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Great reporting from Benjamin Ryan - Dr. Teddy Goetz, nonbinary Kaiser psychiatrist, details the typical fraud scheme in gender clinics. First visit: Gender dysphoria (F64). After hormones start: Endocrine disorder (E34). The “endocrine disorder” billed to insurance is the pathological diagnosis they induced with cross-sex hormones. They then bill...

12,925 views • 1 day ago •via X (Twitter)

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Dr A's profile picture
Dr A1 day ago

@benryanwriter I did gender medicine longer than most of the people doing it now, so I feel confident in saying that those providing so-called "gender-affirming care" are the sick ones. Who other than a sick bastard would sell a fake treatment for an incorrect diagnosis & call it good?

Anonamoose's profile picture
Anonamoose1 day ago

@benryanwriter Eithan Ham MD, expert witness at the upcoming Nuremberg trials.

Those Who Speak Podcast's profile picture
Those Who Speak Podcast1 day ago

@benryanwriter Well played gender freaks.

Eliot Mason's profile picture
Eliot Mason1 day ago

@sometherapist @benryanwriter Ahem “nonbinary Kaiser psychiatrist”? Isn’t there that old saying.. let’s see, ah yes! “ Dr Heal Thyself!” How can a person be qualified to care for others when their own axis of health is so badly tilted?

LC's profile picture
LC1 day ago

@benryanwriter Pharma and hospitals are on board with this because it means cash cow patients for life. Eventually they won't have boomers to treat so they need to create new ways of a "supply".

Dara Martin's profile picture
Dara Martin1 day ago

@benryanwriter @griptmedia @CarrollJennifer Irish taxpayers are not paying for medical malpractice aka gender affirming care. It is not healthcare. The State cannot sanction harm & pretend otherwise. Your reputation is career driven no morals. Your NGO buddies are setting you up for a fall.

ᴱᵁᴳᴱᴺᴱ ɪᴘᴀᴠᴇᴄ's profile picture
ᴱᵁᴳᴱᴺᴱ ɪᴘᴀᴠᴇᴄ1 day ago

@benryanwriter Genuinely fascinating to contemplate how stupid somebody would have to be to process this as a conspiracy

DiegoTrombon's profile picture
DiegoTrombon1 day ago

@benryanwriter Iatrogenic death is a very profitable business model.

