Hospitals Profited From Harmful Gender Surgeries on Minors, HHS Report Says| National Catholic Register

Before receiving their medical degree, doctors pledge to prioritize the well-being of those they serve. But a new report from the Trump administration contends that when it comes to so-called gender medicine, some in the medical establishment have instead betrayed the trust of young patients for their own gain.

Titled “Wolves in White Coats,” the report from the Department of Health and Human Services (HHS) documents what it describes as the “political and financial incentives” that have prompted major healthcare providers to unduly prescribe “gender-affirming” drugs and procedures for minors.

The report, released Aug. 13, also contains several firsthand accounts from children and the parents of children who were allegedly pressured by healthcare providers to undergo irreversible and mutilating “sex-rejecting procedures.”

One girl, Clementine Breen, underwent a double mastectomy at age 14 and suffered severe psychological effects from testosterone therapy. When she decided to “detransition” — or halt and attempt to reverse the so-called gender-transition process — she says she was met with evasive behavior from her healthcare providers and lacked clear support. Breen says she “views her past sex-rejecting interventions as a form of self-harm.”

Over 225 hospitals and health systems nationwide had launched programs “by the early 2020s” to provide these kinds of procedures to children, the report states.

Based on the results of the report, Vice President JD Vance, a Catholic, said he has referred the matter to the Department of Justice “to launch a federal criminal investigation.”

‘Profit Immensely’

The HHS report found numerous instances of hospitals pushing children to “transition,” thus placing them on a course that would require expensive drugs, surgeries and lifelong medical interventions. According to the report, a lifetime of transgender drugs started as a minor can cost between $25,000 and $75,000, while the figure rises to $100,000-$170,000 when factoring in surgeries.

The institutions and providers studied participate in federal programs including Medicaid and Medicare, meaning doctors and entities that provide gender-transition services “could profit immensely.” Watchdog analyses tracking billed charges for minors from 2019 onward estimate almost $120 million in total hospital and clinic billings for related interventions nationwide, encompassing more than 5,500 surgical procedures and 8,500 courses of hormones or blockers.

There is also reason to believe, the report continues, that some — “perhaps many” — providers of sex-rejecting procedures “systemically diagnose minors with physical conditions they did not have,” using vague diagnostic codes in order to secure insurance coverage for procedures like breast removal or hormonal treatment that insurers “might not otherwise have covered had they been provided with full and accurate information.”

For example, from 2015 through 2025 hospitals filed approximately $47 million in insurance claims for puberty blockers billed using the diagnostic code E34.9, which signifies an unspecified form of endocrine disorder. The report’s authors contend that the surge in usage of the vague diagnostic code for minors without a corresponding rise in endocrine disorders reflects a pattern of potentially fraudulent billing that relies on miscoding for endocrine disorders to justify the prescription of puberty blockers.

“[T]his report highlights evidence that healthcare providers may have secured insurance coverage for these procedures, increasing their bottom lines, through potentially fraudulent means,” the report continues, recommending continued oversight of insurance coding practices and appropriate review of billing activity.

‘Timely and Powerful’

Mary Rice Hasson, a Catholic and a fellow with the Ethics and Public Policy Center (EPPC) who speaks frequently on topics of gender ideology, called the report — to which several of her EPPC colleagues contributed — “timely and powerful.”

“For too long, hospitals, gender clinics, and unscrupulous physicians have fast-tracked healthy — but mentally distressed — kids towards harmful sex-rejecting procedures, with little regard for the child’s bodily integrity or future fertility,” Hasson said in a statement to the Register. “As this report on fraudulent billing practices makes clear, the gender industry also scammed the government and profited greatly in the process.”

“Catholic teaching is clear: these medical and surgical interventions are immoral and offend human dignity,” Hasson continued. “This report should move every Catholic to condemn the exploitative practices of the gender industry and recognize the harm done to vulnerable people.”

The Catholic Church teaches that humans are created by God as inseparable composites of body and soul, and thus a person’s biological sex is an unchangeable gift from God. Catholic leaders, including the U.S. bishops, have constantly reiterated that Catholics are called to respond with empathy and compassion to those experiencing gender dysphoria, while never compromising the truth that attempts at “gender transitions” are harmful, misguided and cannot be approved for anyone, adults or children.

In November 2025, the USCCB published a new edition of its “Ethical and Religious Directives for Catholic Health Care Services” guidelines, which expressly prohibit Catholic institutions from providing treatments that “aim not to restore but rather to alter the fundamental order of the human body in its form or function” such as so-called gender transitions. 

Pushback Against ‘Transgender Mandate’

The second Trump administration has largely reversed the federal government’s previous strong promotion of transgender ideology under President Joe Biden, which included a sweeping “transgender mandate” — which Catholic plaintiffs successfully rebuffed in court — to force healthcare providers to perform gender-transition surgeries or provide insurance coverage for them.

Most recently, the Centers for Medicare & Medicaid Services (CMS) announced Aug. 12 that it has implemented a final rule that formally bans the use of funds for drugs and surgeries used to facilitate “gender transitions,” drawing praise from Catholic bioethicists as a sensible move.

The change also drew support from the American College of Pediatricians (ACPeds), which noted that gender procedures can “result in irreversible damage to children and adolescents, including infertility, impaired sexual function, diminished bone density, altered brain development, and other lasting harms.”

Roughly half of U.S. states, including Texas, have passed bans on puberty blockers, cross-sex hormones, and “gender-transition” surgeries for minors under 18.

Other countries in recent years, after careful study, have moved to end or limit the practice of providing transgender drugs or surgeries to minors. England’s National Health Service (NHS), for instance, has moved to limit the availability of drugs meant to facilitate gender “transitions” to minor patients, citing a lack of evidence as to their safety and efficacy.