Children's hospitals across the U.S. are facing growing threats of violence, driven by an online anti-LGBTQ campaign attacking the facilities for providing care to transgender kids and teens.
Twitter has left up the account inspiring the attacks , despite employees voicing concerns in internal Slack channels that it's "only a matter of time" before the posts lead to someone getting killed.
The campaign is led by Libs of TikTok, a Twitter account with more than 1.3 million followers run by a former Brooklyn real estate agent named Chaya Raichik, whose posts are frequently cited by Fox News's Tucker Carlson and other right-wing media figures.
After gaining a large Twitter following in the spring as she baselessly accused LGBTQ teachers of being pedophiles and "groomers," Raichik began criticizing children's health facilities earlier this summer, targeting a hospital in Omaha in June and another in Pittsburgh in August. The attacks resulted in a flood of online harassment and phoned-in threats at both hospitals.
Next came threats against children's hospitals in Boston and Washington, D.C., after Raichik posted tweets targeting them.
Reached by Twitter direct messaging on Thursday, Raichik didn't respond to a question about whether she felt responsible for the threats to the hospitals. "We 100 % condemn any acts/threats of violence," she wrote.
Twitter declined to comment, but people familiar with internal discussions say Twitter executives face internal pressure from some employees to respond more aggressively to the account. Meanwhile, hospital providers and their vulnerable patients have taken action to lessen the possibility of drawing Raichik's attention.
"A lot of people have chosen to try to be as quiet about their practice as they can to avoid those direct attacks," said Michael Haller, a professor of pediatric endocrinology at the University of Florida. "Institutions have removed their websites, taken down their publicly facing phone numbers."
"It's actually crazy. I can't even imagine being one of my patients," said Justine Lee, a craniofacial and pediatric plastic surgeon in Los Angeles who performs gender-affirming surgeries. "I can't think of any other medical condition that would result in this level of hate."
After Raichik falsely claimed on Aug. 11 that Boston Children's Hospital performs hysterectomies on children, the hospital received a barrage of "hostile internet activity, phone calls, and harassing emails including threats of violence toward our clinicians and staff," the hospital said in a statement. The hospital does provide hysterectomies to certain patients over 18.
On Tuesday, police responded to an anonymous bomb threat at the hospital. No explosives were discovered, and hospital officials said they were cooperating with the police investigation of the incident. "We remain vigilant in our efforts to battle the spread of false information about the hospital and our caregivers," the hospital said.
Raichik made a similar accusation against Children's National Hospital in Washington, posting a recording on Aug. 25 in which she can be heard questioning two unidentified hospital employees about whether gender-affirming hysterectomies are offered to patients aged 16. Both employees erroneously said the procedure was available to a 16-year-old and one said even younger patients are eligible, though the hospital says that information was incorrect and that neither employee is involved in patient care. During the call, Raichik said she was asking about care for her 16-year-old child, but she declined to answer Thursday when asked if she has a 16-year-old daughter in need of the surgery.
The recording has been played more than 1.1 million times on Twitter.
After it was posted, Children's National was inundated with threatening emails and phone calls, a hospital spokeswoman told The Post. Social media posts suggested the facility be bombed and its doctors run through a metal shredder. Police in D.C. say they are closely monitoring the risk to providers, while Boston police said they are investigating both the initial threats and the more recent bomb threat.
Medical workers in other parts of the country are watching the events in Boston and Washington with alarm.
Michael O'Brien, a pediatrics resident at a hospital in South Carolina, said he received threats after Libs of TikTok on Aug. 15 retweeted a tweet in which he'd criticized the account. Some appeared serious enough to prompt him to report them to his employer's public safety office. "I got three specific threats that came from within a 50-mile radius of where I live," he said. "The threats felt very tangible. I had to take action to protect my partner and warn my family."
"Every single time [Raichik] claims not to have responsibility, but she continues to do the same thing," he said. "She's very tactical, and purposefully tries not to break the terms of Twitter while knowing what she's doing is causing harm."
Specialists in online disinformation are especially critical of Twitter's approach to Libs of TikTok. The platform on at least two occasions has blocked Raichik's ability to tweet - once for 12 hours in April, and then again for a week in a sanction that ends Saturday.
Asked if she intends to resume attacking hospitals after her current timeout ends, Raichik declined to answer.
Joan Donovan, a leading disinformation expert with the Technology and Social Change Research Project at the Shorenstein Center on Media, Politics and Public Policy at Harvard University, said she sees parallels between Twitter's handing of Libs of TikTok and the way it failed to deal quickly with QAnon and the Stop the Steal movement, both of which faced a crackdown only after numerous acts of violence had been tied to their content.
She criticized Twitter's approach to Libs of TikTok, saying it shows a misunderstanding of how social media influences people's actions. "Networked incitement to violence is a snowball effect, where you see people getting more emboldened to participate," she said.
She drew a comparison between the Libs of TikTok campaign and its amplification by right-wing media and the online campaign that gave rise to the Jan. 6, 2021, riot at the U.S. Capitol. The snowball effect makes people feel "more willing to take action."
"We're seeing more people feeling - as they did during the insurrection - that storming a hospital might be their only option to defend themselves and their values," she said.
Twitter has long struggled with where to draw the line between free expression and harmful speech. The platform prohibits doxing, or the sharing of someone's private information, as well as direct calls for violence and content "that has the potential to lead to offline harm," according to its published content policies.
