HHS Uncovers Millions in Potentially Fraudulent Billing for Pediatric Gender Care | Asst. Sec. Brian Christine

[RUSH TRANSCRIPT BELOW]In this episode, Adm. Brian Christine, assistant secretary for health at the U.S. Department of Health and Human Services (HHS), joins me to break down a major new HHS report on gender medicine, the unspoken consequences of transgender procedures, the incentives involved, and how investigators uncovered potentially millions of dollars in fraudulent billing.

Christine reveals how certain diagnostic codes were used to circumvent both the difficulties of insurance reimbursement and laws in certain states that prohibited transgender procedures. Investigators found that coding for unspecified endocrine disorders accounted for more than $40 million in potentially fraudulent billing for puberty blockers. And a diagnosis of “precocious puberty” was used for over $11 million in billing for patients aged 13 to 17.

Financial incentives combined with the ideological capture of medical institutions create a dangerous mix, Christine warns. But this report, he said, is tremendously hopeful in spotlighting the bad science and bad actors that made the alleged abuses possible.

Views expressed in this video are opinions of the host and the guest, and do not necessarily reflect the views of The Epoch Times.

RUSH TRANSCRIPT

Jan Jekielek:

Admiral Brian Christine, such a pleasure to have you on American Thought Leaders.

Admiral Brian Christine:

Jan, thank you for allowing me to be here today. I really appreciate the work you do here. I appreciate you having me on. It is such an honor to serve as President Trump’s Assistant Secretary for Health. It’s so important that we talk about the things we are going to talk about today.

So thank you.

Mr. Jekielek:

Well, so let’s talk about wolves in white coats. Who are the wolves?

Admiral Christine:

Our report really looks at a few things. It looks at the phenomenon of gender dysphoria in minors, which unfortunately we’ve seen a dramatic increase in the last 10 to 15 years. Understand that gender dysphoria is a real condition. It is a mental health condition. It’s a rare condition. Classically, it has been present in adult males. 

But what we have seen, particularly in the last 10 to 15 years, is there has been a tremendous increase in the numbers of minors who identify as having gender dysphoria, and an increase in the number, particularly in these minors, who are getting sex-rejecting procedures to treat that. And when we say sex-rejecting procedures, what we mean is either castrating chemicals, cross-sex hormones, or even surgeries to change the external appearance of the body. These mutilating surgeries that don’t do anything to change gender, but radically change the appearance of the body and can certainly have complications along the way. And especially we’re seeing an increase in the numbers of our young minor females. Again, classically this has been in adult males. 

Now, we’re seeing a huge increase in our minor females with this phenomenon. Certainly epidemiology doesn’t explain it. We say it’s a social contagion, and it truly is. So our report speaks about this, and then our report goes into different sections talking about the potential fraudulent billing, which I know we’ll talk about, talks about the gender ideology pushed on the American people and these unfortunate children by the Biden administration, the last administration, and by my predecessor, Rachel Levine. He really pushed gender ideology on the country and even suggested removing age limitations on performing mutilating surgeries or castrating chemicals. 

In the report, we talk about the potential fraud and abuse. We talk about some of the medical societies, such as the Endocrine Society and others that we’ll talk about, who really had ideologues at their control that pushed this ideology on the American people and these children. And finally, in the report, we speak directly to these wonderful young children, these minors who were led down this false pathway of sex-rejecting procedures, and we speak to their parents and their families. And that part of the report is illuminating, but, Jan, it’s heartbreaking as well.

Mr. Jekielek:

Absolutely. So who are the wolves?

Admiral Christine:

So these are the individuals, collectively individuals, or even institutions, who really took these children and, as opposed to giving them compassionate, competent mental health care that doesn’t simply affirm their disease but really works to talk to these children about the pain and the suffering they had and counsel them and guide them and give them mental health care to help them get through their condition. Know that if you simply give compassionate, competent mental health care that helps them work through their issues, counseling, not affirming their disease process, not affirming their mental health condition, but truly working through it, the vast, vast majority of these minors come out the other side happy in their skin. You don’t have to subject them to these sex-rejecting procedures. 

And so the wolves would be the over 225 clinics for gender care. In minors that were established throughout the country, it would be the practitioners, the nurses, and the doctors who really didn’t do the best thing for these children. Again, led them down this pathway of sex-rejecting procedures. That’s who we refer to as the wolves in the white coats.

Mr. Jekielek:

Well, and so I understand the vice president has referred a number of these clinics, a number of these individuals for potential criminal prosecution. Can you just expand a little about what exactly that is? Where is this potential criminality?

