The Department of Health and Human Services (HHS) issued a report on Aug. 13 alleging practitioners of so-called pediatric gender-affirming care may have committed tens of millions of dollars in insurance fraud over the last decade.
The report, titled “Wolves in White Coats,” alleged the doctors were driven by profit, since patients with gender dysphoria can rack up huge, insurance-covered medical bills.
The industry was “a strategic area of growth” in revenue, the study found, estimating that hospitals billed nearly $120 million for such treatments since 2019.
Authors of the report said the practice was also fueled by guidance from President Joe Biden’s administration, which used Obamacare regulations to threaten healthcare providers if they refused treatments because of “discrimination based on gender identity.”
Under Biden, there was a “push to normalize” the procedures, Assistant HHS Secretary Adm. Brian Christine said in a Thursday interview with NTD, The Epoch Times’ sister media outlet.
“It’s not simple epidemiology. This is a social contagion that the kids are being drawn into,” Christine said.
“If you take these children and you give them counseling … the vast vast vast majority get through their gender dysphoria by the late teens. They don’t need castrating chemicals and surgeries. They need that compassionate counseling.”
Faulty Insurance Codes
The report alleged healthcare providers played fast and loose with billing codes when charging insurance companies. Instead of using billing codes related to gender dysphoria, they used codes for other medical conditions to increase chances of collecting payment.Between 2015 and 2025, insurers were billed nearly $50 million for patients diagnosed with “endocrine disorders.” About $40 million of that billing went to “unspecified” disorders, and the report hypothesized those drugs were actually being used for minors who wished to live as the opposite sex.
Nearly $11 million more went to puberty blockers for kids age 13–17 diagnosed with “precocious puberty,” it stated.
“By definition, anyone 13 or older cannot have a diagnosis of precocious puberty and should not be given puberty blockers at that age for this indication,” HHS said in a summary of the report.
Vice President JD Vance on Thursday called on the Justice Department to investigate the hospitals.
“When providers miscode treatment in order to secure insurance coverage for gender transitioning interventions that insurance would not otherwise cover, they should be held accountable,” Vance said in a letter to U.S. Attorney General Todd Blanche.
“If they have done so intentionally, thereby perpetrating a fraud on Medicaid or on private insurers, they should go to prison,” he added.
The Epoch Times reached out to the Justice Department for comment on Vance’s request.
‘Captive Patients’
Normally, pediatric care is limited to routine checkups, or further treatments if the child has an acute condition.Meanwhile, every three to six months, the children in these treatment programs with gender dysphoria needed endocrinology tests, hormone prescriptions, and surgical procedures that can last into adulthood. They also needed follow-up treatments to deal with the side effects of hormones, and mental health care.
“This pediatric medical field effectively creates ‘captive patients,’” HHS said. “Once initiated—often with puberty blockers or cross-sex hormones in early adolescence—the patient requires ongoing care for decades.”
The study concluded with stories of patients who underwent hormone therapy before realizing the interventions did not deliver the peace of mind they promised. A patient named Luke Healy told the study authors “the model was built around escalation rather than resolution.”
“The physical changes from estrogen—softened skin, fat redistribution, and other feminizing effects on a male body— made him feel increasingly like a stranger in his own skin. Each intervention led to pressure for further intervention.”
He abandoned the idea of facial feminization surgery—priced at $200,000—and eventually reclaimed his masculine identity.
—Stacy Robinson
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