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

If you take a child who has gender dysphoria and you get them to agree to sex-rejecting procedures, you've created a patient for life. 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. Admiral Brian Christine serves as the Assistant Secretary for Health at the U.S. Department of Health and Human Services, HHS. From 2019 up to 2023, $120 million spent on sex-rejecting procedures in this country. Over 5,500 surgeries, sex-rejecting surgeries on minors. Today he joins me to break down a landmark new HHS report on gender medicine, the perverse incentives involved, and how they uncovered potentially millions in fraudulent billing. 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. Little boys or little boys, little girls or little girls, that cannot change. This is American Thought Leaders, and I'm Jan Jekielek. Admiral Brian Christine, such a pleasure to have you on American Thought Leaders. Yep, 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. Well, so let's talk about wolves in white coats. Who are the wolves? Yeah, so our report, which 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. It 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 fraud and abuse, 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. 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. That part of the report is illuminating, but Jan, it's heartbreaking as well. Absolutely. So who are the wolves? These are the individuals, collectively individuals or even institutions, who really took these children and opposed to, 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. Because we 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. 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 bit about what exactly that is? Where is this potential criminality? Well, 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. Because if you place a child on, let's say, puberty blockers, well then they have to come back for an 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. If you have a young boy who is on estrogens, female hormones, that's over $700 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 in the $12,000, $13,000, $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, and that's where we see that the Vice President did refer, make a referral to the Department of Justice, to our new wonderful Attorney General Todd Blanche, to the Department of Justice, and Secretary Kennedy made a referral to our own Inspector General at the Department of Health and Human Services to look into this potentially fraudulent coding and billing. People don't understand, some folks do, but some folks don't, but 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 potentially fraudulent because it allowed for reimbursement that otherwise these clinics and these individuals couldn't have gotten. And well, so exactly, this is the question, why? But there's also this aspect of, you know, when you're looking at the use of these billing codes, you might actually miss that there's these sex-rejecting procedures actually being done. 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. And precocious puberty is a condition where, as the name suggests, puberty occurs early. It's an early onset, an abnormally, 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 highlight that in the report. Again, potentially fraudulent billing by using these inappropriate codes. So something interesting about these billing codes, they're so important. 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, is that there were not billing codes for people who are 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-rejecting procedures. Now the CDC is introducing these things. 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. Two, in her particular case, as an example of why that's a problem. Well, you point out Clementine and such a really precious young lady, like all these kids, really sweet individuals. But Clementine, who I, if you've seen the video documentary that goes along with our report, I interviewed Clementine extensively. And she points out something that we saw as a common theme with these children and their parents, is that 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-rejecting surgeries or the castrating chemicals would be. And so Clementine mentions that specifically. We also heard again and again from these children and their families, is that when they had decided, and you've 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, 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 we need to concentrate. We need to develop good practice protocols. We do need the proper coding. And so there's still more work to be done to help these children heal. And we certainly, in this administration, we support them, we love them, and we want to help them heal. 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Clearly, 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 using, 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, what is the right thing to do is truly take these children who are having this issue, potentially 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 interviewed these children and we interviewed their families is so many of them say, well, they were quick to say, what you need are sex-rejecting procedures. You must have gender dysphoria, as opposed to give good counseling to really dive into what was going on with these children, the pain they were suffering, the emotional pain and the 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. So again, the harm done to these children in a variety of ways is legion. I think before you mentioned 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. But I took that Hippocratic Oath when I graduated medical school, when I graduated Emory Medical School way back when. I took that Hippocratic Oath. All my classmates and I, we 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 do not to harm them, but to be honest to 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. 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, you know, say that they're having gender dysphoria or become identified. I actually, I should also ask you what term you would use if it's not our 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's kind of becomes the thing to do, if you will. Yeah, 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. And 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. 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, right? They hear the term and we know, listen, we know that there's 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, and it leads them down that dark pathway. 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's 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. Right, right. And we see that again, 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 are someone around them, a gender ideology, ideologue, who then begins to, quote, 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 seen this happen in school systems. We've certainly seen this happen in other areas. So again, things 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, 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. 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, but you can do sex-rejecting procedures and try to push these kids in an ideological direction. What you can do, though, is you can actually prevent them from having puberty, which is permanent. There's no going back from that. No, exactly. Again, 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. Certainly, if you do the surgeries, these surgeries can have major complications, and they can have complications for the rest of their lives. 