The Trump administration is opening another front in its campaign against gender-affirming health care, this time accusing hospitals and doctors of potentially committing insurance fraud while treating transgender minors.
The Department of Health and Human Services released a report Thursday titled Wolves in White Coats: How Doctors and Hospitals Pushed and Profited from the Fraud of “Gender Medicine.” The report alleges that some providers improperly used diagnostic codes for endocrine disorders and precocious puberty when billing insurers for puberty blockers and other gender-affirming treatments.
Vice President JD Vance, who chairs the White House Task Force to Eliminate Fraud, referred hospitals and clinics identified in the report to the Department of Justice for possible investigation. HHS Secretary Robert F. Kennedy Jr. separately referred providers to the department’s Office of Inspector General.
From Restricting Care to Alleging Fraud
The move represents an escalation in the administration’s efforts to dismantle access to transgender health care.
According to HHS, its analysis found approximately $50 million in insurance claims between 2015 and 2025 for puberty blockers billed using a code for an unspecified endocrine disorder. Another nearly $11 million in claims involving patients ages 13 to 17 reportedly used a diagnostic code associated with precocious puberty.
Those figures, however, are allegations of potentially improper coding, not findings that hospitals committed fraud. Investigations would still have to establish whether providers knowingly submitted false claims or whether the billing reflected legitimate medical and insurance coding practices.
Reuters reported that the HHS report relied partly on data from Do No Harm, a conservative medical advocacy organization that has challenged gender-affirming care and diversity programs in health care. The report claims nearly $120 million was billed for gender-related services for minors since 2019.
Hospitals Put Under Federal Scrutiny
More than 225 hospitals and health systems have established pediatric gender programs nationwide, according to HHS. The report specifically identifies institutions including Mount Sinai Hospital and Boston Children’s Hospital among providers with significant billing associated with transgender youth care. Boston Children’s told Reuters it was reviewing the report, while Mount Sinai did not immediately respond.
The investigation comes as the administration is simultaneously using federal health policy to restrict the same care. This week, officials finalized rules barring Medicaid and the Children’s Health Insurance Program from covering certain gender-affirming treatments for minors.
Taken together, the actions suggest a broader strategy: where outright restrictions face legal challenges, federal officials are increasingly turning to funding, billing oversight, and potential criminal investigations to pressure providers.
For hospitals still treating transgender young people, the message from Washington is becoming difficult to miss. Providing care may now bring not only political scrutiny but also the possibility of federal investigators showing up afterward.
