Dear Attorney General Blanche:
This week, the U.S. Department of Health and Human Services (HHS) released a report entitled “Wolves in White Coats: How Doctors and Hospitals Pushed and Profited from the Fraud of ‘Gender Medicine,’” that documents disturbing, and possibly criminal, practices by hospitals and healthcare providers in so-called pediatric gender programs. For years, providers across the country have subjected children to experimental sex-rejecting procedures, despite an alarming lack of evidence about the safety and efficacy of these interventions. The HHS report sheds light on two important details about this shameful exploitation of children: why the industry has been so quick to adopt these questionable interventions, and how some doctors and hospitals may have deceived insurance companies into paying for them.
Unfortunately, children who express discomfort with their sex have come to be viewed as profit centers by some hospitals and doctors. As the HHS report notes, gender clinics have “promised a new stream of continuous revenue for pediatrics, endocrinology, and surgical specialties by taking physiologically healthy young people—who otherwise would not come to seek medical attention (though they might require mental health care)—and rendering them dependent for life on the medical system.” A vulnerable child, in other words, becomes a “captive patient” for life. Indeed, while the average healthcare spending for a child under the age of 18 is around $3,000, a patient who begins transitioning as a minor can expect to pay “$25,000 – $75,000 even without surgeries.” When surgeries are included, lifetime spending “can easily exceed $100,000 and approach $170,000.”
Most American families cannot afford such exorbitant costs. In order to push these experimental, sex-rejecting interventions on more children, 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. As an example, the HHS report notes that some providers have used codes like “endocrine disorder, unspecified,” instead of gender dysphoria codes. One study showed that only about 4.7 percent of patients diagnosed with “endocrine disorder, unspecified,” had that actual condition. Another notes a 30 percent increase in the number of endocrine disorder diagnoses, despite it being unlikely that there has been a substantial increase in pediatric endocrine disorders. This miscoding has allowed hospitals to bill insurance companies tens of millions of dollars for medications like puberty-blocking drugs.
The HHS report includes heartbreaking stories of the consequences when the federal government turns a blind eye to the widespread chemical and surgical mutilation of America’s children. In one instance, a homeless child was taken in by an LGBTQ youth center that pushed cross-sex hormones on her. After years of injecting herself with the medication—acquired initially via a mobile app that facilitated a brief, 15-minute doctor’s appointment for the prescription—her voice grew deeper, and she lost her menstrual cycle. But as her own body changed, she began to reflect on her experience at the youth center and what she witnessed there: children, some as young as six years old, beginning the process of transforming their bodies. She knew it wasn’t right, so she spoke out and sought help. By detransitioning, she lost all her friends. She became homeless again, and is today struggling to find the medical help she needs. The Trump Administration cannot, and will not, allow horror stories like this one to continue.
Today, I am referring the HHS report and the allegations it contains to the Department of Justice to determine whether the providers identified have violated federal law, regulations, or policies including, but not limited to, the Federal Food, Drug, and Cosmetic Act, the False Claims Act, 18 U.S.C. § 24, and federal fraud and conspiracy laws. 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. If they have done so intentionally, thereby perpetrating a fraud on Medicaid or on private insurers, they should go to prison. Rather than allow the proliferation of harmful, sex-rejecting procedures on our children, we must send a clear message that any hospitals and providers that have participated in these practices will face justice.
Sincerely,
JD Vance
Vice President of the United States