Admiral Christine:

What we point out in the report is that there was a tremendous financial incentive for these clinics and these practitioners to produce what we call captive patients. In other words, if you take a child who has gender dysphoria and you get them to agree to sex-rejecting procedures, the cross-sex hormones or the puberty blockers or certainly the surgeries, then what you’ve done, you’ve created a patient for life, is what we like to say. Let’s say puberty blockers. Well, then they have to come back for appointment after appointment after appointment, getting their prescriptions filled, getting laboratory testing done. So you have a patient who continues to come back, and that billing can be big money. 

In the report, we talk about from 2019 up to 2023, $120 million spent on sex-rejecting procedures in this country. Every year for that individual. If you have a young girl and you put her on androgens or testosterone, male hormones, that’s over $500 per year. If you put them on puberty blockers, that’s up to $12,000 to $14,000 per year. So there can be a tremendous financial incentive for these practitioners and these clinics to have these patients who come back again and again and again and bill again and again and again. So there’s that financial incentive.

There’s also potential fraudulent coding, where we see that the Vice President did make a referral to the Department of Justice, to our new wonderful Attorney General, Todd Blanche, and Secretary Kennedy made a referral to our own Inspector General at the Department of Health and Human Services [HHS] to look into this potentially fraudulent coding and billing. People don’t understand—some folks do, but some folks don’t—that in healthcare, you have to code patients. 

In other words, you assign a numeric code to a patient to describe what the condition is.And there’s also a code you assign that will describe what you did to the patient in terms of treating him or her, and that’s where the billing comes from. And what we see in this report is that again and again, codes were assigned for billing purposes that did not accurately describe what was going on with these children. Coding that did not accurately describe what was being done. That coding is potentially fraudulent because it allowed for reimbursement that these clinics and these individuals couldn’t have gotten otherwise.

Mr. Jekielek:

Well, and so, in fact, this is the question, why? But there’s also this aspect: when you’re looking at the use of these billing codes, you might actually miss that these sex-rejecting procedures are actually being done.

Admiral Christine:

That’s right. That’s right. You could. And that’s why some of these codes that were applied didn’t accurately describe what was going on with these children. In one part of the report, we talk about $11 million in inappropriate coding. A code that was used for these children was something called precocious puberty, a condition where, as the name suggests, puberty occurs early. It’s an early onset, an abnormal early onset. For girls, this, in general, would be under the age of eight; for boys, under the age of nine. And that is a condition that can occur, and you can treat it by using puberty blockers. That’s appropriate. 

But what we found in this report is that there was $11 million billed for precocious puberty in kids who were 13 to 17 years old. That’s not precocious puberty. That’s just puberty. In other words, that billing didn’t accurately describe what was going on with the kids but was used to gain reimbursement. We saw this throughout the country, and we saw this at these clinics and by these individuals, and we highlighted that in the report, again, potentially fraudulent billing by using these inappropriate codes.

Mr. Jekielek:

So, something interesting about these billing codes: they’re so important. You know, I just saw something from Do No Harm, which is one of the organizations working on this quite a bit that I’ve worked with in the past, had a number of people on this show about this. There were no billing codes for people who were detransitioning that would accurately describe. You have a number of examples in here. Of course, for example, you have Clementine Breen. 

In her case, there was no real billing code that would, or set of billing codes that could, accurately help her deal with the realities that she was facing after she was subjected to these sex-rejection procedures. And now the CDC [Centers for Disease Control and Prevention] is introducing these things. So could you talk a little bit more about that? Just two things: one, how important the existence of billing codes is for people to be able to get treatment in the way our system works. And two, in her particular case as an example of why that’s a problem.

Admiral Christine:

You point out Clementine, and she’s such a really precious young lady, like all these kids, really sweet individuals. But Clementine, whom I interviewed extensively, if you’ve seen the video documentary that goes along with our report, she points out something that we saw as a common theme with these children and their parents: they were not given really adequate informed consent about what was going to happen. In other words, they say again and again, well, nobody at these clinics, none of the practitioners, really told us what the potential ramifications of the sex-rejection surgeries or the castrating chemicals would be. Clementine mentions that specifically.

We also heard again and again from these children and their families say that when they had decided, and you alluded to this, when they had decided, no, I made a mistake, I’ve been led down this path, but this isn’t right, I want to stop my treatment, and I want to try to detransition and go back, they were virtually abandoned by the same wolves in white coats who led them down this pathway. They were abandoned, which again is heartbreaking to hear. 

