NC children are still being harmed

Bodies permanently mutilated. Children rendered sterile. A lifetime of complications. And none of it can be undone. That is legacy that victims of “gender affirming care” live with. Meanwhile, doctors profited.

North Carolina had the good sense to make sex-rejecting procedures illegal for minors in 2023 with the passage of HB 808. But, evidently, the passage of that law was not enough to stop the doctors who are ideologically committed and financially incentivized to harm children. We now know, some of them kept going.

On Aug. 13, the US Department of Health and Human Services issued a report entitled, “Wolves in White Coats:  How Doctors and Hospitals Pushed and Profited from the Fraud of ‘Gender Medicine’.” The report lists almost 250 providers who are suspected of insurance fraud, many in states that have banned gender transitioning for minors. Three North Carolina providers are cited: Planned Parenthood in Raleigh, Novant Health Pediatric Endocrinology in Charlotte, and the Western North Carolina Community Health Service (WNCCHS) in Asheville. 

In hindsight, we should not be surprised. Not long after HB 808 was enacted, the Campaign for Southern Equality (CSE), headquartered in Asheville, and other transgender advocates began holding training sessions for providers to show them how to miscode diagnoses to evade the law and receive public and private insurance reimbursement. In CSE’s “Trans in the South: A guide to Resources and Services,” there is a section titled, “Insurance Coding Alternatives For Trans Healthcare,” containing tables with codes commonly accepted and codes commonly rejected by insurance providers, including “endocrine disorder, unspecified.” As indicated in the report, WNCCHS used coding for an “unspecified” disorder; the clinic in Charlotte billed for puberty blockers for 13-17 year-olds but coded the diagnosis as precocious puberty, a condition where puberty blockers are given to 8-10 years olds. Planned Parenthood boldly coded the diagnosis as gender dysphoria and prescribed puberty blockers.

Of the three, the WNCCHS should raise the greatest alarm due to their activism and access to vulnerable students. Learning how to engage in illicit bill practices is not the only connection between WNCCHS and the Campaign for Southern Equality. WNCCHS has partnered with the Campaign for Southern Equality’s Trans Youth Emergency Project to “expand access to LGBTQ-friendly primary… care at Southern community health centers.”

Perhaps well-intentioned, school-based health clinics have provided the gender ideologues greater access to our children. WNCCHS is the in-house mental health provider in nine public schools in western North Carolina —one Buncombe County School and eight McDowell County Schools — where they provide confidential mental health assessments, counseling and referrals to students. 

One peer-reviewed study found that many individuals with gender dysphoria have a history of “psychological vulnerability,” with 78% receiving prior treatment therapy and 60% receiving a co-occurring mental health diagnosis. Gender-related distress can change over time, and counselors and medical providers should aim to address underlying mental-health problems and trauma rather than assuming that altering a child’s healthy, developing body is the appropriate response. Permanent, life-altering interventions that harm developing bodies should not be the answer to childhood mental and emotional distress. Children experiencing gender dysphoria deserve careful psychological assessment and compassionate support instead of irreversible medical or surgical interventions.

Adding fuel to the fire, North Carolina law prevents parents from even being notified or have access to medical records if their child, at any age, is receiving physician-provided care for the prevention, diagnosis, or treatment of, among other things, “emotional disturbance.” In sum, a child could be receiving puberty blockers and cross-sex hormones in violation of North Carolina law, and parents can’t do anything about it. Despite the NC House passing legislation to repeal this law in 2025, the bill has yet to be considered by the NC Senate. 

We thought that the passage of HB 808 was the end of the victimization of vulnerable children in North Carolina. It turns out, the passage of HB 808 is just the beginning. We must create stronger penalties, including criminal penalties, or we will continue to see gender-transitioning advocates find ways to abuse our children for the sake of politics and profit. It needs to stop.

Mary Summa is the general counsel for NC Values Coalition