We’ve been told for years that the gender-transition industry is all about compassion, about saving lives, about being on the “right side of history.” Turns out it’s also about billing codes. A new investigative report from Do No Harm reveals that gender-affirming care providers across the country have been openly — and I mean openly — advertising how to commit insurance billing fraud. They’re coding transgender procedures under fake diagnoses so insurance companies foot the bill. And they’re not whispering about it in back rooms. They’re posting the playbook on the internet like it’s a recipe for banana bread.
Because nothing says “we’re the good guys” like publicly instructing your colleagues on how to deceive insurance companies, skirt state Medicaid restrictions, and violate laws designed to protect children. These people put the racket in rainbow.
Here’s how the scam works, and it’s almost impressive in its brazenness. Instead of using the standard F64 diagnosis code — that’s the one for gender identity disorder, the one that would honestly describe what they’re actually doing — providers are using codes like E34.9, which is “unspecified endocrine disorder.” That’s right. They’re taking a perfectly healthy 14-year-old girl, pumping her full of testosterone, and telling the insurance company she has an endocrine disorder. Planned Parenthood of Southeastern Pennsylvania admitted they “typically” use E34.9 instead of F64. QueerDoc — and yes, that’s their actual name — actively recommends E34.9 for insurance claims. WPATH, the World Professional Association for Transgender Health, ran a training session back in 2021 endorsing this exact scheme: use endocrine-related codes to mask gender transitions as routine medical care.
They wrote it down. They taught classes on it. They put it on the internet.
Let’s be clear about what this means. When your kid breaks an arm and the hospital bills your insurance, the code matches the injury. That’s how the system works. What these providers are doing is the medical billing equivalent of crashing your car on purpose and telling your insurance company a tree fell on it. It’s fraud. It’s a federal crime. And they’re bragging about it like they just discovered a life hack.
The report identified some truly damning red flags that investigators should be looking for: teenage girls getting testosterone prescriptions within three days of an office visit where nobody bothered to use a gender dysphoria code. Mastectomies on otherwise healthy adolescents billed under “endocrine disorder.” A suspicious spike in “precocious puberty” diagnoses in kids who are too old to actually have precocious puberty. It’s a paper trail so obvious that a first-year accounting student could follow it.
And yet — and this is where it gets infuriating — when the Department of Justice tried to investigate, Biden-appointed judges shut it down. District Judge Julie Rubin quashed a subpoena to Children’s National Hospital in Washington, D.C., claiming the investigation lacked a “legitimate investigative purpose.” Judge Jamal Whitehead did the same thing to a subpoena targeting QueerDoc. Both Biden nominees. Both running interference for an industry that is, by its own admission, committing fraud.
Remember Eithan Haim? He’s the whistleblower surgeon who exposed pediatric gender transitions at Texas Children’s Hospital. For his trouble, Biden’s DOJ prosecuted him — the guy who blew the whistle. Trump’s DOJ dropped the charges, because in a sane world you don’t prosecute the person pointing out the crime. Haim has been saying for years that the evidence of fraud is “plastered all over the internet.” Turns out he was right. It literally is.
We’re not talking about some shadowy conspiracy here. We’re talking about an industry that built an entire infrastructure of deception — fake billing codes, training seminars on how to use them, and a network of activist judges ready to block anyone who tries to investigate. This is the trans-industrial complex, and it runs on insurance money the same way a chop shop runs on stolen car parts.
They’ll tell you this is about healthcare. It’s not. Healthcare doesn’t require you to lie about what you’re doing. Healthcare doesn’t need a secret billing code to hide from the people paying for it. When your entire business model depends on deceiving insurance companies and evading state laws, you’re not practicing medicine. You’re running a grift. A grift wearing a rainbow flag and hiding behind the word “compassion” while it picks your insurer’s pocket.
The DOJ appeals are now sitting with the 4th and 9th Circuit Courts. The 9th Circuit heard oral arguments in March and hasn’t ruled yet. We’ll see if the judiciary has the spine to let investigators actually investigate what everyone can already see with their own eyes.
Because here’s the thing — they’re not even hiding it anymore. They never really were. They just assumed nobody would care enough to look. Well, people are looking now. And what they’re finding is exactly what we’ve been saying all along: follow the money, and the compassion falls away pretty fast.