But you’re right. I mean, these individuals now, who we call detransitioners, who were taken down this pathway and now are detransitioning, that’s certainly an area in the future where we need to concentrate and develop good practice protocols, and we need the proper coding, and so there’s still more work to be done to help these children heal. And in this administration we support them, we love them, and we want to help them heal.  

Mr. Jekielek:

You know, before I forget, just recently as we’re filming, I think, I don’t know if it’s National ROGD [Rapid Onset Gender Dysphoria] Day, but it’s an opportunity to kind of explain that this exists. You mentioned it earlier, so I want to kind of flesh that out a little bit about what this rapid onset gender dysphoria is and how it has contributed to so many young girls being subject to gender medicine.

Admiral Christine:

Yes, we’ve seen so many, as I said, we’ve seen the rise in youth who identify as having gender dysphoria, particularly amongst young girls. And oftentimes, these young girls can have other things going on. They can do self-harm or self-cutting.This is a mental health condition that’s going on, and there’s so much more than simply saying, oh, this is gender dysphoria. That can be a legitimate diagnosis, but there can be other things that are going on. Instead of saying this is rapid-onset gender dysphoria, which to me is a term that makes no sense, I don’t think it’s legitimate at all to say that the child was fine and all of a sudden, wham, all of a sudden had gender dysphoria. It doesn’t make any sense. I think it’s a terrible term. I don’t think it’s legitimate. I don’t think it’s accurate.

Instead, the right thing to do is to really take these children who are potentially having this issue with gender dysphoria or these other conditions and give them, again, good mental health care. And again, something we see in the part of the report where we interview these children and we interview their families is so many of them say, well, you know, they were quick to say, what you need are sex-rejecting procedures, you must have gender dysphoria, as opposed to giving good counseling to really dive into what was going on with these children, the pain they were suffering emotional pain and suffering, and to try to figure out what was really going on, and to try to help them through this with good counseling, not simply affirming what they called rapid-onset gender dysphoria. 

Again, the harm done to these children in a variety of ways is legion. I think before you mentioned the Hippocratic Oath. I’m a urologic surgeon, a urologist. I practiced for over three decades before getting the honor of being nominated by the president for the assistant secretary for health position.

When I graduated medical school, when I graduated Emory Medical School way back when, I took that Hippocratic Oath. All my classmates and I took that oath. I took that oath to say, I am not going to harm my patients intentionally. I’m going to tell them the good, the bad, and the ugly of treatments. We’re going to have informed consent. I’m going to do everything I can not to harm them, but to be honest with them and give them the best care. And I think so many times the Hippocratic Oath was not followed by these wolves in white coats.

Mr. Jekielek:

I just want to comment a little more about this rapid onset part, right? I mean, basically, what we’ve seen is these clusters of girls that suddenly say that they’re having gender dysphoria or become identified. I should also ask you what term you would use if it’s not rapid-onset gender dysphoria. But basically, clusters of girls become interested in this issue or suddenly sort of find that there’s a kind of a social pressure element. It kind of becomes the thing to do, right?

Admiral Christine:

Yes, and we see this in the report as well. There are a number of individuals in the report who said that they first learned the term, believe this or not, they first learned the term gender dysphoria when they were playing some of these online video games and chats going on amongst the individuals playing the game. I haven’t played any of these games, but I guess you can have actual chatting that goes on between the participants or between the individuals playing. But that’s the first time they ever heard the term. In other words, they heard that term just socially. That’s why we say that this can certainly be described as a social contagion amongst these young girls. 

Listen, we know that there are tremendous emotional and psychological and physical changes that are occurring at that time in our lives. It can be a tremendously tough time to navigate. We can all remember that. And what we see then is this concept of gender dysphoria almost being force-fed, if you will, to some of these young girls and young boys as well. And they say, oh, well, this must be what it is. And then you have those who affirm this. It leads them down that dark pathway.

Mr. Jekielek:

And here’s another thing that is really kind of paradoxical, at least to me, especially in the context of this do no harm idea that you just mentioned. There are many cases where children were basically moved into a kind of a diagnosis of gender dysphoria without the parents even being aware, or were affirmed in pronouns, or essentially like core things related to their basic identity that puts them on this road, if you will.

Admiral Christine:

Right, and we see that talked about in the report. But we’ve seen it certainly in other instances throughout the country where you’ll have a confused minor, someone who’s really confused and struggling with things in their life. And then there is someone around them, a gender ideology ideologue, who then begins to “socially transition” them. In other words, maybe perhaps using a name from the opposite gender or having them dress a certain way without even telling the parents. We’ve certainly seen this happen in other areas. These things are going on without the parents knowing, which is really a problem. 

