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Trump administration accuses hospitals of improper billing over gender care for minors

By Thomson Reuters Aug 13, 2026 | 4:48 PM

By Amina Niasse

NEW YORK, Aug 13 (Reuters) – The U.S. Department of Health and Human Services accused dozens of hospitals and healthcare providers on Thursday of improperly billing for gender-affirming care and referred them ​to the Office of Inspector General and the Justice Department for ‌investigation.

HHS released a report titled “Wolves in White Coats” that argued some gender-related treatments were paid for under unspecified conditions or, in some cases, based on diagnoses of early puberty. The report includes contributors who have been critical of gender-affirming care.

HHS said the providers billed ‌for ​the therapies to treat minors aged 9 to 17, ⁠documenting an unspecified endocrine ⁠or hormone-related disorder diagnosis rather than gender dysphoria. The report alleged inaccurate diagnoses resulted in payments from both private and government-sponsored health plans.

HHS said that as gender care for minors has grown, it has become a ​larger revenue source for hospitals, creating financial incentives for more frequent billing. Citing conservative medical advocacy organization Do No Harm, the agency said hospitals and ⁠clinics billed nearly $120 million for the services ⁠provided to minors since 2019.

Gender-affirming care for minors can include ​clinical counseling, puberty blockers or hormone therapy. Advocates for transgender minors say the ​services can reduce mental distress and support social wellbeing.

Do No Harm ‌has legally challenged gender-affirming care and diversity, equity, and inclusion programs in healthcare.

A spokesperson for the American Hospital Association declined to comment on the report.

The Trump administration finalized a rule this week barring two major federal health programs ⁠from funding puberty blockers, hormone therapy and surgeries to treat gender dysphoria, which is distress from a mismatch between a patient’s sex at birth and gender identity.

HHS, ⁠based on Do No ‌Harm data, named Mount Sinai Hospital, based in New York ⁠City, and Boston Children’s Hospital as some of the ​top ‌billing providers of the services for minors.

“In an era ​of razor-thin pediatric ⁠margins and pressure on hospital reimbursements, this new patient cohort — young, insured or Medicaid-eligible, and requiring perpetual follow-ups — represented a strategic area of growth,” the report said.

Mount Sinai did not respond in time to a request for comment. A spokesperson for Boston Children’s Hospital said it is reviewing the report.

(Reporting by Amina ​NiasseEditing by Rod Nickel)