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 rejecting procedures that simply don't go away. If I recall, Clementine Breen had her double mastectomy at 14. That's right. I believe that's correct. Maybe to get your commentary as a surgeon, right? Clementine, a physiologically healthy young girl, 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, right? 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. It's tragic. I remember some years back, it was almost like a mantra that none of these sex rejecting surgeries are being done to people that are not adults, that are still children, that are still minors. But it turns out that's not the case. Of course, you do talk about this Can you give me a picture of how common that is? Just in terms of people that are minors being subjected to these kinds of surgeries, some of these procedures that we were told were not being done for minors. Well, that's of course how the left and the left ideologues can certainly start out. Well, 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. 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, this $120 million spent on sex rejecting procedures, that includes over 5,500 surgeries. So just to give you an idea of the number, over 5,500 surgeries, sex rejecting surgeries on minors. It's almost unbelievable, but unfortunately, it's true. Recently at an action at the FTC, this group called WPATH basically set up, essentially what 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 while their approach to gender medicine and so forth has been criticized heavily this way. 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? Well, you're right. We talk about in the report, another section 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. Yes, they like to consider themselves as having the standards of care, but we saw that truly driven by ideology from within WPATH to push these children towards sex rejecting procedures, but they weren't the only society. We mentioned the endocrine society in our report. We mentioned the American Psychological Association and the Academy of Pediatrics. We talk about those in the report. These societies that really had ideologues who pushed sex rejecting procedures as the only treatment for minors with gender dysphoria, and they use the power of their position to really push that idea and to sell that idea to those around them. And I'm sure, I feel certain that there are many in these societies, members who didn't agree with this, but unfortunately the word from the top was, yes, this is how you treat these children. Not even really looking at these societies, not even really acknowledging the fact that the evidence doesn't support sex rejecting 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 rejecting procedures on these children. And so societies like WPATH and the others really rejecting the fact that evidence doesn't support using these procedures, pushing this ideology forward. 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. WPATH is one thing, but the Endocrine Society, wow. You know very well, in your role, how powerful a voice they have. So what is the impact? And frankly, also our government, basically taking some of those same positions. I'm struggling with the ramifications of that type of, let's say, affirmation of these methodologies. No, you're exactly right. And 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 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. The Office of Civil Rights 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-rejecting procedures or institutions didn't offer the sex-rejecting procedures, then basically you could be said to be performing or be carrying out discrimination, gender, looking at this Section 1557 being reinterpreted to include gender discrimination. It made no sense whatsoever. The heavy hand of government involved. We saw that my predecessor, Rachel Levine, he 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-rejecting procedures and to not offer these sex-rejecting 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 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-rejecting procedures. We're taking care of them, standing for them, and recommending treatment that's appropriate. 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. Yeah. So 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 commission from the President, in which case you're commissioned as the Senior Flag Officer, the Senior Admiral for the Commission Corps of the United States Public Health Service. That's the uniform 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 Commission Corps of the Public Health Service. It was really important to me to serve in uniform and to support the Public Health Service. I mean, in our Commission Corps, in the uniform 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, we even have veterinarians, believe it or not. We have dentists, we have individuals who serve in uniform as part of the uniform 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, Commission Corps officers who are at the FDA serving as scientists and pharmacists. We have Commission Corps officers who serve at NIH. We have Commission Corps officers who serve with the Department of Homeland Security. We have Commission Corps officers now who are at Guantanamo Bay working with the Department of Homeland Security. We have Commission Corps officers that are staffing our Ebola response unit that we have, facility we have in Kenya. It's a quarantine facility for American citizens there. So we have Commission Corps officers that are throughout the world and throughout this country, and I'm incredibly proud of them. And just to quickly summarize, so what exactly is the role collectively of this institution? Yeah, well, it depends. 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 Commission Corps officers, for instance, working with 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 Commission Corps officers, like I said, that serve with Department of War at the Pentagon, helping carry out the functions of the Department of War. So our officers, they 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 Commission Corps officers rendering health care for the Indian Health Service and working at different clinics throughout the United States. So basically, do people request getting one of you guys in their institution, or is it you're just supposed to have that many? How does that work? No, they certainly do. Listen, they're in high demand, our officers, 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, motivated to serve the republic. They're in demand. Wonderful. Let's talk a little bit about yourself and your background. How is it that you came to be chosen for this role? Yeah, that's a great question. So I am, as I said, a urologist. I went to medical school at Emory University in Atlanta, and I graduated medical school. And 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, does a lot with NASA and DOW. And then you've got the University of Alabama in Birmingham, where you have the medical school and the dental school and the allied health and healthcare research. That's where I did my residency in urology as a urologic surgeon. I did my residency. I joined a group in Birmingham, a large urology group. I guess now there's about 32 doctors. Well, maybe 31 since I left the group last year, but it's a practiced urology, specifically focusing on men's health. My practice was exclusively men's health, taking care of men, prostate cancer survivors, hormonal health in men. So men's health was what I did in the group. And 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, hey, let me take a look at your CV. I sent it to him, and he said, there's some real interest here, and put an application with the transition team and went through interviews. And before I knew it, I was being interviewed by Mr., at that point, Mr. Kennedy and his team, and then several other interviews. And then the last interview was at the West Wing of the White House with the presidential personnel office, not the president, but thereafter got the nomination, and then was Senate confirmed, and here I am. 