But again, this all contributes to this social contagion and these children being led by ideologues down the pathway of sex-rejecting procedures, as opposed to what they really needed. Again, it was mental health support to help them work through these issues so that they could understand that they are a little boy or are a little girl. Because little boys are little boys, and little girls are little girls, that cannot change. 

You can do any kind of surgery you want. You can remove body parts. You can do plastic procedures, which is what these procedures are, simply to change appearance. That doesn’t change your gender. You’re still a boy; you’re still a girl. You can take a little girl and give them all the testosterone you want. She is still a girl. You can take a little boy and give him estrogen or stop testosterone production. He’s still a boy. You can’t change the gender/sex, rejecting procedures and trying to push these kids in an ideological direction.

Mr. Jekielek:

What you can do, though, is you can actually prevent them from having puberty, which is permanent. There’s no going back from that.

Admiral Christine:

Exactly. When we talk about captive patients, I referred to patients that before, when you put children on either these cross-sex hormones or perhaps puberty blockers, again, you can cause complications. You can compromise their fertility for the rest of their life. You can compromise their sexual function, their ability to have intimacy later in life, which is a tremendous problem. You can compromise their bone health because you’re giving those hormones.That’s a problem. 

And certainly, if you do the surgeries, these surgeries can have major complications, and they can have complications for the rest of their lives. And we see this again in the report, speaking to people like Clementine and such about pain that they always have, or dryness, or just problems they have resulting from these sex-rejecting procedures that simply don’t go away.

Mr. Jekielek:

And if I recall, Clementine Breen had her double mastectomy at 14.

Admiral Christine:

That’s right. I believe that’s correct.

Mr. Jekielek:

And I mean, that’s, I mean, maybe to get your commentary as a surgeon, right?

Admiral Christine:

So, Clementine, a physiologically healthy young girl, okay, that didn’t mean she didn’t have emotional issues that needed to be worked through. I’m not saying she didn’t have psychological issues that didn’t need to be worked through, but a physiologically normal young girl underwent surgery to remove normal tissue and normal organs because of the sex-rejecting procedure ideologues. That is certainly a tragic situation for that young lady. You’re right. Taking this normal, healthy tissue and removing it or altering it, in her case, removing it simply because of the ideology and to walk her down this pathway is a tragedy.

Mr. Jekielek:

You know, I remember some years back there was almost like a mantra that none of these sex-rejecting surgeries are being done to people under, you know, that are not adults, that are still children, that are still minors. But it turns out that’s not the case. And you, of course, you do talk about this in the report. Can you give me a picture of how common that is?

Admiral Christine:

In terms of?

Mr. Jekielek:

Just in terms of minors being subjected to these kinds of surgeries, some of these procedures, we were told, were not being done for minors.

Admiral Christine:

That’s, of course, how the Left and Left-wing ideologues can certainly start out saying, we’re going to have whatever the procedure is. We’re going to have it just for this small segment, never for this. And then the slippery slope occurs. And before you know it, you’ve got 14-year-olds having their breasts removed. I pointed out that in the report, we talk about from 2019 to 2023, $120 million was spent on sex-reassignment procedures. That includes over 5,500 surgeries. So just to give you an idea of the number, that is over 5,500 sex-reassignment surgeries on minors. It’s almost unbelievable, but unfortunately, it’s true.

Mr. Jekielek:

Recently, at an action at the FTC [Federal Trade Commission], this group called WPATH [World Professional Association for Transgender Health] basically set up what would have been considered standards of care. In this discussion, in this FTC action, they basically seem to have admitted that their position on gender medicine, on all these procedures, is just an opinion and not something that’s substantiated in the literature. This is how their approach to gender medicine and so forth has been heavily criticized.

Admiral Christine:

Yes.

Mr. Jekielek:

And so I just want to get you to answer on the implication. I’ve heard different things about the implications of this. Is this very meaningful? How does this change things?

Admiral Christine:

You’re right. And we talk about in the report another section that talked about these societies that really were ideologically driven, not doing what was best for these young patients, but were ideologically driven. WPATH being one of them, the World Professional Association for Transgender Health. And yes, they like to consider themselves as having the standards of care, but we saw that it was truly driven by ideology from within WPATH to push these children towards sex-reassignment procedures. But they weren’t the only society. 

We mentioned the Endocrine Society in our report. We mentioned the American Psychological Association and the American Academy of Pediatrics. We talk about those in the report. These societies really had ideologues who pushed sex-reassignment procedures as the only treatment for minors with gender dysphoria, and they used the power of their position to really push that idea and to sell that idea to those around them. I’m sure, I feel certain that there are many members in these societies who didn’t agree with this, but unfortunately, the word from the top was yes, this is how you treat these children. These societies were not even really acknowledging the fact that the evidence doesn’t support sex-reassignment procedures on these minors. 

