2025: The Year Patent Gender Medicine Fraud Was Finally Prosecuted

And what that means for The Distance

During October, the U.S. Department of Justice charged Children’s Hospital of Philadelphia (CHOP) and Children’s Hospital of Pittsburgh with “fraudulent billing practices.”

Lisa Hsiao, who runs the Department of Justice office that used to be called the Consumer Protection Branch, cited “off-label uses” of puberty blockers prescribed with an “incorrect diagnosis and/or billing code” when clinicians “know that certain insurance plans may not cover off-label prescription of puberty blockers or cross-sex hormones for gender-related treatment.”

Now titled the Enforcement and Affirmative Litigation Branch, Hsiao’s office searched “extensive anonymized insurance claims” to find 250 minors with central precocious puberty at age 10 or older “including numerous teenagers aged 14 to 18” from 2017 to 2024. This is patent medical fraud.

With the assistance of a federal judge, CHOP and CHP are still resisting the Trump administration’s efforts to identify those patients, calling them “invasive”. Advocates for pediatric sex lobotomy insist this is a war on “transgender people” when it is in fact a war on the frauds committed in the name of gender.

Pennsylvania stands out, however. Clinics around the country have stopped practicing patent gender medicine fraud on children. The University of Utah shut down their clinic in May. Montana, a red state where the state supreme court had sanctified pediatric sex lobotomies, lost their gender abattoir for kids in August. So did the eastern half of Texas.

Blue states are seeing the most significant closures, likely because there was plenty of billing and prescription fraud. Connecticut parents lost their best facility for child sterilization in July. Children’s Hospital Los Angeles closed their clinic, the nation’s largest, in June when they were threatened with loss of federal Medicaid funding. Kaiser Permanente, one of the biggest healthcare providers in the Golden State, also shut down their pediatric gender clinic; so did Stanford Medicine in San Francisco.

It is worth noting that some patient families and advocates who were shut out by the Pittsburg clinic under pressure from the Trump administration have cried “discrimination”. Worth noting, because Secretary of Health and Human Services Robert F. Kennedy, Jr. just announced a rule change last week to remove protections against discrimination from childhood gender dysphoria.

Democrats have dug themselves in since last week’s HHS announcement. Electeds have signaled their virtue all over social media, and while opinions will vary, my impression is that their tweets are not performing as well as they wish and the replies are dominated by dissent. It feels as if the Bluesky crowd has returned in full force only to find their power to control the app diminished while they were gone.

There may be something to my impression. According to Grok AI, which researched sentiment on the app for me, roughly 80 percent of posts are opposed to pediatric transition now, a marked increase since 2020. More interestingly, there has been little change in the arguments promoting pediatric transition in the last five years. They have only become more specific and defensive as the Cass Review, state bans, and WPATH disclosures have all put a spotlight on the risible ‘science’ involved.

In July, after attending the Federal Trade Commission workshop on pediatric gender medicine fraud, I wrote that the cult of the ‘trans child’ was doomed. Nothing has changed in five months. To be sure, this medical ethics scandal is not over, indeed it will take years to completely end. But it will end, ultimately, because criminal fraud is not a sustainable business model. It never was.

I began my own ‘gender critical’ journey in 2018 when I walked out of a progressive conference room because I was quite sure I had just heard two women, both ostensibly in the reproductive rights space, describe a plan to commit Medicaid and insurance fraud with pediatric gender cases. By their own telling, this was effectively legal, necessary, and life-sustaining. They were lying, of course, and the fraud I detected in their scheme back then is being prosecuted, now.

No child was ever born in the wrong body. No child needs to have their normal puberty blocked for any reason. Puberty is not a disease process, it is a critical stage in the evolved human life-cycle. At no point did anyone ever announce the discovery of the ‘trans child’. No laboratory test has ever been developed to detect and measure ‘gender identities’ in anyone. The iatrogenic harms of ‘gender medicine’ are intrinsic to the fraudulent premise behind the practice.

And then there are the detransition lawsuits. Any one of these stands to become a landmark judgment that erases the profit motive. Meanwhile, no wave of suicides will register as a result of all this change. We have passed the peak intensity of this social climate change, even if the shouting is not over. The ‘trans kids’ project is culminating.

It is therefore apparent that the issue is unlikely to go another way anytime soon, that the next three years will see the extinction of the pediatric gender clinician in America. Insurance companies will no longer cover it, or cover the doctors who do it, after state attorneys general and the Trump administration have inflicted exemplary punishments. The American Medical Association, which has enabled the fraudulent coding, may very well be subject to their own investigation.

I am not equipped or positioned to do anything about these changes, anymore. The most I can do is describe them and explain them. The ‘gender critical’ fight has been taken out of the hands of regular people at this point; we have been a pop-up movement, a temporary cause that will fade and be forgotten, because in ten years the average teenager will have no idea what the fuss was even about.

Where does that leave The Distance? In recent weeks, I have talked to multiple people in a state of burnout. Many of us have been fighting this battle for too many years. The ‘gender critics’ who made whole careers out of agitation on X must find new preoccupations, and Substacks like this one do not have a long-term future, indeed paid subscribers have declined this year precisely because the issue is no longer as salient as it was. I have a book project in mind, but that’s it.

Another issue with this website is that it is not really my own. I was originally hired to run a team of people on behalf of a startup nonprofit that soon folded, leaving me with The Distance and no staff. It was never a permanent internet residence, for me, but just another of the dozen or more websites that I have worked for over the years.

Early next year I will be combining this website with my own, OsborneInk.com, to carry on with occasional articles, frequent book reviews, and the podcast. This site will remain as an archive. I have not decided on every detail yet, but sometime in the next few months this website will suspend billing and all updates will continue at Osborne Ink under a new vertical there.

If you want to stay with me through this ‘transition’ (heh), come sign up as a subscriber, and consider a premium subscription. Happy holidays!