Forget 'Gender Dysphoria': Almost All The Hormonal 'Gender Medicine' Is Billing Fraud
Why the old arguments are becoming irrelevant to the outcome
Everyone can stop talking about ‘gender dysphoria’ now. The term is largely irrelevant to questions about kids and puberty blockers and hormones, anymore, because hardly anyone is actually billing for coverage under that diagnosis.
For example, Texas Children’s Hospital recently settled litigation with the Department of Justice that alleged billing fraud for pediatric sex rejection medicalization in the amount of $10 million.
However, a database maintained by Stop the Harm indicates that Texas Children’s only billed $11,000 over five years to ‘treat’ gender dysphoria.
Instead of billing for the diagnosis found in DSM-V, the standard diagnostic reference published by the American Psychiatric Association, Texas Children’s submitted false claims for nonexistent endocrine disorders.
Damages are tripled under the False Claims Act. For every dollar in claims the hospital submitted for medicalized treatments for gender dysphoria, they submitted approximately $300 in fraudulent claims for ‘endocrine disorders’.
This is not happening at just a few facilities.
Medical watchdog Do No Harm found just 22 annual insurance claims for puberty blockers or hormones for minors from 2019-2023 at the Children’s Hospital Colorado’s TRUE Center for Gender Diversity.
In court testimony, on the other hand, the TRUE Center admits treating 1,140 patients under 18 in 2025 alone.
Fraud explains the entire difference. Children’s Hospital Colorado, Texas Children’s Hospital, and the Cleveland Clinic have all settled with the Department of Justice over charges of submitting false insurance codes in pediatric sex rejection cases. Similar cases are playing out elsewhere.
This is what the World Professional Association for Transgender Health, WPATH, actively advised clinicians to do. As a result, the entire industry of sex rejection medicalization is almost certainly completely rife with potential fraud claims awaiting slam-dunk prosecutions based on black-letter law.
Arguments about transgender identification become moot under the federal False Claims Act. WPATH allegedly told American sex rejection providers to break the law, and they did.
This was not like leaving an exhaust port on the Death Star. This is like leaving a big, fat bullseye on a Death Star exhaust port that is a mile wide. This was hubris by an activist organization pretending to do scientific medicine when what they were really doing was fraud, all along.
This was happening from the start.
WPATH exists at all because gender doctors wanted insurance coverage for their patients. As attested by internal documents from the organization, there was never a preliminary scientific evidential stage to anything they have ever done. WPATH is an industry advocacy organization.
The WPATH organization expanded their patient pool to include children in 2008. To justify the change, WPATH declared it was “medically necessary” for children to realize their “embodiment goals” as future adults, so that they would be happier as adults.
This exactly mirrored the approach of the so-called Dutch protocol developed by Peggy-Cohen-Kettenis and Louis Gooren. Altogether, during the 1990s, 12 of 105 adult male patients in their vaginoplasty program committed suicide, while a staggering 70 percent were lost to follow-up.
The clinicians still presented their findings in a positive light, saying that because so many patients had declared they were satisfied immediately after the procedure, the results were good, actually. Regret never registered on their scales.
Rather than stop and think, Gooren and Cohen-Kettenis reasoned that if they started earlier, in pre-pubertal males, the cosmetic results would be more pleasing. The unhappy boys would be a happier as transgender ‘women’, they said, because they would be more pleasing ‘women’ in the eyes of adult men.
While the industry peddled sex rejection as ‘giving kids time to think’, the actual results of puberty blockade were a fast track to medicalization with cross-sex hormones and surgeries.
In the years to come, parents across the western world were extorted with the imminent suicide of their children unless drastic endocrine disruption began immediately.
There was never an evidence basis for this claim. It is instead the rationalization of Gooren and Cohen-Kettenis for the world’s first experiment in blockading nonprecocious puberty. It remains the official justification for following WPATH guidelines to medicalize a sex-rejecting child.
Questions about brain development, body development, sexual development, and the ability of a minor child to effectively consent to future iatrogenic health effects were pushed aside at every stage.
The medical-scientific world pretended that everything it knew about the evolved human life-cycle had been disproven by ‘ settled science’.
In the United States, however, there was an important snag in health care coverage. WPATH found that insurers were never suspicious about ‘endocrine disorders’, whereas gender dysphoria diagnoses required lots of paperwork.
Being careful did not pay. Getting paid was easier if they just lied, so WPATH did, and told providers to do it. This put them on the wrong side of the law years ago. Such petty concerns were easily swept aside by the urgency of turning boys into better-looking women, so they would not take their own lives, later.
Activists in lab coats invented the ‘trans kids’.
Dr. Norman Spack, the man who brought pediatric sex rejection medicalization to the United States from the Netherlands, gave a TED Talk in 2014 that ought to have raised red flags. Instead, it was celebrated at the time.
Spack presented Jackie Green, transgendered son of former Mermaids CEO Susie Green, as a case study. Spack crowed about his decision to start Jackie on estrogen early, to fuse his growth plates faster, so that “she” would not be over six feet tall.
In this video, Spack wants us to focus on Jackie Green’s “normal breast size.” He shows a photo of Jackie in a beauty pageant representing Mermaids. Spack is similarly effusive about twin boys, ‘Nicole’ and Jonas, that diverge in appearance thanks to his endocrine interventions.
My dissection of the Spack TED talk video is the highest-performing post in the history of The Distance. It is preserved here for the historical record as well as the potential criminal and civil court record.
The evident satisfaction that Dr. Spack takes in achieving adult “embodiment goals” by altering the body of a minor child to fit the sexual tastes of adult men in the future is disturbing.
He thinks of himself as a good person, of course. Spack does not live with the damage, years later. None of them do, these gender quacks.
Jonni Skinner, who appeared in a podcast for The Distance earlier this week, had the same early hormonal interventions as Jackie Green. His puberty was blocked at 13 and his bone growth plates were locked at 14.
Just like Dr. Spack, they said it would make him better able to attract a husband.
Today, Jonni Skinner is a young gay man trapped in a boy’s body, unable to have a fulfilling adult relationship with anyone. He is anorgasmic despite being in his 20s.
Jonni’s ‘care’ was charged to his insurance coverage as an endocrine disorder, even though he was dysphoric.
Curing dysphoria was never the point. Meeting embodiment goals was always the point. It was impressed on him from the beginning of his medicalizeed sex rejection.
Doctors made Jonni “very distressed about my height”, he tells The Distance in a recent exclusive podcast interview.
One of them went out of his way to convince Jonni that he needed his growth plates locked. “I remember him specifically pulling up a chair because he was very short. He pulled up a chair and climbed in the chair to measure me just to make me feel like I was freakishly tall.”
“And it worked because I was 14.” Jonni had normal adolescent anxieties on top of other issues. “Being made to feel like I was so much taller than a grown man” was “very distressing for me.”
In another twisted turn, the boom in pediatric sex rejection medicalization saw a complete demographic flip. Today, girls are medicalized at a far higher rate than boys, with serious long-term health implications.
Jonni was the intended target of the Dutch protocol and WPATH standards. He does not expect personal justice, sadly, but the justice system is moving, and its wheels grind exceedingly fine. A reckoning is here.