In fact, we produced a report at the Department of Health and Human Services last year on gender dysphoria in minors. We produced that report looking at all the evidence, and then we actually had a peer review. In other words, we had independent scientists review our report and comment, and the peer reviewers said, yes, you guys got it right in this report. The evidence doesn’t support using sex-rejection procedures on these children. And so societies like WPATH and the others are really rejecting the fact that evidence doesn’t support using these procedures, pushing this ideology forward.

Mr. Jekielek:

And, you know, these are incredibly influential organizations that you just named. I mean, huge cachet. A lot of doctors will just simply hear that one of these institutions supports this, I mean, WPATH is one thing, but, you know, the Endocrine Society, wow, right? I mean, you know very well your role, how powerful a voice they have. So, what is the impact? And frankly, also, our government, right, basically taking some of those same positions. I’m struggling with the ramifications of that type of, you know, let’s say, affirmation of these methodologies.

Admiral Christine:

You’re exactly right. When you refer to the heavy hand of government being involved here, really within hours of being sworn in as president, Joe Biden signed an executive order directing all of the agencies in the government to work against fighting against gender discrimination. And actually, what happened at the Department of Health and Human Services under his guidance. Under President Biden’s direction, the Office of Civil Rights at the Department of Health and Human Services looked at Section 1557 of the Affordable Care Act. That’s the section that talks about discrimination. And there’s part of that section that talks about sex discrimination. 

Under President Biden, the Office of Civil Rights at HHS reinterpreted that to include gender discrimination, saying that, in effect, if insurers didn’t cover these sex-rejection procedures or institutions didn’t offer the sex-rejection procedures, then basically you could be said to be performing or carrying out gender discrimination, looking at this Section 1557 being reinterpreted to include gender discrimination. It made no sense whatsoever. 

The heavy hand of the government got involved. My predecessor, Rachel Levine had a document issued through the Office of Population Affairs that falls under the Assistant Secretary for Health that said, yes, you basically have to be offering these sex-rejection procedures, and to not offer these sex-rejection procedures to minors was wrong. So the heavy hand of government absolutely played a role in driving, in the last administration, driving forth gender ideology. 

And I’m happy to say, under President Trump, under this administration, under President Trump and Secretary Kennedy, we are certainly reversing that. We’re not treating these children with sex-rejection procedures. We’re taking care of them, standing for them, and recommending treatment that’s appropriate.

Mr. Jekielek:

Let’s talk about this position of the Assistant Secretary for Health for a moment. You’re wearing an Admiral’s uniform, but you’re not in the Navy. Some people might be wondering why that is.

Admiral Christine:

When one serves as the Assistant Secretary for Health, you can either serve as a civilian, or if you wish, if you desire, you can seek a commission from the President, in which case you’re commissioned as the senior flag officer, the senior admiral for the Commissioned Corps of the United States Public Health Service. That’s the uniformed branch of the United States Public Health Service. And our uniform does resemble the Navy uniform because we sprang from the Naval Services, the Public Health Service did. 

So, yes, so I am an admiral. I’m a four-star admiral with all the privileges and responsibilities therein. I do serve as the senior admiral for the Commissioned Corps of the Public Health Service. It was really important to me to serve in uniform and to support the Public Health Service. 

In our Commissioned Corps, in the uniformed branch of the Public Health Service, we have over 5,300 officers, men and women who serve. We have physicians, we have nurses, we have scientists, we have pharmacists, we have engineers, and we even have veterinarians, believe it or not. We have, and dentists, we have individuals who serve in uniform as part of the uniformed branch of the United States Public Health Service. We have Public Health Service officers that serve throughout the world. 

We have Public Health Service officers, Commissioned Corps officers, who are at the FDA [U.S. Food & Drug Administration] serving as scientists and pharmacists. We have Commissioned Corps officers who serve at NIH [National Institutes of Health]. We have Commissioned Corps officers who serve with the Department of Homeland Security. 

We have Commissioned Corps officers now who are at Guantanamo Bay working with the Department of Homeland Security. We have Commissioned Corps officers that are staffing our Ebola response unit. We have a facility in Kenya that is a quarantine facility for American citizens there. So we have Commissioned Corps officers that are throughout the world and throughout this country, and I’m incredibly proud of them.

Mr. Jekielek:

And just to quickly summarize, what exactly is the role collectively of this institution?

