Vice President JD Vance has referred a newly released Department of Health and Human Services report on pediatric gender medicine and insurance billing practices to the Department of Justice for review of potential federal law violations. The report, titled “Wolves in White Coats: How Doctors and Hospitals Pushed and Profited from the Fraud of ‘Gender Medicine,’” examines insurance coding for treatments such as puberty blockers and cross-sex hormones provided to minors.
According to the report and accompanying HHS materials, more than 225 hospitals and health systems established pediatric gender programs. Nationwide insurance claims data from 2015 to 2025 identified approximately $50 million in claims for puberty-blocking drugs billed under the diagnostic code for “endocrine disorder, unspecified” (E34.9). An additional nearly $11 million involved claims for patients ages 13 to 17 billed under a precocious puberty diagnosis code.
The report notes that precocious puberty diagnoses are typically inappropriate for patients older than 13. All-payer claims data further indicated nearly $120 million in billed charges since 2019 for related procedures involving minors, including over 5,500 surgical procedures and 8,500 courses of hormones or puberty blockers.
HHS Secretary Robert F. Kennedy Jr. referred a defined set of claims showing potentially anomalous billing patterns to the HHS Inspector General. These included claims for puberty blockers paired with an endocrine disorder diagnosis lacking accompanying gender dysphoria or precocious puberty codes for patients ages 9 to 17, claims using precocious puberty codes for ages 13 to 17, same-day cross-sex hormone prescriptions with a primary gender dysphoria diagnosis in states restricting such care for minors, and certain affiliated billing patterns.
The report draws on peer-reviewed literature, hospital records, whistleblower testimony, claims analyses, and interviews with patients and parents. It states that average annual healthcare costs for a minor are roughly $3,000, while pathways involving these interventions can reach $75,000 without surgery and nearly $170,000 with surgery, creating ongoing revenue through lifelong monitoring, prescriptions, and follow-up care.
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🚨 WOW. It was just exposed by JD Vance and Robert F. Kennedy Jr. that hospitals who billed for child transgender operations cost up to $170,000 DOLLARS
For TOTALLY unnecessary and manipulation-induced operations.
The hospitals have now been referred to DOJ for federal law… pic.twitter.com/uosjPQGjYd
— Eric Daugherty (@EricLDaugh) August 13, 2026
In a letter to Attorney General Todd Blanche, Vance outlined concerns from the report. “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,” the vice president wrote.
“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,” the letter went on.
“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.”
The referral follows the Trump administration’s recent decision to end federal Medicaid and CHIP funding for sex-rejecting procedures on minors. HHS officials, including Kennedy, have stated that the report raises questions about financial incentives and coding practices that warrant further scrutiny to protect program integrity and patients.
The Justice Department has not yet issued a public comment on the referral as of this report.
