Shady nonprofits push child sex change: no questions

President Trump’s earlier order to freeze government grants and aid to nongovernmental organizations has drawn rapid and loud condemnation from his political opponents, who pointed to potentially lost funding for Meals on Wheels and other popular, largely apolitical, charities. 

However, NGOs and private foundations play important, but largely invisible, roles in implementing the progressive agenda, including the furtherance of gender ideology.  According to Statista, as of 2022, US private foundations had over $1 trillion in assets, indicating their significant influence. 

These nonprofits play a large role in spreading gender ideology and propaganda about child sex change medicine, including funding the creation of curriculum materials in schools, sympathetic coverage in media outlets, biased research, and, in some cases, directly subsidizing these dangerous procedures.  

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In the state of Missouri where I live, one large but little-known nonprofit, the Missouri Foundation for Health (MFFH), illustrates how these entities that possess enormous assets, operate and flourish with virtually no accountability. I highlight it as a case study in light of the insidious nature of the nonprofit sector’s influence.

Most people in the Show Me state have probably never heard of MFFH as it does not advertise, nor does it even raise funds from the public. Its website says it is “committed to making lasting positive changes in health,” focusing on “key issues, community needs, and policy work.” They go on to describe several strategic initiatives, including behavioral health, contraceptive access, and crisis response, all of which MFFH says it views through the “equity lens that shapes all of [its] work.” 

But what are the specifics of the activities they support? They don’t exactly hide them, but you’d have to look. For example, you would not even know they were subsidizing Planned Parenthood’s wrong sex hormones program unless you visited the website of the St. Louis Planned Parenthood franchise and learned about their “TRANSforming Community, TRANSforming Care” program, which they describe as a partnership with MFFH. This presumably includes children. 

While Missouri generally bans minors from being subject to sex change procedures, including wrong sex hormones, children who were patients when the law went into effect in 2023 were excluded from the state ban pursuant to a grandfather clause in the statute. In Planned Parenthood’s own words, the partnership with MFFH “expands health care services, conducts trauma-informed research, and builds a sex education curriculum centering the needs of the gender expansive community.” The nonprofit group also enables Planned Parenthood to provide hormone treatments at a number of its clinics in Missouri and nearby areas in Illinois. MFFH is directly subsidizing the provision of hormones to children through this program.

Before Missouri banned so-called “gender-affirming care” for minors, the largest pediatric gender clinic in Missouri was a partnership between Washington University in St. Louis and BJC Healthcare, the largest healthcare system in the state. In 2021, MFFH gave the clinic’s co-head, Dr. Sarah Garwood, an award for outstanding leadership in the healthcare area. The award included a $2,500 payment for Dr. Garwood and $25,000 to support on-site clinics in local high schools created by Dr. Garwood. These clinics had a specific focus on LGBTQ-identified youth and created a convenient pipeline from the school to the gender clinic. 

MFFH’s executive leadership is on the record supporting the progressive agenda. In 2022, MFFH’s Vice President of Responsive Philanthropy published an article in an industry journal about oppression of the LGBT community, which focused on laws restricting sex change procedures for children. At the time of publication, there was widespread awareness of the harms of “gender affirming care,” none of which were discussed. When MFFH’s latest CEO joined the organization in 2021, he gave interviews to the press proclaiming his commitment to diversity, fighting structural racism, LGBT rights and other ideological components of the progressive consensus. 

How much money does MFFH have to influence the delivery of healthcare in this one state? ProPublica’s summaries of their filings with the IRS tell quite a story. In 2023, MFFH spent $75 million on its agenda and had a net worth of nearly $1.4 billion. Unlike the United Way, the Salvation Army, or other big charities, they don’t raise money from the public. According to their IRS filings, they have not raised a single dollar in contributions since 2014. So where did they get $1.4 billion in assets?

Unlike a lot of large foundations, MFFH was not founded by individual donors. MFFH was founded so that a large nonprofit health insurer could get state approval to convert to for-profit status. In 1996, Missouri’s Blue Cross Blue Shield wanted to convert to a for-profit business. Blue Cross Blue Shield was one of the first health insurance companies and is still in existence in some states today as a health insurance organization. Some are nonprofit, but today most are for-profit. These remnants of the Blue Cross insurance system do business under different names now, including Elevance, which was formerly Anthem. 

In the 1990s, many state BCBS insurers (each state entity is separate) wanted to convert to for-profit status. Most states require that tax-exempt entities obtain approval to engage in large transactions, like converting to a for-profit enterprise. The theory is that these entities, being free from taxation, must hold their assets in trust for the citizens of the state and any transaction that is going to yield a significant profit, must somehow inure to the benefit of the public. 

Missouri’s Attorney General wanted to ensure that some portion of the value of the non-profit enterprise would be held to benefit the public. Blue Cross proposed a novel idea. They set aside two hundred million dollars in cash and stock of the new for-profit plan (RightCHOICE) as an endowment for a new foundation, MFFH, which would operate and spend money to improve the healthcare outcomes in the counties that BCBS had served and, specifically, focus on underserved populations. The state agreed that this was an effective way to make sure the public benefited from BCBS’s for-profit conversion and approved the deal. In fact, it became a model for how BCBS entities in other states could obtain regulatory approval to convert to a for-profit enterprise. 

From this $200 million grubstake almost 30 years ago, MFFH has grown its endowment to over $1.4 billion. Its 990 filings since 2013 indicate it has spent between $50 million and $70 million per year on its progressive agenda. 

There is no way for the public to influence MFFH’s goals. They answer to no one. In theory, the current Attorney General has the authority to oversee tax-exempt entities to make sure they are using their assets for the public good. However, ideological bias is not necessarily a violation of the public trust. One might argue that subsidizing cross-sex hormone treatments is against public policy, but that would be a novel claim as long as no law is being violated. You cannot buy shares of their stock to vote for their board members. 

Barring any internal changes, for the foreseeable future, MFFH will continue as a powerful, but little known, player in pushing healthcare policy in Missouri in the progressive direction, totally immune from outside pressure.

Do you have a nonprofit group like the Missouri Foundation for Health in your state? You might. If you dare to do a bit of research, you’ll soon see the insidious, substantial influence of the nonprofit sector that is wholly unaccountable to voters.