Admiral Christine:

It depends on where they serve. For instance, if you have pharmacists or scientists at FDA, they’re working with the FDA evaluating drugs and devices and such. When we have our Commissioned Corps officers, for instance, working with the Department of Homeland Security or Border Patrol, they’re offering medical care for individuals who may have been picked up at the border. We have Commissioned Corps officers, like I said, that serve with the Department of War at the Pentagon, helping carry out the functions at the Department of War.

So, our officers offer medical care. We have a number of officers in the Indian Health Service throughout the country, and caring for Native Americans and Alaskan Natives is a real passion for Secretary Kennedy. So, we have a large number of Commissioned Corps officers rendering healthcare for the Indian Health Service, working at different clinics throughout the United States.

Mr. Jekielek:

So, do people request getting one of you guys in their institution, or are you just supposed to have that many?

Admiral Christine:

Yes, they certainly do. Our officers are in high demand because they’re known. The men and women who serve in uniform in the Public Health Service are incredibly dedicated, highly professional, motivated to care for this country, and motivated to serve the Republic. They’re in demand.

Mr. Jekielek:

Oh, wonderful. And let’s talk a little bit about yourself and your background. How did you come to be chosen for this role?

Admiral Christine:

That’s a great question. So, I am, as I said, a urologist. I went to medical school at Emory University in Atlanta and graduated from medical school. Then I went to the University of Alabama at Birmingham, which is the medical arm of the University of Alabama system. You have the main campus in Tuscaloosa with the football team and the undergrads. You have the University of Alabama at Huntsville, which is more hard sciences and engineering, and does a lot with NASA [National Aeronautics and Space Administration] and DOW [U.S. Department of War]. You have the University of Alabama in Birmingham, where you have the medical school and the dental school and allied health and healthcare research. 

That’s where I did my residency in urology as a urologic surgeon. I did my residency, then I joined a large urology group in Birmingham. I guess now there are about 32 doctors, and it’s a large urology group. I practiced urology, specifically focusing on men’s health. My practice was exclusively men’s health, taking care of men, prostate cancer survivors, and hormonal health in men. So, men’s health was what I did in the group. 

After the election, after Donald Trump was elected, I expressed an interest in wanting to serve in the administration. I knew someone who was going to be serving at the Department of Health and Human Services, and he said, let me take a look at your CV. I sent it to him, and he said, there’s some real interest here. 

Then I put in an application with the transition team and went through interviews. Before I knew it, I was being interviewed by Mr. Kennedy and his team, and then several other interviews. Then the last interview was at the West Wing of the White House with the Presidential Personnel Office, not the president. But thereafter, I got the nomination and was then Senate confirmed, and here I am.

Mr. Jekielek:

And I think you have a unique—well, not necessarily entirely unique, but because you’re a urologist, you have an unusual grasp of what this so-called bottom surgery is and how it impacts people. Speak to that. Maybe just tell me, what is bottom surgery, for starters?

Admiral Christine:

Bottom surgery for a male would be castrating, removing the testicles, and removing the penis. I know when you hear this, it’s astounding. There are reconstructive aspects of bottom surgery where if you have a woman who identifies as a man and they’re undergoing one of these sex-reassignment surgeries, you can have a surgery where you produce what’s called a neophallus, basically a plastic surgery where you’re taking other tissue to make something like a penis.

Mr. Jekielek:

So it often comes off the arm, like the tissue?

Admiral Christine:

It can. That’s not unusual to use that, exactly, to use the tissue harvested from that particular area of the body. So these are some of the things that happen. And listen, these surgeries are extremely expensive. When we talk about getting patients for life and captive patients and the financial compensation, with the surgeries particularly, can be extreme. They can have complications for sure.

Mr. Jekielek:

Complications, it’s also just, it strikes me—I mean, as you, I know I was wincing as you were describing it, but they’re just incredibly invasive. I mean, in a way that’s difficult for most people, I think, to fathom, even.

Admiral Christine:

Yes, these aren’t minor procedures; these are major surgeries. They can be, excuse me, they can be major reconstructive surgeries. So they’re big surgeries for sure, and they can have complications.

Mr. Jekielek:

How easy is it if you’ve undergone one of those surgeries to come back from this, or is it? I mean, or how do you come back?

Admiral Christine:

I’ve never done, for instance, a gender transition surgery; I’ve never done anything like that. I don’t know the exact steps involved, but I think it’s certainly not easy. You think about that. If you’re a male and you’ve had your genitalia removed, then producing new genitalia, that’s a big deal. Things are never going to be the same. 

