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In the first 3 months of the 2023 legislative session, 

 have been proposed in the United States. The majority of these bills are anti-transgender and specifically target free speech, education, civil rights and especially health care. In just the past 7 weeks, 19 of these bills have been signed into law in 10 states, stripping away the rights of parents, children, and their medical providers. Hundreds of additional laws, in nearly all 50 states, are under consideration. These laws (both proposed and passed) outlaw gender-affirming care, ignoring the clinical recommendations of every major medical organization, including the 

American Academy of Child and Adolescent Psychiatry

I am a midwesterner, where we are supposed to politely avoid talking about politics, religion or money. I am a startup co-founder, where we are supposed to avoid alienating customers that may have different political beliefs. But at my core, I am a parent and a clinical psychologist who is saddened, angered, and deeply worried about how these new laws, driven by misinformation, fear-mongering, and transphobia, will hurt my patients, my colleagues, and my loved ones.

At Equip, we are honored to have already served over 150 children and adolescents that are 

. Transgender individuals experience eating disorders at 

 higher than cisgender individuals. (For those of you new to learning about gender identity, 

gender describes people whose gender corresponds to their sex designation at birth.) Recent 

 have shown that 10-30% of transgender individuals will develop an eating disorder, compared to 2-5% of their cisgender peers.

 of transgender people report having attempted suicide at some point in their lives, a rate exponentially greater than the rest of the population. As a clinical psychologist, it is easy to see how thoughts of suicide, common in 

 of transgender people, have been tied to the rampant discrimination and mistreatment they experience in education, housing, and employment; the rejection many experience from families and communities; the elevated levels of violence perpetuated against them; and the lack of access they have to healthcare.

These new laws codify the same discrimination and mistreatment of transgender people that make their lives feel unlivable. These laws tell them that they can’t wear what they want to wear. These laws tell them they can’t receive the evidence-based medical and behavioral health care that they seek, their parents desire, and their doctors advise. These laws tell them that they can’t learn about other people like them in school. And many of these laws permit and encourage housing, employment, and commercial discrimination against them. As a clinical psychologist and a human being, it is terrifying to watch our state governments make laws that we know will harm people's physical and psychological well being, while having absolutely no benefit for our society.

As both a clinician and a parent, I’m terrified by politicians' intrusion in our personal healthcare decisions and their blatant disregard of experts and clinicians. For weeks, I have not been able to stop thinking about Pastor Martin Niemoller’s poem, 

These laws take away the rights of parents.

 These laws say that politicians know more than physicians, researchers, and medical experts. Do you see the slippery slope? It takes only a one-minute Google search to find misinformation about ADHD medication. There are already politicians that think stimulants, like Ritalin and Adderall, are “harmful to children”, “equivalent to meth”, and “a gateway to drug abuse and addiction.” Thankfully, there is not (yet?) a politician sitting with me, my husband, and our child in our doctor’s office discussing the medication that we all agree has drastically improved his social and educational experience. The same negative rhetoric and debate exists around prescribing children antidepressants and antianxiety medications. There are current lawmakers who have been vocal about their opposition of these medications for minors-and I’m glad that they too weren’t in the room with our medical team when we all decided that our other son needed Zoloft in 2nd grade when his anxiety was robbing him of enjoying life.

But for both of our sons, while there are currently politicians that would object to their doctor’s evidence-based recommendations, they would not reject my children as humans. These laws targeting the human rights of transgender people not only rob them of evidence-based healthcare and the autonomy to make medical decisions for their family, but 

they also rob transgender people of their humanity.

And so while I am sad as a clinician and worried as a parent, I am mostly outraged–as a friend, a colleague, and a loved one to the many transgender and nonbinary people in my life. They are kind and brilliant and funny and deserving and HUMAN. I hope that we can all unite in our shared humanity to stop the dehumanization of our peers, and replace the fear mongering with our shared belief that we all deserve the same human rights.

To combat this legislation, there are a few actionable steps you can take in your communities and beyond:

1. For my peers in healthcare: hire transgender people, train providers in gender-affirming care, support your transgender patients, and create explicit gender affirming care protocols to enable providers to put their training into practice. Over the past three years, 

 has learned from, consulted with, and hired people from some of the organizations below. Please reach out if we can be helpful and/or if you have suggestions on other organizations.

