Dr. Eithan Haim, the doctor who exposed Texas Children’s Hospital’s secret transgender procedures on minors, testified before Congress on Wednesday, warning lawmakers of a growing pattern of deceptive plan accounting in connection with female change surgeries.
National Review reports that while speaking before the House Judiciary Committee’s Subcommittee on the Constitution and Limited Government, Haim responded to a question from Representative Brandon Gill ( R., Texas ) regarding a fact sheet distributed by the Campaign for Southern Equality. The report, produced by the LGBTQ volunteer, advises health services on which plan codes to use when identifying and treating patients seeking what activists call “gender affirming treatment”.
According to Haim, the document guides medical professionals on how to circumvent insurance scrutiny by using alternative diagnosis codes.  ,” What this document does is inform doctors at these clinics how to get insurance companies, whether private or government, to cover interventions without revealing that it’s being used for gender dysphoria”, Haim said.
He explained that a physician could perform a mastectomy on a girl and” not raise any red flags” by coding the procedure as a breast reduction surgery. Likewise, hormone therapy prescriptions for females could be disguised as treatment for male testosterone deficiency.
Insurance companies “don’t know that they’re getting defrauded”, Haim told lawmakers. ” This guide is essentially a template for how to commit medical fraud. We should all remember that this is something that people go to prison for. This is a major deal. They have entire departments and hospitals for this”.
Haim’s testimony was supported by Vanessa Sivadge, a former nurse at Texas Children’s Hospital, who also spoke to lawmakers. Sivadge claimed to have uncovered evidence of Medicaid fraud while working at the Houston-based pediatric hospital.
” My job consisted of refilling medications and obtaining insurance approval for those medications. I discovered how Medicaid was being billed for transgender interventions in direct violation of Texas law”, she said. ” I also observed how TCH had misdiagnosed patients for the purpose of justifying those treatments. Additionally, the hospital had changed medical records by listing the preferred gender identity on the medical record instead of the birth sex, making fraudulent billing difficult to detect”.
Texas has enacted strict laws surrounding youth access to gender transition procedures. S. B. 14, passed by the state legislature in 2023 shortly after Haim’s whistleblower disclosures, bans minors from receiving puberty blockers, hormone therapies, or undergoing surgical transitions. The law was upheld by the Texas Supreme Court last year.
Haim said he believes this type of medical fraud is being used to conceal transgender procedures in states like Texas, where insurance providers may take a more cautious stance on these treatments due to legal and political scrutiny.
That concern is reflected in ongoing legal actions by Texas Attorney General Ken Paxton, who has sued at least three doctors accused of misrepresenting diagnoses to mask gender-transition treatments. One lawsuit involves pediatrician May Lau, who allegedly used a diagnostic code for endocrine disorders to obtain insurance approval for a “puberty blocker device” for a 15-year-old.
According to the suit, Lau “falsely represent]ed ] that she’s treating patients for an unspecified endocrine disorder, when in fact she is transitioning their biological sex or affirming their belief that their gender identity is inconsistent with their biological sex”. Lau later reached an agreement with Paxton that bars her from treating patients and limits her work to research and administrative roles.
The federal government has also weighed in. Shortly after taking office in January, President Donald Trump signed an executive order barring medical institutions from performing gender reassignment surgeries on children. Facilities found in violation could lose access to federal funding.
Haim himself faced prosecution under the Biden administration after leaking internal documents to a journalist, revealing that Texas Children’s Hospital continued performing transgender procedures on minors despite publicly claiming it had stopped. While he was charged with violating patient confidentiality under the Health Insurance Portability and Accountability Act ( HIPAA ), none of the records he released contained individualized patient information. The case was ultimately dismissed with prejudice after Trump assumed office.
If convicted, Haim could have faced up to ten years in federal prison and fines up to$ 250, 000 for four counts of HIPAA violations.
The hearing had initially been scheduled to include testimony from Department of Justice attorney Tina Ansari, who led the prosecution against Haim. Ansari was later removed from the case due to significant conflicts of interest, and Representatives Jim Jordan ( R., Ohio ) and Chip Roy ( R., Texas ) had requested her appearance before the committee on Wednesday.
The revelations presented during the hearing have raised alarm among Republican lawmakers and whistleblowers, who are calling for increased oversight of medical billing practices and stricter enforcement of state and federal laws regarding transgender procedures for minors.