That’s one thing as a surgeon: you always know that when you operate on someone, you change their body. You change their tissue forever. No matter what the surgery is, you take out someone’s gallbladder, you change their body forever. Doesn’t mean it’s a bad thing, but you have to realize the body’s never the same after surgery. And certainly after one of these sex-reassignment surgeries, the body’s never the same.

Mr. Jekielek:

What do you say to a surgeon who has done a double mastectomy or bottom surgery on a minor? I don’t know if that’s been done, but I don’t even know what to say to someone like that.

Admiral Christine:

I don’t know. Again, I think that’s one of the important things about this report: we put it down on paper so people can see, read, and watch the documentary. We put down what can be so hard to simply talk about.

Mr. Jekielek:

So, with these criminal referrals, I mean, you’re seeking to see some accountability, presumably, but also kind of a shift in the culture of how we approach these conditions or even, you know, talking about ROGD, making these conditions more common that exist at scale, which they never did in the past.

Admiral Christine:

Yes, I think we certainly want to hold individuals who did wrong, who coded fraudulently or did wrong, accountable. And we talk about in the report Texas Children’s Hospital, which had a gender dysphoria clinic for minors, and they ultimately paid $10 million to the state of Texas. They were looked at by the Department of Justice and by the Attorney General Ken Paxton of Texas. They were found to have used fraudulent coding. They paid $10 million. 

There was a whistleblower whom we talk about, Vanessa Savage, in the report, and she basically told folks, told the state of Texas and the Department of Justice, they were using false codes. They were falsifying records. And so those individuals are being held accountable. 

The Cleveland Clinic, they’re going to put $2 million forth to establish a gender detransition clinic, or they’ll be taking care of some of these children who were led down a sex-rejecting procedure pathway at the Cleveland Clinic. So we are seeing these things start to happen. We certainly hope and we believe that’s going to continue to happen in the future. And by producing this report and by doing things like we’re doing today, talking about it so people can hear and can see and can learn and can understand, that’s how we change this. 

That’s how we stop this by educating, by holding those responsible who did wrong. You know, that’s very important. And by educating the American public as to what’s going on. If you’re having emotional trauma, don’t be led down the pathway of these sex-rejecting procedures. We want to get them the kind of care they need to get through this and to be happy in their skin and not be harmed.

Mr. Jekielek:

What has been the response of these medical associations that basically promoted this approach to medicine?

Admiral Christine:

I think you’re seeing a real change. You can look at something like Texas Children’s Hospital now producing this detransitioner clinic—again, I understand it was part of the settlement with the government—but still, seeing them do this is great. That doesn’t mean we can’t continue to hold people accountable. We have to do this. We always have to keep our eyes on what’s going on. 

But hopefully, you’re going to see more of this as time goes on. You know, I think as you start to see—and I think you will start to see—more malpractice suits, you know, civil suits where individuals who were led down this pathway underwent these surgeries without proper informed consent, as they’re suing those who did that. That’s already happened a few times. I think you’ll see more of that. We’ll continue to change more, but we’re never going to stop talking about these kids in this administration. 

We’re going to continue to push forward. We’re going to continue to hold those accountable who need to be held accountable. We’re going to continue to evangelize about this. We can’t take our foot off the accelerator. I’m certainly not. As the Assistant Secretary for Health, I am not going to take my foot off the accelerator because the minute we do, we know what the ideologues on the left are going to do. They’ll roar back with a vengeance. We have to keep pushing this.

Mr. Jekielek:

You mentioned financial incentives, right, in some hospitals because you get this patient for life type situation. I mean, that’s a very instrumentalized view of humanity. It’s something I’m very familiar with, having written about forced organ harvesting in China and things like this, but we’re not in communist China. This is America. Do American doctors view patients like this?

Admiral Christine:

As you can imagine, I’ve known a lot of doctors in my life and worked in a large practice. My personal belief is that the vast majority of physicians and nurses and nurse practitioners out there really care about their patients. I think we’ve seen some bad actors. Our report talks about that, Ian, the financial incentive, the fraudulent coding, the potentially fraudulent coding, the society saying what they do.

Mr. Jekielek:

It’s just such a cold view of people. Like, some of these people, do they really believe they’re helping? Like, this is the part I’m trying to get at. What are you seeing in that?

Admiral Christine:

There are some that do believe they’re helping, but I think that there are some, again, we speak about this in the report, who have other things that are motivating them.

Mr. Jekielek:

Getting the word out, you said we’re going to keep evangelizing around this point. What do you think can be done to sort of expand the awareness of what you’ve found?

