US hospitals billed $120mn for sex-change procedures on minors – report

The charges since 2019 included over 5,500 surgeries and 8,500 courses of hormones or puberty blockers, the health department has said

US hospitals have billed tens of millions of dollars for sex-changing interventions on minors, according to the Department of Health and Human Services (HHS).

The ‘Wolves in White Coats’ report, released this week and citing watchdog research, said hospitals and clinics have billed nearly $120 million for more than 5,500 surgeries and 8,500 courses of hormones or puberty blockers for minors since 2019.

Some providers may have used misleading or potentially fraudulent billing codes to get insurers to cover the interventions, according to HHS. The department identified nearly $50 million in claims for puberty blockers given to children aged nine to 17 under a general hormone-disorder code without a gender-related or early-puberty diagnosis on the same claim.

Hospitals and clinics identified in the report have been referred to the Department of Justice and investigators from the Department of Health and Human Services (HHS) for potential violations of federal law. According to HHS, the observed billing patterns require additional investigation.

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Another nearly $11 million was billed for puberty blockers for hundreds of patients aged 13 to 17 under a diagnosis for unusually early puberty. HHS said that diagnosis does not apply at those ages.

The report said the procedures offered hospitals a long-term source of revenue, as minors who begin hormone drugs can remain in medical care for years. Citing outside estimates, it put lifetime costs at up to $75,000 without surgery and as much as $170,000 when operations are included.

“The Biden Administration ... contributed to the expansion and normalization of sex-rejecting interventions through nondiscrimination policies ... and other federal programs,” the report stated.

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This week, President Donald Trump moved to end federal Medicaid and Children’s Health Insurance Program (CHIP) funding for sex-change procedures for minors.  The restrictions, due to take effect on October 13, cover puberty blockers, cross-sex hormones and surgeries, although states can continue funding them themselves.

The move is part of a broader rollback of transgender-related policies since Trump returned to office. His administration has moved to restrict medical transition procedures for minors, bar transgender athletes from competing in women’s sports, and restrict people with gender dysphoria from serving in the US military.

At least 27 US states have enacted restrictions on gender-transition procedures for minors, while several major hospitals have stopped offering some services amid legal challenges, funding pressure and changing medical guidance.