2. To support transgender people in accessing healthcare during these unprecedented times or simply to learn more, here are a few resources:

, a transgender and intersex run group providing direct support, case management, and advocacy to impacted communities.

, a legal defense fund for those criminalized for accessing gender-affirming healthcare.

 (TWVA), a website with specific action for Mar 25-31, the third annual TWVA

, an eating disorder non-profit providing earmarked funds specifically for transgender and intersex people to access care.

, a nonprofit organization founded in 1920 to defend and preserve civil rights and liberties.

’s substack, a great resource for accurate up-to-date information.

, real-time updates as bills either move or are defeated.

3. You can reach out to your state representatives to make your voice heard. You can look up your state legislators 

. Click on their name to get their contact information and call or email your representatives. We have drafted emails 

4. Importantly, check on your friends and colleagues who are transgender, or who have transgender kids and loved ones, to see how they would best feel supported during these times. They may need you to listen and process fears, and they may need you to participate with them in joyful resistance.

As a Clinical Psychologist, I’m Terrified About Anti-Trans Legislation.

The information in this article originally appeared in an Equip Academy presentation. Watch the presentation 

 to learn about other eating disorder-related topics and earn free CE credits.

When most people think about eating disorders, they think of anorexia, bulimia, or maybe binge eating disorder. But it’s actually a lesser-known eating disorder that has the largest financial impact in the United States. In 2018-2019, other specified feeding and eating disorder (

, or 35% of the $64.7 billion total financial burden of eating disorders. For reference, binge eating disorder cost the country $19.4 billion, while bulimia and anorexia cost $11.4 billion and $11.2 billion, respectively. OSFED is just as serious as other eating disorders, as evidenced by its massive economic toll.

So what is OSFED? Put most simply, it’s a catch-all diagnosis used to describe eating disorders that significantly impact a person’s health and life but do not meet diagnostic criteria for another eating disorder. Though it can be used as a general diagnosis, there are several specific diagnosis that fall under the OSFED umbrella, including:

Binge eating disorder of low frequency or limited duration

Bulimia nervosa of low frequency or limited duration

Here, we’ll be looking closely at one of the most misunderstood OSFED diagnoses, 

Atypical anorexia is a diagnosis that describes someone who meets all of the criteria for anorexia nervosa (AN) except that despite significant weight loss, the individual’s weight is within or above the normal range.

Atypical anorexia and anorexia nervosa share many of the same diagnostic criteria, including:

Restriction of energy intake relative to requirements

Intense fear of gaining weight or becoming fat, or persistent behavior that interferes with weight gain

Disturbance in the way in which one’s body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or persistent lack of recognition of the seriousness of illness

The primary difference between the two is that in anorexia nervosa, the restricted intake leads to significantly low body weight, whereas in atypical anorexia nervosa, it does not. Additionally, those with anorexia nervosa fail to recognize the seriousness of their illness and low body weight, whereas those with atypical anorexia fail to recognize the seriousness of their illness only (since low body weight isn’t present).

Despite the name, atypical anorexia is actually more “typical” than anorexia nervosa: AAN has a 

. And this number is likely low, given that many people with atypical anorexia are misdiagnosed or undiagnosed due to weight stigma and anti-fat bias in medical spaces. Often, people with atypical anorexia are assumed to have bulimia or binge eating disorder based on their body size alone (if an eating disorder is suspected at all). What’s more, patients with atypical anorexia may even be prescribed restrictive eating behaviors, which can exacerbate symptoms and highlights the confusion that many patients with AAN experience.

Because of stigma, misconceptions, and lack of awareness, there’s currently limited research on the effective treatment of atypical anorexia. In fact, atypical anorexia wasn’t even added to the DSM until the publication of the DSM-5 in 2013.

Prior to 2013, patients with atypical anorexia presented for treatment, but were often turned away or given a diagnosis of eating disorder not otherwise specified (EDNOS). In an effort to reduce the number of patients diagnosed with EDNOS, atypical anorexia was added to the DSM-5 in 2013 under the new OSFED diagnosis. It’s important to note that patients who met AAN criteria were always there, but were often overlooked by doctors for treatment because there was no established diagnosis that fit their presentation.

Is atypical anorexia less serious than anorexia nervosa?

