicus brief was filed by attorney Parker Douglas, who worked with ADF in 2018 on the R.G. & G.R. Harris Funeral Homes case, which sought to end employment discrimination protections for transgender people. Other court records show Douglas was later employed directly by ADF. Minutes from the ACPeds April 2019 board meeting confirm the brief, and a separate brief in the case of Adams v. School Board of St. Johns County (Florida), were filed as part of ADF's and ACPeds’ campaign "against pro-transgender bathroom, locker room, and sports policy."

Not long after ACPeds issued its public affirmation of "sex-segregated bathrooms," in August 2016, the group issued a policy statement titled "Gender Dysphoria in Children" and an accompanying blog post claiming that "gender ideology harms children." Neither the policy statement nor the blog post mention Title IX. However, they use language about binary gender identity and threats of surgical escalation that is similar to ACPeds’ previous school board letter.

Policy statements and amicus briefs are major tools used by ACPeds in their campaign to co-op the language of science to promote anti-LGBTQ+ ideology. On its website, ACPeds currently lists 66 policy statements and nearly three dozen amicus curiae briefs it filed, some with the help of the anti-LGBTQ+ groups Liberty Counsel and ADF, in cases opposing same-sex adoption and marriage, a case brought by ADF that argues professors have a constitutional right to misgender students, and other cases opposing abortion and nondiscrimination protections for LGBTQ+ students in public schools.

ACPeds compares its practice of producing policy statements to the American Academy of Pediatrics, saying both groups "employ similar first steps in producing a policy." Although the American Academy of Pediatrics notes their policy statements are rigorously reviewed, including an evidentiary review and submission to multiple groups of peer reviewers before being weighed by the group's board, ACPeds’ process includes only evaluation by a "small committee" known internally as the Scientific Policy Committee. Then, provided three-quarters of the ACPeds "executive committee" supports a statement, it is "passed and published."

Whereas the group's policy statements receive at least a nominal committee review, journalists Madison Pauly and Emma Rindlisbacher previously reported that amicus briefs were typically the sole purview of the former executive director, Michelle Cretella. Others have reported that under scientific scrutiny, ACPeds’ amicus briefs have been called into question for mischaracterizing scientific findings and cherry-picking data to fit conservative, anti-LGBTQ+ and anti-abortion narratives.

The documents reviewed by Hatewatch also suggest that ACPeds understood that ADF was willing to subsidize its anti-LGBTQ+ policy advocacy, giving ACPeds a potential financial motive for complying with ADF's anti-trans research requests. Minutes from the spring 2019 board meeting and executive committee conference calls show Cretella met with a senior attorney at ADF to solicit a $15,000 grant for a "white paper" that "refutes" the World Professional Association for Transgender Health (WPATH) Standards of Care 7 – a document that provides best practices for treating trans and gender non-conforming patients. The minutes suggest that ACPeds knew the white paper could be used in future ADF litigation and that ADF was "willing to fund" the project.

ADF continues its efforts to challenge inclusive education practices as well as trans-inclusive school sports, gender-affirming healthcare, and abortion rights. ACPeds continues to help. In June 2019, the ACPeds executive board entertained a request for an amicus brief from ADF supporting the claim that "sex is innate and immutable." The minutes show the request would overlap with a position paper, authored by Cretella and ACPeds’ current president Michael Artigues, titled "Sex is a Biological Trait of Medical Significance." In 2020, Notre Dame law professor Gerard Bradley filed an amicus brief for ACPeds in an ADF case called Meriwether v. Trustees of Shawnee State University , which discusses the importance of "sex" to medical science.

Both Artigues’ position paper and the brief use language directly from ADF's request, as recounted in the 2019 conference call, to argue that unlike sex, gender identity is not "innate" and "immutable." In its brief, ACPeds argues a pseudoscientific case in support of ADF's client by claiming gender identity is an ideological "flight from reality" that "threaten[s] the integrity of science and medicine." ADF subsequently won the case.

Similarly, in 2021, ADF filed a lawsuit on behalf of ACPeds against Xavier Becerra, secretary of the Department of Health and Human Services, using the same incendiary clams that gender affirmation will lead to "drastic" escalations in medical care that ADF first requested of ACPeds in 2014. Namely, the suit claims the department's interpretation of nondiscrimination provisions of the Affordable Care Act "require gender transition … surgeries and drugs on demand, even for children, no matter a doctor's medical judgment." A federal district court in Tennessee dismissed the case in November 2022. ADF filed a notice of appeal in January.

(Editor's note: An earlier version of this story misidentified the founder of ACPeds as Kenneth Zucker. The founder is Joseph Zanga. We regret the error.)

Photo illustration by SPLC (L-R Alan Sears, Jeremy Tedesco and Michelle Cretella)