But the company was years late to take action against the conspiracy theory QAnon, banning its adherents under a new "coordinated harmful activity" policy in 2020 - four years after a proponent opened fire at a pizzeria in Northwest Washington that was falsely accused of allowing powerful Democrats to imprison and abuse children in a nonexistent basement. The conspiracy raged on Twitter, Reddit and other social platforms.
The issue came to a head again in the aftermath of the 2020 presidential election, when many Trump supporters claimed the election was fraudulent, using the slogan Stop the Steal. Twitter chose to label some of those tweets as misinformation and took some action to limit their spread, but largely did not penalize the accounts involved - despite a company policy prohibiting purposeful attempts to manipulate elections. Twitter took strong action only after the Jan. 6 Capitol riot, banning tens of thousands of accounts associated with both the Stop the Steal movement and QAnon. Twitter also banned former president Donald Trump.
Twitter's April action against Libs of TikTok came after Raichik violated the platform's rules against targeted harassment, according to a tweet she posted at the time that included a screenshot of Twitter's penalty language.
The offending tweet included an image of a transgender woman and claimed the person had been using female locker rooms, referring to the woman as male. Some employees argued in internal Slack channels that more should have been done because the account's misgendering of someone - purposefully changing the gender pronoun of a transgender person - violated the company's policies on hate speech, according to internal correspondence that was shared with The Post.
But Twitter executives told the workers who were upset that further sanctions were unlikely because Raichik had already deleted the tweet and that the target of the attack needed to report it themselves, according to the Slack exchange shared with The Post.
Internal debate raged again in June after the right-wing extremist group the Proud Boys disrupted a Drag Queen story hour for children at the public library in San Lorenzo, Calif., an unincorporated settlement across the bay from San Francisco. A spokeswoman for the Alameda County Sheriff's office, which provides policing services in San Lorenzo, told The Post then that investigators believed the confrontation had been spurred by a post from Libs of TikTok.
Again, employees demanded that the company take stronger action, arguing that it was "only a matter of time" before the posts led to someone getting killed, according to the internal Slack exchange shared with The Post. But experts within the company argued that the account's tweets did not meet the standard for prohibited threats and harassment. When employees pushed back, an executive asked employees to "refrain" from discussing if an account should be suspended, arguing the conversation could be leaked, according to a Slack conversation viewed by The Post.
Debate raged again in August, after Twitter's lack of a strong response to the events at Children's Hospital in Boston. Late last week, the company locked Raichik's account for violating the company's hateful conduct policy and issued a warning that she could be permanently banned. Twitter declined to say what tweet it was responding to, but The Post has learned that the action was taken in response to a tweet where Raichik again misidentified a person's gender.
As in April, Raichik deleted the offending tweet herself, before Twitter could do so.
Donovan said quickly deleting problematic tweets is a common way for disinformation sowers to make an impact with a broad online audience but then incur a lesser penalty from Twitter. She noted that influencers such as Libs of TikTok play a sophisticated cat-and-mouse game with the social media companies, "paying close attention to the company's twists and turns in their terms of service," to purposefully dance around the rules.
The one service that has banned Libs of TikTok is TikTok, which banned her account in March of this year. But Raichik frequently posts on Facebook and Instagram. She also sells subscriptions on the email newsletter platform Substack and merchandise on the e-commerce platform Shopify.
Substack declined to comment.
Facebook has taken even less action than Twitter against Raichik. The company suspended Libs of TikTok for 24 hours earlier this month, but later said the suspension was in error, according to a screenshot of messages Raichik received from Facebook and posted to Libs of TikTok on Twitter. Andy Stone, a spokesman for Meta, the parent company of both Facebook and Instagram, declined to comment, and referred questions from The Post to Raichik's Twitter account. Stone offered no reason for the temporary suspension and would not comment on whether any of Raichik's Facebook or Instagram posts constituted harassment.
On Tuesday, activists launched a campaign to pressure Shopify to drop Libs of TikTok, claiming Raichik's store was in violation of Shopify's acceptable use policy, which bans hateful content and goods or services that lead to harassment, bullying, or threats. As of Thursday morning, over 4,300 users submitted reports to Shopify to drop Libs of TikTok. In a statement, Shopify seemed to defend Raichik's presence. "We host businesses of all stripes and sizes, with various worldviews," a spokesperson said, declining to be named and refusing to elaborate on the company's policies.
"Libs of TikTok relies on monetizing through Shopify and Substack. They use these funds in continuing their work to target children's hospitals and getting them shut down," said Erin Reed, a content creator and legislative researcher.
Healthcare providers say Raichik's campaign is already having an effect on people's ability to seek health care. "Kids are getting this significant messaging of, not only are you not okay, but we want to hurt you," said Michelle Forcier, a clinician at Folx Health, a national telehealth group that provides care for LGBTQ health issues. "That's a pretty scary message to get as an 8-year-old or 12-year-old. It absolutely makes everybody think twice about walking in the door [to a hospital], kids and parents."
Meredithe McNamara, assistant professor of pediatrics at Yale, specializing in adolescent medicine, said that "allowing this hate speech to fester on the internet and fuel direct threats is going to create long standing harms that are difficult to recover from."
In a Substack post on Monday, Raichik says she'll continue her campaign against children's hospitals.
"Getting suspended by Twitter has made me realize my biggest mistake: I only called one hospital. I should've called dozens because I promise you, Children's National is not the only one," she wrote. "I promise to learn from my mistake and uncover more of what our Big Tech overlords don't want us to know."