After the U.S. Department of Health and Human Services (HHS) released a report on billing fraud in pediatric gender medicine, Vice President J.D. Vance is urging the Department of Justice to investigate the chief offenders detailed in the report Wolves in White Coats. While there is debate about the precise role played by financial incentives in the rise of youth gender medicine, the report expounds on these financial motivations. It also chronicles how medical associations actively encouraged fraudulent billing practices using inappropriate diagnostic codes like endocrine disorder, unspecified and precocious puberty, to ensure patients were able to access “affirming” interventions. “Doctors and hospitals must put children’s health ahead of ideology and financial gain,” HHS Secretary Robert F. Kennedy Jr. said in a statement. “This report identifies troubling billing practices that demand scrutiny. HHS will follow the evidence, protect taxpayers, and hold accountable anyone who broke the law or violated the trust of patients and families.”
The San-Francisco based 9th U.S. Circuit Court of Appeals reinstated a Department of Justice subpoena seeking patient records and billing information from the “affirming” telehealth provider, QueerDoc. The Appeals court determined that a Seattle judge erred when concluding that the subpoena was issued in bad faith and blocked its enforcement. “The President may direct DOJ to exercise its statutory authority in a manner that aligns with his broader policy goals,” wrote Circuit Judge Carlos Bea. The case will now be sent back to the Seattle judge to rule on QueerDoc’s arguments that the subpoena is overbroad and would impose an undue burden on the small clinic.
A U.S. District Judge has struck down a provision from the Trump administration's Marketplace Integrity and Affordability Final Rule, which prohibits some medical transition procedures from being categorized as essential health benefits under the Affordable Care Act. A coalition of twenty states sued the Trump administration over the rule last year, arguing that several provisions were unlawful. While the judge vacated the provision on “affirming care” and essential health benefits, four other provisions in the rule were upheld.
Journalist Ben Ryan has published previously redacted emails between then WPATH president, Dr. Walter Bouman, and staffers at HHS revealing that WPATH was pressured by then HHS Assistant Secretary for Health, Rachel Levine, to remove age minimums for treatment eligibility. In the email, Dr. Bouman suggests that WPATH strongly considered the feedback from HHS, and agreed to recategorize age minimums as suggestions, rather than recommendations. Ultimately, however, WPATH did remove the age limits—seemingly without following a systematic protocol known as Delphi—after additional pressure from the American Academy of Pediatrics, and the Trevor Project.
Starting in October, a slate of new diagnosis codes recognizing the phenomenon of detransition, and more specific aspects of medical transition, will become available under the Centers for Disease Controls ICD-10. “Well over 14,000 children have received sex-change treatments in recent years. As they get older, many will realize they have made a mistake and understandably want to go back,” wrote Do No Harm senior fellow Aida Cerundolo, in a recent piece in the Hill. The new codes include codes for gender dysphoria in remission, as well as codes that reflect a personal history of detransition, and social, medical, and surgical transition. “These patients deserve a medical system that recognizes them,” Cerundolo added, “because recognition is the first step to ensuring they get the right care.”
A parent is suing Portland Public Schools after she was served a trespassing order barring her from school premises after she criticized the school for teaching her 11-year old about “gender identity” without a formal announcement or opt-out. The parent is accusing the school of pursuing a trespass order against her as an act of retaliation for her critique of Portland Public Schools. The district’s guidance on gender expansive students asserts that the “district’s push to improve inclusion ‘requires an unwavering commitment to a systematic shift in paradigms to increase the understanding of sexual and gender diversity.’”
The Board of Supervisors in Alameda County, California, voted to approve $1.5 million in funds to Oakland’s LGBTQ Community Center to help subsidize services impacted by the Trump administration’s federal policies on “affirming care.” “The Center is proud to steward these critically needed funds in collaboration with other nonprofits, delivering no-fee gender-affirming care, mental health access, and youth support: refusing erasure, and laying the foundation for resilient LGBTQ+ healthcare infrastructure that can weather the current crisis,” said Joe Hawkins, CEO of the LGBTQ Community Center. “It’s just a very important part of the overall strategy of filling in all of the gaps that are going to open,” said organizer Arne Johnson, “if any of these federal policies come into play.”
Joseph Figliolia
Policy Analyst
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