Federal oversight of taxpayer-funded mental health programs is drawing renewed attention after internal training documents revealed instructions encouraging “gender-affirming care” for minors.
The disclosure raises concerns over whether services funded through the 988 Suicide & Crisis Lifeline are adhering to federal limits on ideological advocacy.
The contractor at the center of the scrutiny, Protocall Services, reportedly continues directing staff to guide young callers toward gender-affirming resources, according to documents obtained by the Daily Caller News Foundation.
Employees are trained to connect minors with LGBT-focused organizations, online communities and advocacy programs, while carefully evaluating when parental involvement is appropriate.
Protocall serves as a national backup for the 988 Lifeline, manages state crisis lines in New Hampshire and New Mexico, and maintains contracts with public colleges in Pennsylvania, Arizona, Virginia, California and New York.
Funding comes from a combination of state contracts and federal grants administered by Vibrant Emotional Health, the nonprofit overseeing the 988 network.
The 988 Lifeline, launched nationwide in July 2022, replaced the 1-800-273-TALK hotline to streamline access to trained crisis counselors.
Managed by the Substance Abuse and Mental Health Services Administration (SAMHSA), the system now encompasses more than 200 local centers offering free, round-the-clock mental health support.
Former Protocall counselor Jaime Brooks told TDC that employees were required to review and demonstrate comprehension of the gender-affirming guidance through regular assessments.
Brooks resigned in December after more than a year at the company, citing ethical objections.
“I no longer wish to be an accomplice to such criminal and unethical behavior,” Brooks wrote in her resignation letter, criticizing policies she said could allow minors access to irreversible medical procedures.
Advocacy groups have also expressed concern. Do No Harm said that ideological affirmation should never take priority over child welfare.
“This taxpayer-subsidized program should provide compassionate, life-saving care to confused youth, not send them further down a path that can lead to lasting mental and physical harm,” Executive Director Kristina Rasmussen said.
Protocall’s guidance lists resources including the Trevor Project, PFLAG and the Family Acceptance Project.
The Trevor Project, which formerly operated the federal LGBT youth hotline, continues providing private crisis services and operates the online platform Trevor Space, which has faced criticism over age verification and safety practices.
Federal officials stress that all subcontractors receiving grant funding are subject to executive orders and federal law.
“SAMHSA funds cannot be used for activities that violate federal law or the requirements set forth in current Executive Orders,” a Department of Health and Human Services spokesperson said, noting that compliance rules extend to all subcontractors.
Financial records show Protocall received roughly $5.85 million from Vibrant Emotional Health in fiscal year 2023 and $2.67 million in 2022.
The company also holds a New Hampshire contract exceeding $10 million, partially funded by federal grants.
Despite federal changes, some states continue offering LGBT-specific options.
Los Angeles County reinstated a local “press 3” routing in December, while Pennsylvania officials announced plans to expand LGBT clinical training for crisis counselors and maintain referrals to advocacy organizations.
Protocall’s leadership has reaffirmed its commitment to internal diversity, equity and inclusion initiatives.
In a January 2025 email, CEO Phil Evans wrote that federal executive orders would not affect the company’s operational policies or organizational culture.
Officials preparing future 988 cooperative agreements said they will continue prioritizing compliance alongside broad access to crisis services.
“Anyone who calls the Lifeline will receive compassion and help,” an HHS spokesperson said.
