HHS Report Alleges Fraud in Pediatric Gender Medicine

A new Department of Health and Human Services report accuses hospitals and physicians of profiting from gender-related medical treatments for minors while, in some cases, using misleading diagnoses and billing codes to obtain insurance reimbursement.

The 64-page report, titled “Wolves in White Coats: How Doctors and Hospitals Pushed and Profited from the Fraud of ‘Gender Medicine,’” says hospitals and clinics billed nearly $120 million for gender-related services to minors since 2019, citing data from the medical advocacy group Do No Harm.

The report alleges some providers billed puberty blockers and hormone treatments under diagnoses for unspecified endocrine disorders or precocious puberty rather than gender dysphoria. HHS said more than 30 hospitals, clinics and pharmacies billed puberty-blocking drugs using nonspecific hormone diagnoses.

Vice President JD Vance, who chairs the White House Task Force to Eliminate Fraud, discussed the findings Thursday and referred the report to the Justice Department for possible investigation.

“Some pediatric gender clinics and children’s hospitals have apparently used misleading or even fraudulent diagnostic and billing codes to ensure that insurance companies will cover the procedures,” Vance wrote in a letter to Attorney General Todd Blanche. He asked DOJ to determine whether providers identified in the report violated federal laws or regulations.

The report also contends financial incentives helped fuel the expansion of pediatric gender medicine, citing thousands of surgical procedures and hormone treatments involving minors.

Whether questionable coding amounts to criminal fraud remains unresolved. Incorrect medical coding can result from errors as well as deliberate misconduct, and any criminal determination would require further investigation.

The report comes as the Trump administration moves broadly to restrict federal funding for gender-related medical interventions for minors. Advocates for such care maintain that treatment can reduce psychological distress and improve well-being for transgender youth, while critics say it can cause irreversible damage.