New report finds tens of millions of dollars in puberty-blocker claims coded as unrelated or unspecified endocrine disorders; health systems quietly building pipelines of lifelong patients while shielding the nature of the interventions
The Independent Medical Alliance (IMA), the nation’s largest coalition of independent doctors and healthcare professionals, today highlighted hospital billing practices detailed in the HHS investigation Wolves in White Coats: How Doctors and Hospitals Pushed and Profited from the Fraud of Gender Medicine. The report shows that profitable pediatric gender interventions were routinely billed under vague, unrecognizable codes such as E34.9—“Endocrine Disorder, Unspecified.”
“Why were hospitals hiding what they were doing to children behind billing codes that parents, taxpayers and insurers would never recognize as transgender medicine?” asked IMA President and Chief Medical Officer Dr. Joseph Varon. “If medical institutions were disguising these procedures while creating a pipeline of young patients requiring years of continued treatment, the American people deserve to know exactly what happened and who profited.”
The HHS report found that more than 225 hospitals and health systems established pediatric gender programs nationwide and identified tens of millions of dollars in insurance claims for puberty blockers that were submitted under obscure or potentially misleading diagnostic codes.
According to HHS:
- Approximately $50 million in insurance claims for puberty blockers between 2015 and 2025 were billed under E34.9.
- Nearly $11 million in claims for children ages 13–17 were billed under E30.1, a code associated with precocious puberty.
- More than 225 hospitals and health systems established pediatric gender programs across the United States.
“The lack of transparency is stunning,” Varon continued. “The public has every right to question what large healthcare systems are telling them—from the COVID revelations to the quiet financial incentives surrounding these procedures on children.”
The findings have already prompted federal action. Vice President JD Vance, Chairman of the White House Task Force to Eliminate Fraud, and HHS Secretary Robert F. Kennedy Jr. have referred hospitals and clinics identified in the report to the Department of Justice and the HHS Office of Inspector General for review of potential violations of federal law.
The report also examines the financial incentives surrounding pediatric gender medicine, describing a system in which vulnerable children could become what the report calls “captive patients” requiring potentially lifelong medical interventions.
“HHS is documenting an industry involving hundreds of medical institutions, large financial incentives, and billing practices serious enough to trigger federal investigation. There must be full transparency and accountability,” Varon concluded.
