A new federal report alleges that hospitals and physicians used questionable insurance codes to obtain payment for gender-transition procedures for minors. The findings should prompt an immediate investigation in New York—but the problem goes far beyond potentially fraudulent billing.
Children should never be subjected to drugs and surgeries intended to alter their healthy bodies in the impossible pursuit of a different sex. These interventions are morally wrong, medically dangerous, and unworthy of taxpayer support.
Nevertheless, some New York officials and organizations—including Planned Parenthood—are demanding that taxpayers provide even more money for them.
On August 13, the U.S. Department of Health and Human Services released Wolves in White Coats: How Doctors and Hospitals Pushed and Profited from the Fraud of “Gender Medicine.” The report examines the financial incentives and insurance practices that fueled the rapid expansion of pediatric gender medicine. An executive summary is available here.
According to HHS, insurance claims since 2019 have included nearly $120 million in billed charges for gender-transition procedures involving minors—including more than 5,500 surgeries and 8,500 courses of hormones or puberty blockers.
The report also identified nearly $50 million in claims for puberty blockers prescribed to patients ages nine through seventeen, billed under a diagnostic code for an unspecified endocrine disorder. Another $11 million was billed—including claims submitted to Medicaid and Medicare—for patients ages thirteen through seventeen diagnosed with “precocious puberty.” That diagnosis raises obvious questions, as precocious puberty begins well before age thirteen.
The report does not establish that every questioned claim was fraudulent, and providers are entitled to due process. However, the billing patterns are serious enough that Vice President JD Vance and HHS Secretary Robert F. Kennedy Jr. referred the hospitals and clinics identified in the report to the Department of Justice and the HHS Office of Inspector General.
“Doctors and hospitals must put children’s health ahead of ideology and financial gain,” Kennedy said. “This report identifies troubling billing practices that demand scrutiny.”
That scrutiny is especially needed in the Empire State.
New York Medicaid covers hormone therapy and certain surgeries for gender dysphoria. Attorney General Letitia James has aggressively defended access to these procedures, even pressuring NYU Langone to resume providing puberty blockers and cross-sex hormones to minors after the hospital discontinued its Transgender Youth Health Program.
Meanwhile, New York City Mayor Zohran Mamdani recently announced a $15 million taxpayer-funded initiative to expand so-called gender-affirming care. The plan includes direct funding for providers serving minors, a referral line to connect families with services, and additional research.
At the state level, Planned Parenthood Empire State Acts has urged lawmakers to establish and fund a Gender-Affirming Care Access Program. Planned Parenthood and its allies want New York taxpayers to replace funding threatened by federal restrictions and to sustain providers who offer hormones and other interventions to minors.
“Fraudulent billing would compound an already profound moral wrong with financial wrongdoing,” said Jason J. McGuire, Executive Director of New York Families Foundation. “Children should never be given puberty blockers or opposite-sex hormones, nor should they be subjected to surgeries intended to make their bodies resemble the opposite sex. New York should not spend a single taxpayer dollar to support these harmful interventions, regardless of how they are coded.”
The HHS report describes children undergoing these interventions as potential “captive patients.” Puberty blockers can lead to cross-sex hormone therapy, repeated lab tests, specialist visits, surgeries, and lifelong medical monitoring. According to HHS, annual payer costs for some puberty-blocking drugs can exceed $16,000 per patient, while surgical costs can range from $12,000 to more than $130,000. Such a system creates a financial incentive to turn a child’s distress into lifelong medical dependency.
New York’s Department of Health and Medicaid inspector general should determine whether providers used inaccurate diagnostic codes or submitted false claims involving minors. Any provider who violated the law should be held accountable.
Albany must also address the deeper problem. New York should end taxpayer funding for minors’ medical transitions and reject proposals to direct additional public funds to providers that perform or facilitate these interventions.
Every child is made in the image of God and deserves patience, compassion, and truthful care. A child struggling with their identity should be helped to understand and accept the body God has given them—not be placed on a medical pathway that could cause permanent injury and lifelong regret.
Fraudulent billing must be investigated, but accurate billing would not make these procedures ethical. The question is not merely whether providers charged taxpayers honestly. It is why New York is paying anyone to medically transition children at all.