Related Videos

In WPATH's Own Videos, Doctors Describe Billing Gender-Transition Care Under Alternative Diagnoses A psychiatrist called switching to "unspecified endocrine disorder" a way to "work around" the system. A Utah OB-GYN said she billed that way for 14 years. The Trump administration calls such coding fraud. When New York City’s Mt. Sinai Health System reached a settlement with the Justice Department last week to keep its pediatric gender clinic closed, much of the public debate over why the hospital had capitulated focused on the Trump administration’s efforts to obtain patient records via subpoena. This overlooked the mounting efforts by Republican lawmakers more broadly and the Trump administration in particular to leverage accusations of fraudulent medical billing to target doctors in this field and drum them out of providing gender-transition interventions to minors. A spokesperson for Mt. Sinai said last week: “The settlement is complex, but at its core reflects Mount Sinai’s commitment to safeguarding our patients’ confidential information and protecting our clinicians.” Those last few words, protecting our clinicians, at least theoretically could refer to protecting clinicians from prosecution or civil lawsuits for the use of non-gender-identity-related diagnosis and procedure codes when seeking reimbursement for puberty blockers, cross-sex hormones or gender-transition surgeries to treat gender dysphoria in minors. Last year, I obtained several hundred videos from conferences held by the World Professional Association for Transgender Health and its US affiliate, USPATH, between 2021 and 2023. These videos were subject to a subpoena by the Alabama attorney general, Steve Marshall, as part of his defense in a lawsuit against the state’s ban on gender-transition interventions for minors. I covered how these videos portrayed the besieged field of pediatric gender medicine in a report for Compact magazine earlier this year and have been serially publishing key videos on my Substack since then. I have newly scoured these videos for conference speakers addressing the use of alternative procedure or diagnosis coding in transgender care. I found a number of examples, video clips of which I have published and analyzed below. None of them included speakers specifically referring to minors in the moments when they made such references to coding choices, mind you. But in at least some cases, the wider context of their presentations or their response to audience questions did not rule out that minors could be included in what they were suggesting or recalling about coding practices. In American medicine, physicians use diagnosis codes from the ICD system, which specify the condition being treated, and procedure codes known as CPT codes, which indicate the actions the physician took to treat the condition. These codes are integral to obtaining reimbursement for services. Insurers require diagnosis codes to serve as an appropriate justification for the corresponding procedure. The U.S. Department of Health and Human Services on Aug. 13 published a scathing report bearing the incendiary title “Wolves In White Coats: How Doctors and Hospitals Pushed and Profited from the Fraud of ‘Gender Medicine.’” Much of the report is devoted to examining how leaders in pediatric gender medicine advocate the use of alternate codes when seeking insurance reimbursement for gender-transition interventions. These practices, the report asserts, have become widespread in this field. The report serves as an ominous warning to health care providers still practicing in what remains of a field that the Trump administration has seen considerable success in destroying outright. “When healthcare providers use fraudulent medical coding to obtain payment from the federal government,” the HHS report asserts, “they may be liable under the federal False Claims Act, which carries fines and imposes damages of ‘3 times the amount of damages which the government sustains.’” To follow federal regulations, the report asserts, physicians treating patients for transgender-related purposes are meant to use a number of ICD diagnosis codes related to gender identity, sex reassignment or “dual role transvestism.” But it has become common for medical providers to use alternate diagnosis codes, according to the report—in particular those related to endocrine disorders. This includes, the report states: “Endocrine disorder, unspecified,” coded as E34.9. Using this code in place of a gender-related diagnosis (e.g., gender identity disorder, F64.0) violates CMS guidelines for the simple reason that gender dysphoria is not an endocrine disorder, since it exhibits no hormonal abnormalities. In fact, the only endocrine disorders these patients have are the ones created by their doctors through the use of sex-rejecting interventions. Yet it appears that healthcare providers are misusing this code. In a 2016 studytitled “Identifying the Transgender Population in the Medicare Program,” CMS’s Office of Minority Health acknowledged that proxy diagnosis codes are being substituted for gender dysphoria. In the methods section, the authors explain that they included the ICD-9 diagnosis code for Unspecified Endocrine Disorder in their analysis because it is “frequently used by the transgender community to combat the perceived stigma of a GID diagnosis.” The report goes on to note that a 2023 study also finds such use of alternative billing codes. The report further notes an analysis of medical-claims data by Leor Sapir, a senior fellow at the Manhattan Institute who studies pediatric gender medicine, that found an almost 30 percent increase in endocrine disorder, unspecified diagnoses in minors between 2020 and 2022. Dr. Sapir asserted in 2025 that this was likely the product of a “greater willingness” by medical providers to use endocrine disorder codes over gender identity disorder codes in pediatric care of patients with gender dysphoria. The authors of the HHS report analyzed health insurance databases covering 2015 to 2025 and found that insurers were billed nearly $50 million for puberty blockers for patients age nine to 17 under endocrine disorder codes, excluding precocious puberty. There was nearly $11 million in billing for 13- to 17-year-olds using a precocious puberty diagnosis code. The report asserts that “this data strongly suggests a pattern of potentially fraudulent billing that relies on miscoding for endocrine disorders to justify the prescription of puberty blockers.” WPATH, the report goes on to state, has promoted “the misleading use of several ICD-10 codes” in its training presentations. Teddy Goetz Dr. Teddy Goetz is a psychiatrist who currently works at the Mid-Atlantic Permanente Medical Group. Dr. Goetz, who identifies as nonbinary, was a coeditor of a controversial text put out by the American Psychiatric Association’s publishing arm in 2023 outlining how to apply the gender-affirming method to the care of what these days are known as gender-expansive patients. Dr. Goetz spoke at USPATH’s 2021 conference. The moderator, taking an audience question, asked about how to move away from a distress-based model of care for transgender patients, in which it is required that they harbor distress related to their gender identity to qualify for a diagnosis that will justify gender-transition treatment. “We can think about it in the terms of billing codes,” Dr. Goetz replied. When a patient first presents, Dr. Goetz said, a doctor could use a gender dysphoria-related billing code to process a prescription for gender-transition treatment such as testosterone. But if this treatment ultimately attenuates the patient’s dysphoria, Dr. Goetz said, “Then you could switch your billing code to ‘unspecified endocrine disorder,’ for example, saying that their body produces less testosterone than it should for them to feel their best. So there are different ways that you can work around that. And thinking about moving towards euphoria and away from dysphoria.” Addressing a common conundrum that expands well beyond transgender medicine, Dr. Goetz continued: “But our current health care system in the United States is really set up against a preventive health care model and towards more of a responding-to-active-problems model.” It remained unclear whether Dr. Goetz was referring to treating pediatric patients when describing these billing practices. What is evident, however, is that Dr. Goetz, who at the time was a medical resident at the University of Pennsylvania, was then working at least part of the time at a children’s hospital. At one point during the conference session, Dr. Goetz made a specific reference to “the children’s hospital where I do work in addition to the adult hospital.” A spokesperson for Kaiser Permanente provided me a statement indicating that “We understand” that Dr. Goetz “was speaking hypothetically” at the conference. “Dr. Goetz is an adult psychiatrist and does not provide care to, nor prescribe puberty blockers or hormone therapy to Kaiser Permanente pediatric patients,” the statement continued.