The atypical anorexia diagnosis has been referred to as “subthreshold anorexia nervosa” by some researchers, likening it to other OSFED categories of bulimia nervosa of low frequency or duration or BED of low frequency or duration. However, this separation puts patients in danger, because data show clearly that atypical anorexia is just as serious as anorexia nervosa.

Patients with atypical anorexia experience:

More severe eating disorder symptoms and greater body dissatisfaction

Similar rates of suicidality and suicide attempts to those with anorexia nervosa

High levels of depression and anxiety, similar to rates among those with anorexia nervosa

Atypical anorexia is also more prevalent among cisgender boys/men, BIPOC individuals, and transgender and gender diverse people, all of whom already experience barriers to care.

Atypical anorexia comes with many of the same physical health complications as anorexia nervosa, 

How do you actually differentiate between AAN and AN?

That’s a good question, and we wondered the same thing. To get to the answer, we began by trying to gain clarity about the difference between atypical anorexia and anorexia nervosa.

The primary distinction between AN and AAN is that people with AAN are at a weight that is within or above normal range—but there’s no consensus on what this means. In fact, a recent systematic review found that in 75 separate studies of AAN, 29 unique definitions of AAN were used.

The four most common definitions for atypical anorexia are:

 BMI at admission to treatment is greater than or equal to19 kg/m2 for adults aged 18 or older, or above the median BMI for patients under 18.

 BMI at admission to treatment is greater than 18.5 kg/m2 for adults or over 85% of the median BMI for adolescents and children.

 BMI at admission to treatment is over the 10th percentile (only relevant for children/adolescents).

BMI at admission to treatment is greater than or equal to 19 kg/m2 for adults or above the median for adolescents, and they had reported no previous treatment experience beyond outpatient treatment. The BMI thresholds are the same as the DSM-5 definition. However, patients with previous eating disorder treatment at a higher level of care (e.g., treatment at a residential treatment center) were classified as AN even if their BMI was above the threshold, as previous treatment may have resulted in weight gain that would place patient BMI above the threshold.21–23

Little information is available about treatment for atypical anorexia, and few studies have examined effectiveness. Some research supports the preliminary effectiveness of family-based treatment (FBT) and PHP-level care, but this research notes complicating factors related to treatment.

 examining FBT for AAN described treatment and outcomes for 42 adolescents with atypical anorexia. The research showed symptom improvement and preliminary support for using FBT to treat adolescents with atypical anorexia, but called for more in-depth studies into its effectiveness.

Providers who have used FBT to treat atypical anorexia report a few challenges, most notably:

Difficulty identifying when an AAN diagnosis is appropriate

Pushback in setting target weights for adolescents with AAN

Increased need to emphasize seriousness of AAN to families during FBT

To learn more about what treatment works for AAN—and whether AAN requires a different treatment approach than AN—we conducted a robust study that compared treatment for the two populations. Our aims with this research were to:

Compare symptom severity at admission between AN and AAN

Evaluate treatment response among AAN patients

Compare change over treatment among patients with AN and AAN

We used all four of the most common definitions of AAN to ensure that outcomes were not affected by the definition being used.

Our patient population included 1,463 patients with AN or OSFED, with a median age of 15.3. Seventy percent were white, and 85.4% were cisgender girls or women. The outcomes we measured were eating disorder symptoms, anxiety, depression, caregiver burden, and weight.

The number of patients classified into the AN and AAN analysis groups varied greatly depending on which definition of AAN was used. Some patients were classified as AAN under all four definitions (n = 308), some were classified as AN under all four definitions (n = 299), and a majority were mixed (n = 856).

Of the patients classified as AAN, 70.4%-80.7% required weight restoration, compared with 85% to 94% for those with AN, depending on the definition used. Eating disorder symptoms were significantly greater for those with atypical anorexia compared with anorexia for three out of the four AAN definitions. For patients with AAN who required weight restoration, the amount of weight gain required varied depending on the definition used. BMI-10th AAN required the most weight gain to meet target weight (an average of 17.1 lbs).

We had three key takeaways from symptoms at admission:

Most patients with AAN required weight restoration, regardless of how they were classified

Patients with AAN had less weight to gain to meet their target weights, but the average weight to gain was 14+ lbs no matter how we defined AAN

Patients with AAN reported more severe eating disorder symptoms than those with AN

Upon beginning treatment, there were similarities and differences between patients with AAN and AN. All patients improved with treatment on all measures, and there was no difference in rate of improvement. However, weight gain progressed more slowly for patients with AAN.