Admiral Christine:

With the referrals, for instance, to the Department of Justice and to our Inspector General, depending upon what happens with those, as we get ramifications from that, that’s going to help people to understand. Obviously, it will be in the news and be talked about. One of the most important things and one of the most powerful things is hearing from these detransitioners themselves, like Clementine, who are out there talking about what their experience is, talking about what happened to them, how they were lied to, how they were misled, how they were abandoned. Clementine is one. There are a number in the report, Luke is one. 

But I think that’s some of the most powerful things, hearing from these kids themselves, and now young adults themselves. Now they’ve gotten older. But yes, hearing from them, I think, is incredibly important because then you’re hearing from the person who really suffered personally. And I think hearing from their families is incredibly important. So that’s some of the most important education that can be done out there for the American people: hearing from these detransitioners.

Mr. Jekielek:

So, Chloe Cole, someone that’s been on the show a number of times, was, I think, one of the earlier ones, and she is at a very young age able to communicate about a lot of these experiences. I mentioned these associations. You mentioned Texas Children’s Hospital, but are you getting any sense of a rumbling of doctors that are part of these international societies or national societies or international societies, medical societies? Are they saying, hey guys, what have we done here? What are we doing?

Admiral Christine:

Earlier in the year the American Society of Plastic Surgeons came out and released a statement saying, no, we shouldn’t be doing these surgeries on people under the age of 19. That was huge. That was seismic. So we are seeing some of the societies and physicians saying, no, we really have to think about this. You know, is it really right to be doing these things to minors? And listen, I think people are coming around, but again, we’ve got to keep working.

Mr. Jekielek:

How does this become something that’s longer term? Because there have been a number of executive orders now related to this issue. You know, we were pretty significant, moved a lot of things, but that can be basically stopped with a stroke of a pen in the future.

Admiral Christine:

No, it can be. And we saw last week, before our report was released, that through Dr. Oz and the Centers for Medicaid and Medicare, the CHIP  [Children’s Health Insurance Program] funds and Medicaid funds would no longer go toward these sex-rejecting procedures and minors. So that was another arm of HHS, another arm of the government that’s now doing the right thing. Again, every time something like this happens, meaning our report is released, or Dr. Oz makes an announcement, that gains attention. People take notice. People throughout the United States take notice because people like yourself talk about it, interview, and speak about it. 

So this is how we win. I think this is how we win with firm action and leadership from President Trump and people like him, from Attorney General Blanche, from Vice President Vance, from Secretary Kennedy, myself, Dr. Oz, and others, we lead from the front. We ride to the sound of the guns, right? 

When we know these things are happening, we charge in. We’re not afraid to do that. We take action. I like to use the term evangelize because I think it applies. We talk about these things. We educate. That’s how we win. And it’s not a one-day win. It’s not just that you win one battle. You have to continue to fight and move forward.

Mr. Jekielek:

And what are you hearing about legislation, both at the state level and the federal level?

Admiral Christine:

Very, very early on, we passed laws through the legislature so that you couldn’t perform these sex-rejecting procedures on kids. And I tell you, I stood with the legislature. I spoke about it. Trust me, you go back and you look in Ireland, there are articles written from the Left about me saying incredibly unpleasant things because I supported this. But we do have a number of states that have already done that. 

We need to continue to push at the local level and also the federal level. I’m not aware of any federal legislation right offhand. There may be, I’m just not aware of that personally. But I do know there are active efforts in states to continue to push this forward. And states like Alabama and Texas, you know, we led the way in these things.

Mr. Jekielek:

Admiral Christine, thank you so much for joining me here today. Perhaps a final thought as we finish up?

Admiral Christine:

Certainly. Number one, thank you, President Trump, for your leadership in this. Thank you, Secretary Kennedy, for your leadership in this. Thank you also, Vice President Vance, for becoming involved, really taking this to heart and being with us in this fight. I thank those three individuals tremendously. To the parents who have children who are suffering, I think we’re offering you hope. We’re not simply saying you need to take your child onto castrating chemicals or mutilating surgery. There’s a better way. 

There’s a better way that science supports, a better way for your child. We’re helping to illuminate that. We’re helping to eliminate the bad actors. We’re helping to change the culture about this that was pushed so stridently by President Biden and my predecessor. We’re offering hope. We’re offering science. We’re offering truth and love and support to your children and to you.

Mr. Jekielek:

Well, Admiral Brian Christine, it’s such a pleasure to have had you on.

Admiral Christine:

Thank you so much. I really appreciate being here, Jan, and thank you for talking about this. God bless you, and God bless our country.

 

This interview was partially edited for clarity and brevity.