Benjamin Ryan

26,273 views • 2 days ago

The American College of Pediatricians just put out a 🔥🔥🔥 statement calling out all the major medical associations by name for pushing the gender transition craze on kids. They ask for these groups to "IMMEDIATELY stop the promotion of social affirmation, puberty blockers, cross-sex hormones and surgeries for children and adolescents who experience distress over their biological sex." The full The American College of Pediatricians statement ⬇️ "Therefore, given the recent research and the revelations of the harmful approach advocated by WPATH and its followers in the United States, we, the undersigned, call upon the medical professional organizations of the United States, including the American Academy of Pediatrics, the Endocrine Society, the Pediatric Endocrine Society, American Medical Association, the American Psychological Association, and the American Academy of Child and Adolescent Psychiatry to follow the science and their European professional colleagues and immediately stop the promotion of social affirmation, puberty blockers, cross-sex hormones and surgeries for children and adolescents who experience distress over their biological sex. Instead, these organizations should recommend comprehensive evaluations and therapies aimed at identifying and addressing underlying psychological co-morbidities and neurodiversity that often predispose to and accompany gender dysphoria. We also encourage the physicians who are members of these professional organizations to contact their leadership and urge them to adhere to the evidence-based research now available.” They link to MANY studies on their site:

Robby Starbuck

55,695,656 views • 2 years ago

I’m 100% in support of adults pursuing whatever gender they please, by whatever means they like. More power to you! However, we will look back at this time, when doctors and “professionals” pressured parents to perform surgery and give hormones to *children*, with great shame and regret. The detransition stories are just starting, and they are devastating. These stories always include the parents and children being bullied into making irreversible decisions. They make decisions they don’t fully understand but are told will solve a complex problem. However, in most cases, this “problem” is solved best with love, compassion, counseling, and time. Adolescence is challenging 100% of the time, as we all have experienced. Imagine your darkest and most confusing moment as a teenager. Now, imagine a group of authorities telling you that your gender confusion causes all your pain and that you can solve all of that pain with surgery and hormones. Now imagine the state of California acting to hide this child’s struggle from their parents — and then pursuing a gender transition covertly with the child. That is the crime that is happening right now. We don’t let kids smoke vapes or drink until they are fully informed of the ramifications of those decisions as adults — yet we put them on puberty blockers and have them do surgery to change their gender as teenagers? What is the rush? There isn’t one, so they tell the parents, “Your child will kill themselves if they don’t transition.” This is pure evil. There are no parents who agree with this, there are only bullied and confused parents… and that needs to end now. I say this with unlimited compassion and love for any child or family dealing with gender dysphoria. Please speak up parents.

@jason

5,286,938 views • 2 years ago