Since the cut-off threshold between AN and AAN did not have substantial impact on outcomes between definitions, we tested BMI as a continuous variable. If indeed there is a “true” distinction between AN and AAN based on weight status that warrants separate diagnoses, we would expect symptom presentation and outcomes to be associated with BMI. There was no significant association between BMI and symptom presentation or treatment outcomes.

Our research showed that there were no differences in treatment response between groups no matter how we defined AAN. FBT created meaningful symptom improvement independent of diagnostic classification or BMI. We suggest that weight status in AN and AAN is, similarly, not a factor requiring diagnostic distinction. Rather, weight status may provide information about the individual’s experience in the world and may be associated with experiences of clinical focus, such as widespread weight stigma, delayed access to care, and praise for weight loss associated with one’s eating disorder.

Earn free CE credits and learn more about eating disorders from Equip's clinical experts. 

Explore future Equip Academy events

Although more research is needed to better understand atypical anorexia, how it differs from anorexia nervosa, and how best to treat it, our research does provide some clear implications for treatment of AAN at this point.

Considerations for providers treating AAN include:

Effectiveness of our treatment wasn’t dependent on classification into AN versus AAN, or BMI

There’s growing evidence that AN and AAN may be treated in the same or similar ways

Comprehensive Health At Every Size (HAES) training for providers and HAES-informed practice may especially benefit patients with AAN

Despite the fact that our study showed no significant differences between treatment effectiveness for patients with AAN vs AN, there are some unique factors that apply to treatment for patients with AAN. Although it’s not diagnostically important, weight may impact patients’ experience with their eating disorder, as patients at higher weights often experience the compounding effects of weight stigma.

 throughout the trajectory of their illness.

During the development of the eating disorder

Dual messaging from family and medical community

Provider discounts or minimizes eating disorder

Provider encourages or congratulations eating disordered behaviors

Delayed diagnosis and/or limited access to care

Provider minimizes or denies eating disorder

Weight stigma in higher levels of eating disorder care

Reluctance by caregivers or support people to engage with or support treatment

Increased fear or grief related to weight gain in recovery

Provider now acknowledging eating disorder

Social and economic cost of eating disorders in the United States of America Report for the Strategic Training Initiative for the Prevention of Eating Disorders and the Academy for Eating Disorders, June 2020 

https://www.hsph.harvard.edu/wp-content/uploads/sites/1267/2020/07/Social-Economic-Cost-of-Eating-Disorders-in-US.pdf

Harrop, Erin N et al. “Restrictive eating disorders in higher weight persons: A systematic review of atypical anorexia nervosa prevalence and consecutive admission literature.” The International journal of eating disorders vol. 54,8 (2021): 1328-1357. 

Hughes, Elizabeth K et al. “A case series of family-based treatment for adolescents with atypical anorexia nervosa.” The International journal of eating disorders vol. 50,4 (2017): 424-432. 

Harrop, Erin N et al. “"You Don't Look Anorexic": Atypical anorexia patient experiences of weight stigma in medical care.” 

Vo, Megen, and Neville Golden. “Medical complications and management of atypical anorexia nervosa.” Journal of eating disorders vol. 10,1 196. 16 Dec. 2022, 

Not So “Atypical” Anorexia Nervosa: Clinical History, Diagnostic Considerations, and Treatment Approaches

People commonly associate eating disorders with thin, white, cisgender girls. While eating disorders affect people across body size, gender, race, and age, this stereotype has persisted for decades, and it’s had an effect on both society and the realm of research. One effect is that most of the current modalities for treating eating disorders in young people focus on cisgender girls, leaving cisgender boys and transgender and gender expansive youth out of the equation.

 are at a heightened risk for developing disordered eating behaviors and eating disorders 

 too, and often go undiagnosed or untreated. Everyone with an eating disorder is equally deserving of effective treatment and lasting recovery, so it’s essential to understand what treatment approaches work for different populations. That was the impetus for our most recent study.

In the study, we looked specifically at the effectiveness of 

 (FBT) for cisgender boys and transgender and gender expansive youth. While FBT is the evidence-based gold standard for treating eating disorders in young people, most of the research supporting its effectiveness was based on cisgender girls. This investigation is an important first step toward understanding how best to treat different populations.

