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The Prager University Foundation, a conservative advocacy group, purchased a “takeover” ad on X on Thursday as part of a larger $1 million marketing campaign to promote its polarizing film “Detrans: The Dangers of Gender-Affirming Care.”
The 21-minute film focuses on two people who have detransitioned, meaning they previously identified as transgender and later decided they were not. Though both of them began transitioning when they were adults, their stories are part of the film’s larger criticism of transition-related care for minors, which has recently become the target of Republican state legislators, who have passed laws to restrict puberty blockers, hormone therapy and surgery in 22 states over the last three years.
PragerU’s X takeover represents X’s shift toward promoting more conservative — and, critics would argue, more extreme — views after billionaire entrepreneur Elon Musk purchased the platform and removed many of the policies that barred ads promoting anti-LGBTQ views or misinformation, reinstated accounts that previous Twitter management had suspended for anti-LGBTQ harassment, and shared an anti-trans video from his own account.
The "takeover" placement meant the ad for the "Detrans" was the first one displayed for most users of the social media platform throughout the day.
In June, X’s chief of trust and safety resigned after Musk publicly undermined her decision to moderate the spread of the same anti-trans video.
Craig Strazzeri, PragerU’s chief marketing officer, named Musk as part of the reason the nonprofit group advertised on X.
“We decided to pursue an X takeover because it’s a great opportunity for us to reach a massive audience on the dangers of gender affirming care given that X is one of the least censored social media platforms thanks to Elon Musk,” Strazzeri said in an emailed statement. “This will give millions of people the opportunity to hear important stories from detransitioners themselves, many of whom have been censored and even ostracized because their lived experiences do not affirm the mainstream media’s narrative.”
Strazzeri said the organization hopes that, after they have watched “Detrans,” “viewers will have a better understanding of how young Americans are being manipulated by social media and medical professionals to undergo life-altering surgeries that often come with major regret.”
Strazzeri’s comments echo language used by conservative groups and lawmakers who have advocated for restricting care for minors. However, more than a dozen major medical associations — including the American Medical Association, the American Academy of Pediatrics and the American Psychological Association — support access to care and have opposed laws that restrict it.
PragerU did not immediately reply to an additional request for comment about criticism of the film and the medical community’s support for access to care.
In contrast to X, YouTube rejected PragerU’s ad takeover placement “almost immediately upon submission,” PragerU said in a news release. The advocacy group said multiple film festivals have also rejected the film.
YouTube spokesperson Michael Aciman said the platform did not reject PragerU's ad completely.
"The ads in question do not violate our ads policies and are currently running across our platforms," Aciman said in an email. "In accordance with our YouTube ad requirements, since 2021, ads related to political topics are ineligible to run on the YouTube Masthead.”
There have been a number of documentaries about people who have detransitioned in recent years, and in some cases, theaters have canceled screenings because of backlash. Some advocates and trans people have criticized the films — including “Detrans” — which they say are misleading because they focus on the small number of people who detransition when the overwhelming majority of trans people report being happier after transition.
A 2021 review of 27 studies that evaluated rates of regret among people 13 and older who received gender-affirming surgery found that an average of 1% experienced regret.
“Detrans” criticizes young people’s access to transition-related care, but both of its main characters began medical transition when they were legal adults. Daisy Strongin, for example, was 18 when she began testosterone, though the film does not disclose that and it shows videos and images of Strongin in which she looks younger. Abel Garcia, the other main character, says in the film that he was 19 when he began medical transition.
The documentary describes the case of Layla Jane, who alleged in an ongoing lawsuit filed in June against the Kaiser Hospital Foundation that she received hormones and a double mastectomy at 13, but it does not interview her.
Kaiser Permanente, the network that includes the Kaiser Hospital Foundation, said its transgender care services "are aligned to guidelines endorsed by major medical associations to meet individual patient needs."
"When adolescent patients, with parental consent, seek gender-affirming care, the patient’s care team carefully evaluates their treatment options and then a multidisciplinary team of physicians and other experienced professionals are available to provide the patient and their family with information, counseling, and other support," it said in an emailed statement Thursday.
Though not all trans people pursue medical transition, access to gender-affirming care for minors is widely supported among the medical community, and it has been found to improve mental health outcomes and reduce suicidality. Standards of care developed by the World Professional Association for Transgender Health, a nonprofit professional association devoted to transgender health, recommends that treatment for all trans people, including minors, be individualized and require informed consent from both the patient and, in the case of a minor, at least one of the patient’s parents. The standards of care recommend gender-affirming mastectomies for minors only in very rare circumstances.
PragerU’s “Detrans” documentary argues that young people are fast-tracked into medical transition, though it does not include the viewpoints of any physicians.
It’s unclear exactly how many people a trending takeover ad on X reaches. The ad information on the platform’s business site says takeover ads “are the most premium, mass-reach placements that drive results across the funnel by taking over the Timeline and Explore tabs.” X did not immediately respond to a request for comment about the estimated reach of an X trending takeover ad.
Kelley Robinson, the president of the Human Rights Campaign, the country’s largest LGBTQ rights organization, condemned Musk and X for “prioritizing their bottom line over the lived experience and humanity of transgender people.”
“So-called documentaries like the one peddled by PragerU do nothing more than spread misinformation and stigmatize transgender people,” Robinson said in a statement. “Given the growing threats of violence faced by the transgender community, offering a platform to this type of hate-filled propaganda is not just immoral—it’s dangerous. Today’s timeline takeover is another stain on the platform.”
This article was originally published on NBCNews.com