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. Can you speak to that? No, I think so. You know, when you're taking... Maybe just tell me what is bottom surgery, for starters. Well, bottom surgery could be for a male, would be castrating, removing the testicles, removing the penis. I know, I know. When you hear this, it's astounding. There's reconstructive aspects of bottom surgery where if you have a woman who identifies as a man, and they're undergoing one of these sex-rejecting 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. So the bottom surgery... I saw it often comes off the arm, 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, very, very expensive surgeries to have done. And they can have complications for sure, complications. It strikes me. 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. Yeah, 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. How easy is it if you've undergone one of those surgeries to come back from this? Or how do you come back? Yeah. So 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, it's 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. It 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-rejecting surgeries, the body's never the same. 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, what do you say to someone like that? Why? I don't know. Again, I think that's one of the important things about this report, is that we put down on paper so people can see and they can read and they can see the documentary. We put down what can be so hard to simply talk about. With these criminal referrals, you're seeking to see some accountability, presumably, but also a shift in the culture of how we approach these conditions, or even talking about ROGD, making these conditions more common that exist at scale, which they never did in the past. Yeah, I think we certainly want to have individuals who did wrong, who coded fraudulently or did wrong, we want to have them held accountable. 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 who 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. 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 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. We want mothers and fathers and the kids to know, listen, if you have things 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. What has been the response of these medical associations that, you know, basically promoted this approach to medicine? Yeah, I think you're seeing a real change. I mean, the fact that you have something like Texas Children's 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 those who did that. That's already happened a few times. I think you'll see more of that. I think you're going to see things 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. You mentioned financial incentives, right, in some hospitals because you get this patient for life type situation. 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? I will tell you, I've obviously, as you can imagine, have known a lot of doctors in my life. A lot of nurses. And you've worked in a large practice, too, right? Worked in a large practice, for sure. I will tell you, 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 did. This is such a cold view of people. Some of these people, do they really believe they're helping? This is the part I'm trying to get at. What are you seeing in that? Well, I think perhaps 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. 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? Well, I think with the referrals, for instance, to the Department of Justice and for our Inspector General, I think depending upon what happens with those, as we get ramifications from that, that's going to help people to understand because it'll obviously be newsed and be talked about. Again, I think 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's a number in the report. Luke is one. But I think that's one of 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, is hearing from these detransitioners. So Chloe Cole, someone that's been on the show a number of times, was, I think, one of the earlier ones. At a very young age, she's able to communicate about a lot of these learning experiences in a very articulate way. I can't help but think of her right now. I mentioned these associations. You mentioned the Texas Children's Hospital, but are you getting any sense of a rumbling of doctors that are part of these international society or national societies or international societies, medical societies? Are they saying, hey guys, what have we done here? What are we doing? Well, we saw earlier in the year, the Society for the 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. Is it really right to be doing these things on minors? And listen, I think people are coming around, but again, we got to keep working. How does this become something that's longer term? Because there's been a number of executive orders now related to this issue. They were pretty significant. It moved a lot of things, but that can be basically stopped with the stroke of a pen in the future. No, it can be. And we saw last week, before our report was released, we saw that through Dr. Oz and the Centers for Medicaid and Medicare, the fact that CHIP funds and Medicaid funds would no longer go toward the sex-rejecting procedures in minors. So that was another arm of HHS, another arm of the government that's now doing the right thing. And so I think these are going to continue. Again, I think every time something like this happens, meaning our report is released, or Dr. Oz announces what he announced, that gains attention. People take notice. People throughout the United States take notice because people like yourself talk about it and 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 Blanch, from Vice President Vance, from Secretary Kennedy, myself, Dr. Oz, others. We lead from the front. We ride to the sound of the guns. 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 you win one battle. You have to continue to fight and move forward. And what are you hearing about legislation, both at the state level and the federal level? Well, I come from Alabama, which 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 and there's articles written from the left about me saying incredibly unpleasant things because I supported this. But, you know, 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 right offhand any federal legislation. There may be. I'm just not aware of that personally. But I do know there's active efforts in states to continue to push this forward in states like Alabama and Texas. You know, we led the way in these things. Admiral Christine, thank you so much for joining me here today. Perhaps a final thought as we finish up? 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 on 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 we're offering love and support to your children and to you. Well, Admiral Brian Christine, it's such a pleasure to have had you on. Thank you so much. I really appreciate being here, Jan. Thank you. Thank you for talking about this. Thanking you for letting me be on. God bless you and God bless our country. Thank you all for joining Admiral Brian Christine, the Assistant Secretary for Health, and me on this episode of American Thought Leaders. I'm your host, Jan Jekielek.