Our study included 1,235 young people (age 6 to 24) who received FBT-based eating disorder treatment during the time period from September 2020 to November 2022. Of this group, 975 were cisgender girls, 152 were cisgender boys, and 108 were transgender or gender expansive youth.

In our research, we looked at various different outcomes, including:

Parental confidence in supervising treatment

We analyzed outcomes for all patients included in the study, and then compared outcomes for cisgender boys and transgender youth with outcomes for cisgender girls. Our analysis showed that regardless of gender identity, all symptoms and outcomes improved during treatment, and improved at similar rates.

The importance of studying treatment approaches for cisgender boys and transgender youth can’t be overstated. Millions of young people with these identities are struggling with debilitating and potentially life-threatening eating disorders right now, and there is an alarming absence of knowledge about how to treat them. There are no universally accepted, empirically supported eating disorder treatment guidelines for cisgender boys and men, or for transgender youth. Because of this, many boys and men and transgender folk report feeling misunderstood by providers, and it’s tragically common for transgender youth specifically to report having negative treatment experiences.

We know eating disorder treatment isn’t one-size-fits-all, and so it’s essential to understand what adaptations and modifications must be made to ensure that everyone suffering, regardless of identity, gets effective and supportive care. Because FBT involves family and friends (and, at Equip, 

 with similar backgrounds and identities), it allows for treatment to be more tailored to the individual patient, and provides a unique opportunity to address issues like social challenges, stigma, and family support of a child’s intersecting identities. However, up until now, we had no quantitative evidence supporting the use of FBT for populations besides cisgender girls (who make up about 90% of participants in other FBT studies).

Our study is the first to demonstrate that FBT leads to meaningful improvements in eating disorder symptoms and other outcomes in young people across the gender identity spectrum. This is promising, especially since FBT is generally the first line of treatment for youth with an eating disorder, and because FBT lends itself well to virtual care, which helps eliminate other barriers to treatment these populations might face.

While more research is needed—specifically with larger and more diverse populations—we’re heartened at these initial outcomes. Our research team is looking forward to doing more research into how FBT works for people of all genders and identities, and how we can continue to adjust and personalize treatment to make it the most effective for every patient who seeks help.


https://www.sciencedirect.com/science/article/pii/S1054139X23005967

Baker, Jessica H. et al. Eating Disorder Clinical Presentation and Treatment Outcomes by Gender Identity Among Children, Adolescents, and Young Adults, Journal of Adolescent Health, 2024, ISSN 1054-139X, 

https://doi.org/10.1016/j.jadohealth.2023.11.015.

New Research: FBT Outcomes Across Gender Identity

Since day one, our mission at Equip has been crystal clear:

to make evidence-based eating disorder treatment accessible to everyone who needs it. From that first day, we’ve known that eating disorders don’t discriminate—they affect people across all identities—including all ages.

Today, we are thrilled to announce that Equip treatment is now available to patients of all ages.

Until now, we’ve treated patients ages 6 to 24 who live with their parents, as we know this is the age range in which eating disorders normally begin. Over the past few years of treating patients, we’ve built out and validated our treatment model, ensuring that we were able to maintain our industry-leading outcomes at scale before expanding to adults. We’ve been thrilled to see our treatment for 6-24-year-olds yield tremendous results, and we’re confident that our now expanded age range will lead to full healing and recovery for many.

Our new, expanded care model takes the best parts of Equip’s family-based treatment and makes them adaptable to patients of all ages and living situations, allowing us to personalize treatment to every patient. Rather than creating separate treatment tracks for young patients and adults, we’ve made a holistic shift that allows for tailored, individualized treatment, regardless of age—without compromising the evidence-based foundation that has yielded strong outcomes for thousands of patients.

As always, Equip patients of all ages can expect:

 that includes a therapist, dietitian, and medical provider, as well as mentors with relevant lived experience and identities

100% virtual care that fits into your life, not the other way around

The involvement of your village—whether that means family, chosen family, friends, colleagues, or anyone else you rely on for support. If you don’t have anyone or aren’t sure who to bring into treatment, we’ll help you identify or expand your support system during treatment.

