By MEGAN BLOCK | DAILY CALLER NEWS FOUNDATION
The Biden-Harris administration opened the door for a massive increase of taxpayer-funded transgender interventions, including child sex-change surgeries, and the Daily Caller News Foundation has obtained enough data to give a partial estimate of the cost.
From January 2018 to September 2023, 16 states spent more than $165 million funding “gender transition services” — including puberty blockers, hormones, and sex-change surgeries — with more than $45 million spent on interventions for children 17 and younger, according to data obtained by the DCNF through a series of public record requests.
The DCNF asked states to provide reimbursement data for gender transition services covered through state insurance and medical assistance programs, such as Children’s Health Insurance Program (CHIP), which is funded through Medicaid. The states were able to identify gender transition services through medical billing codes such as International Classification of Diseases (ICD) codes. Published by the World Health Organization, ICD codes provide comprehensive diagnostic information for diseases and injuries and create a valuable dataset used in medical research.
The DCNF requested the total amount of reimbursements paid for all gender transition services — which could include speech therapy and mental health services as well as life-altering surgeries — that were covered through state insurance and medical assistance programs.
The states that provided data to the DCNF include: Michigan, Idaho, Illinois, Virginia, Nevada, Wisconsin, Massachusetts, Louisiana, Maryland, New Hampshire, Wyoming, Kentucky, North Dakota, Oregon, Utah, and Washington.
Editor’s note: Alaska apparently did not provide data to the DCNF.
The three states with the highest amount of reimbursements for gender transition services for adults and kids were Illinois, Oregon, and Washington state. Illinois spent $40,843,721, which included $14,296,558 in services for children 17 and under. Oregon spent $30,045,262 and Washington State spent $27,145,383. Other statewide totals for gender transition services includes Maryland, which spent $11,849,062, Nevada, which spent $10,096,655, Michigan, which spent $6,821,169, and New Hampshire, which spent $2,360,534, according to data sent to the DCNF.
Virginia provided the DCNF with data from 2020 to 2022, spending a total of $13,933,635 on gender transition services in three years, with $3,480,492 spent on sex-change interventions for children 17 and under.
The state of Oregon specified that their data included reimbursement costs for a range of sex-change procedures including surgeries, anesthesia costs, hair removal, speech therapy, hormone therapy, and puberty suppression.
The data showed a 60% increase in sex-change interventions for adults and kids under the Biden-Harris administration across the 15 states that provided yearly data totals for 2020 to 2022, jumping from $27,753,478 spent on gender transition services in 2020 to $44,553,052 in 2022. Utah did not break down its data into yearly totals and was excluded from this calculation. While data for 2023 was incomplete, 12 states provided some totals showing $22,017,362 had been spent on sex-change interventions over the first nine months of last year.
The DCNF attempted to obtain similar data from 48 states. However, many states outright denied the requests or sought exorbitant fees to obtain public data.
For example, Rhode Island wanted a prepayment of more than $3,000 to fulfill the request that other states considered exempt from public information processing fees.
Explosion In Sex Changes For Minors
Democrat-led policies that required insurers to pay for sex changes for minors led to an increase in the procedures nationwide, according to a leading transgender activist and physician.
In a June 2022 email exclusively obtained by the DCNF, Jason Rafferty, the lead author of the American Academy of Pediatrics sex-change policy, attributed the growth of pediatric sex-change surgery to services being more “accessible” due to increased Medicaid funding.
“I would say that there has likely been an increase in ‘top surgery’ among 16 and 17 year olds simply due to the fact that this surgery has become more accessible. 10 years ago when I started in this field, if a patient wanted surgery there was really only 1 surgeon in the region doing it for patients under 18 and aside from that they would need to travel across the country and pay out of pocket,” wrote Rafferty.
“Clearly if you were on Medicaid or did not have the resources, it was off the table. Today, we have 3 surgeons in [Rhode Island] doing these surgeries and probably half a dozen in [Massachusetts] plus a pediatric plastic surgeon at Boston Childrens specializing in gender surgeries. Most if not all now take Medicaid – very few patients are paying the fully cost of surgery out of pocket. So, the point is that my experience is not that surgery is ‘more popular’ but just more (or simply just) accessible,” he wrote.
Rafferty did not respond to multiple requests for comment from the DCNF.
The rapid growth of tax dollars funding the sex-change industry can be attributed to policies from Democrat presidential administrations.
In 2014, the Obama-Biden administration overturned a rule preventing Medicare from funding sex-change surgeries, opening the doors for taxpayers to pay for sex-change operations. They further expanded coverage for sex-change interventions in 2016 through their interpretation of Section 1557, a non-discrimination provision of the Affordable Care Act.
In May 2016, the Obama-Biden administration issued a rule that quietly redefined the discrimination policy to include sexual orientation and “gender identity,” a move which strong-armed the entire medical community into embracing gender ideology and sex-change interventions, especially for children. “Gender identity” is a term used by transgender activists to describe how a person feels about or perceives their sex. Activists believe these feelings override a person’s biology and should have equal weight in law and society.
The Obama-Biden administration’s regulatory change prevented insurance companies from categorically denying coverage for sex-change interventions, considering such bans a form of discrimination, which forced insurance plans to offer coverage for sex-change services.
“What the rule was about under Obama, and now under Biden-Harris, was to force medical providers to do the surgeries, even against their medical judgments, and for insurance companies to pay for it, which means we all pay for it,” Roger Severino, vice president of domestic policy at the Heritage Foundation and former director of the Office for Civil Rights at Health and Human Services, told the DCNF.
“That includes the whole gamut from hysterectomies to breast augmentations to tracheal shapes, voice training — just an extraordinary number of very expensive procedures to treat a psychological condition using physical interventions, surgeries, etc. and no real religious exemption,” Severino said.
A 2023 study published in the Journal of the American Medical Association (JAMA) showed the impact of Obama’s 2016 Rule, finding the number of sex change surgical procedures performed in the U.S. nearly tripled between 2016 to 2019. Roughly 8% of patients were between the ages of 12 to 18, the study found, and showed a sharp rise in breast and chest surgery from 2016 to 2019 within the pediatric population.
Biden-Harris Restores Gender Surgery Funding After Trump Admin
In June 2020, the Trump administration overturned Obama’s Rule on Section 1557, reinstating the government’s previous interpretation of discrimination must be based on biological sex rather than “gender identity.” At that time, Severino was the director of the Office for Civil Rights at Health and Human Services.
On May 10, 2021, however, the Biden-Harris administration reversed the Trump rule and redefined discrimination under Section 1557 to include “gender identity,” again forcing the medical community, including insurance companies, to provide sex-change services to children or face accusations of discrimination.
“I issued the Trump regulations, undoing the Obama Section 1557 changes that added gender identity as a protected class and requiring cross sex, surgeries, hormones, puberty blockers, included on children in federally funded programs and in insurance,” Severino said.
“They were as comprehensive as they could to try to push unscientific gender ideology into the medical system, and they succeeded, over the last three plus years, in trying to coerce hospitals, doctors, and insurance companies to push experimental treatments and surgeries, including and especially on children,” Severino added.
Do No Harm, a medical watchdog group, recently published a databasethat found from 2019 to 2023, 13,994 children in the United States have received sex change-related treatments and 5,747 sex change surgeries had been performed on children.
“Medical professionals must provide evidence-based care, not pursue a political agenda,”Dr. Stanley Goldfarb, chairman of Do No Harm, told the DCNF. “We are committed to ending this predatory practice, which is harmful to the thousands of minors whose lives and bodies will never be the same.”
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