Nearly 14,000 Minors Underwent Sex-Change Procedures in Recent Years, According to New Watchdog Database

A medical watchdog organization released groundbreaking data on Tuesday revealing the number of total child sex-change interventions that have been administered in the U.S. in recent years, as well as the locations where the procedures are taking place.

Do No Harm, a nonprofit that combats child gender transitions and discrimination in medicine, constructed a database quantifying the extent to which American children are receiving gender-transition procedures.

From January 2019 to December 2023, 13,994 minor patients received gender-transition treatments, with 5,747 undergoing sex-change surgeries and 8,579 getting hormones and puberty blockers, according to Do No Harm’s database. A majority of the body-modification procedures were conducted on minors around the age of 15.

In order to reach precise estimates, Do No Harm’s methodology matched gender and prescription medical codes to a diagnosis code for gender dysmorphia, the often temporary medical condition where teenagers feel trapped in the wrong body. The database likely undercounts the true number of trans medical interventions because it excludes “gray area” cases and lacks data from certain health-care providers. Available alongside the database is a  white paper explaining Do No Harm’s methodology and a glossary of terms for those who may be less familiar with the details of child sex changes.

“We’ve really been meticulous in trying to make sure that the data are as clear as possible and are as accurate as possible,” Do No Harm board chairman Dr. Stanley Goldfarb told reporters on a press call. “If anything, we’re showing the lower limits of what’s going on in this whole arena,” he added.

Do No Harm’s database has an age range of zero to 17.5 years old and does not disclose any personal details about the patients in order to comply with the Health Insurance Portability and Accountability Act, a federal law that protects patients’s personal healthcare information.

Do No Harm’s figures are based on publicly available insurance claim data the organization obtained from clearinghouses, data aggregators, payers, health systems, the Centers for Medicare and Medicaid Services, and open sources. The data includes claims from commercial insurers, Medicare, Medicaid, and the Department of Veterans Affairs. Kaiser plans, internal VA claims, self-pay, and charity payments are not included in the data.

The database lines up with anecdotal accounts of teenagers being rushed into surgical operations and hormone procedures that permanently alter their bodies. A number of medical patients who later came to regret these procedures, known as “detransitioners,” have publicly spoken about their experiences being pushed to undergo gender-transition operations while they struggled with mental-health issues and sought guidance.

Children’s hospitals with the most sex-change operations are highlighted in Do No Harm’s database, especially a list “dirty dozen” facilities that have promoted and delivered the controversial procedures. The number one hospital on the list is the Children’s Hospital of Philadelphia with 122 sex-change patients, five of whom received surgical operations. The facilities Do No Harm spotlights are almost entirely concentrated in blue states where transgender procedures are entirely legal and gender-transition activists have political support from elected officials.

Over the relevant time frame, patients submitted close to $120 million in charges to insurers, Do No Harm found. The database does not have the reimbursement figures for those charges.