Evidence-based care that's focused on getting you the outcomes you want so that you can fully engage with your life

Our new approach now leverages additional evidence-based modalities including 

CBT-E (enhanced cognitive behavioral therapy)

, DBT (dialectical behavioral therapy), FBT, and ERP (exposure and response prevention), among others. Each patient’s dedicated care team will tailor treatment to best suit their needs—closely monitoring what’s working and what’s not—and will be by their side for every step of the 

Eating disorders affect 10% of the population, and recovery is possible for each and every one of those people—but only with the right treatment. Our goal is to get treatment that works to every single person who needs it, enabling them to rediscover the beautiful lives that are waiting for them on the other side of these complex, debilitating illnesses.

Equip Now Treats Patients of All Ages!

It’s impossible to read the news these days without encountering one (or several) headlines about AI. Seemingly every industry is exploring ways to leverage AI-powered tech, and these applications have the potential to transform the way we interact with the world and each other. This is understandable: AI capabilities are advancing at an exponential rate, and the possibilities feel endless. But it’s vital to recognize not only the possibilities, but also the limitations—and 

 is one place where this comes vividly to life.

Most AI news has centered around highly advanced chatbots, most notably those that use GPT, or Generative Pre-training Transformers. GPT is, essentially, a large language model that uses natural language processing technology to understand user input and generate helpful, relevant responses. The technology pulls from a huge dataset of existing (human-created) language to learn about language, grammar, the meaning of words, and more, and informs how it both interprets and responds to human input.

It would be an understatement to say that both consumers and industry leaders are enthusiastic about the potential of AI. 

 of internet users prefer using chatbots to people when looking for answers to simple questions, 

 feel comfortable handling an issue without a human agent, and 

 say that chatbots bring in significant ROI with minimal effort. A striking 

 believe that AI chatbots will become more important for communication between customers and businesses.

The healthcare industry isn’t exempt from these seismic shifts despite the more fragile nature of the industry’s work. Experts estimate that up to 

 tasks could be automated by AI within the next year, and chatbots are starting to take over more “human” roles as well. 

 found that 22% of adults had used a mental health chatbot, and 47% were interested in using one. When asked why they sought out a chatbot over a human, most respondents cited affordability, ease of use, and ability to connect with a chatbot at any time.

At first glance, it makes sense that chatbots could serve as quick, low-cost alternatives to trained mental health professionals. After all, GPT technology is adept at responding to questions, synthesizing research, and having human-like conversations. But AI-powered chatbots also have points of failure, and in the realm of mental health—and eating disorders in particular—these can come at a serious, high cost.

Eating disorders are complex and highly nuanced mental illnesses; their signs and symptoms may be hidden or counterintuitive, and treatment needs to be highly individualized in order to be effective. What’s more, up to 90% of people with eating disorders have co-occurring illnesses, which makes their treatment even more complex. This murky landscape is not one in which chatbots thrive. Because the language models look for rules and patterns in their dataset, they’re likely to miss eating disorders that don’t fit a certain mold, or to misdiagnose someone whose symptoms correspond to more than one pattern.

There’s also the reality that while bots themselves don’t have biases, the data they learn from does. GPT chatbots are trained on massive sets of human-created language, and much human-created content around food, weight, bodies, and eating disorders is shaped by the powerful force of 

. This means that their interpretation of and response to questions may reflect weight bias, fatphobia, and the thin ideal. As Dr. Angela Celio Doyle, Equip’s VP of Behavioral Health, put it 

: “Our society endorses many unhealthy attitudes toward weight and shape, pushing thinness over physical or mental health. This means AI will automatically pull information that’s directly unhelpful or harmful to someone struggling with an eating disorder.”

This potential risk was brought to life recently, when the National Association for Eating Disorders replaced its human helpline staff with a chatbot named Tessa. Within a week, it was reported that Tessa gave harmful advice that promoted dieting and weight loss behaviors to callers who struggled with an eating disorder, and the bot was shut down.

With chatbots, there’s also the risk of providing false information, which can be extremely detrimental in the case of eating disorder patients. While chatbots are designed to provide only information validated through their  training data, they can be prone to what are called “hallucinations,” which is essentially when bots make things up and deliver them as facts. For a parent who is trying to assess their child for eating disorder risk, a patient researching treatment options, or a provider looking up the medical criteria to admit a patient to the hospital, this sort of false information can have dire consequences.