By Kelly Notarfrancesco | Contributing Writer, Rocky Mountain Voice
Hundreds of children were provided puberty blockers or cross-sex hormones by Children’s Hospital Colorado’s TRUE Center for Gender Diversity annually in 2024 and 2025 — in numbers that may be more than 35 times higher than those previously reported in 2024 by medical watchdog group Do No Harm.
Do No Harm (DNH) analyzed five years of insurance data and demonstrated an average of 22 minor patients per year had received either puberty blockers or hormone therapy at Children’s from 2019-2023. DNH’s analysis led it to place Children’s on its “Dirty Dozen” list of the 12 worst-offending children’s hospitals promoting sex change treatments for minors.
The stark difference between Children’s self-reported numbers of medicalized minors and DNH’s insurance data numbers raises questions at a time when hospitals and the medical community are under increased scrutiny from the U.S. Department of Health and Human Services and the Department of Justice for potential health care fraud.
“What could explain Children’s soaring report of patient numbers, far above what insurance data showed?” questioned Dr. Travis Morrell, a Colorado physician and Senior Fellow with DNH. “All the possibilities are as shocking as the high numbers.”
Children’s Hospital testimony
Children’s is a nonprofit hospital system headquartered in Aurora and affiliated with the University of Colorado School of Medicine. Children’s has provided gender-related care to minors for years — the program dates to 2007, according to court testimony — and organized it into the multidisciplinary TRUE Center for Gender Diversity under Daniel Reirden, an adolescent medicine physician.
The center provides “trans youth” with puberty blockers and hormones, as well as other medical supports, according to a Denver Post story on Reirden from 2017.
The findings of fact in Boe v. Children’s Hospital Colorado, entered by a Denver District Court in February 2026 and later filed as an exhibit in the federal case Oregon v. Kennedy, revealed previously unconfirmed details about the number of minor patients and the type of medical interventions provided by the TRUE Center.
Both sides stipulated in the Findings of Fact:
• The TRUE Center treated 1,140 patients under 18 in 2025. Up to 806 — as many as 71 percent — received puberty blockers (257) or hormones (549); the two counts may partially overlap.
• In 2024, it treated 1,203 patients under 18. Up to 809 — as many as 67 percent — received puberty blockers (260) or hormones (549), again with possible overlap.
• The TRUE Center, part of a Medicaid program that designated tens of millions of dollars for underserved patients, cannot survive without that funding.
Source: Boe v. Children’s Hospital Colorado Findings of Fact, Conclusions of Law and Order on Class Plaintiffs’ Motion for Preliminary Injunction, February 13, 2026.
A wide gap from the insurance data
The hundreds of TRUE Center minor patients revealed in the court testimony are in sharp contrast to the previously available number of TRUE Center patients indicated by Stop the Harm’s detailed analysis of the hospital’s 2019-2023 insurance data. Stop the Harm, a project of the medical advocacy nonprofit DNH, analyzed Children’s insurance claims data and determined that the hospital treated a total of 120 total sex change patients aged 0 to 17.5 years between 2019 and 2023.
Children’s insurance data showed the hospital had prescribed 108 total unique children with either puberty blockers or hormones over the five-year period, for an average of 22 patients each year.
“Do No Harm was careful to count cases in STH so that numbers would represent the floor and not the ceiling. No one can say they exaggerated, not even by a tiny bit,” shared Morrell. “Higher numbers have been widely expected.”
Benjamin Ryan reported early this year in the New York Sun that government Congressional Budget Office data pointed to higher rates of medicalized minors than was previously understood.
“But the degree to which Children’s Hospital Colorado’s testimony points to much higher numbers at just one institution is not just very concerning — it’s astonishing,” Morrell added.
Source: Stop the Harm Database Children’s Hospital Colorado sex-change patient data for minors ages 0-17.5 according to insurance claims.
Insurance fraud a national concern
The significant discrepancy between STH’s insurance claim data from Children’s and Children’s own public testimony comes at a time when hospitals are under increased scrutiny regarding concerns of insurance fraud.
In the past two months, two large hospital systems agreed to stop providing “gender transition” procedures to minors and agreed to fund care for detransitioners recovering from the treatments the HHS described as “neither safe nor effective.”
The U.S. Department of Justice accused both Texas Children’s Hospital and Cleveland Clinic of submitting false billings to public and private payors to obtain insurance coverage for pediatric gender transition procedures on minors. Both hospitals reached settlements with the DOJ, while neither hospital admitted to liability.
Accusations of false insurance claims were furthered by the Federal Trade Commission’s June 17 lawsuit against the World Professional Association for Transgender Health (WPATH), alleging, “…that the organization made false and unsubstantiated claims regarding the necessity, effectiveness and safety of puberty blockers, hormones and sex-change surgeries,” said Chairman Andrew N. Ferguson.
WPATH promotes alternative billing codes
Physicians are required to enter a specific code to document and justify medical services provided to the insurance payor for treatment provided to each patient. WPATH training materials promote the use of alternative endocrine codes (such as E34.9) to facilitate insurance reimbursement for puberty blockers and hormones when gender dysphoria-specific codes (F64.x) face denials or restrictions.
This has been documented in both primary WPATH handouts and secondary government and watchdog reports such as the HHS Treatment for Pediatric Gender Dysphoria Review of Evidence and Best Practices report.
“What WPATH did is encourage doctors to tell insurers that kids with “gender dysphoria,” a mental disorder, actually have an “endocrine disorder” that they don’t actually have,” Morrell explained. “Why would they do this? The most concerning reason doctors might be motivated to use incorrect codes would be to get an expensive prescription covered (under an endocrine disorder the patient doesn’t truly have) that wouldn’t otherwise be covered (for a psychiatric code that the patient is actually being treated for).”
Children’s follows WPATH
“The differences in the number of children reported to have undergone pubertal suppression or underwent cross-sex hormones interventions between DNH’s reports and Children’s Hospital Colorado, could be explained by coding manipulation employed by many gender clinics,” shared Erin Friday, Esq., President of Our Duty USA.
It is unknown whether Children’s or the University of Colorado School of Medicine trained its TRUE Center doctors to use the alternative billing codes WPATH promotes.
In its November 2025 review, HHS found WPATH’s “medical necessity” framing was “constructed to remove key safeguarding criteria” and characterized it as a means of “compelling insurance coverage through the courts.”
But the ties between Children’s and the controversial WPATH are strong.
Children’s TRUE Center has followed WPATH standards from its inception. Reirden, who helped start the TRUE Center, is a member of WPATH, and the parties stipulated in the Boe v. Children’s Hospital Colorado’s Findings of Fact that “CHC and, since its founding, the TRUE Center, has followed the World Professional Association for Transgender Health’s (“WPATH”) internationally-accepted medical standards of care, including the medical standards of care regarding adolescents who experience gender dysphoria.”
Some legal experts remain concerned about WPATH’s encouragement to use alternative billing codes.
“While I have no specific proof that Children’s Hospital Colorado was doing that, I would suspect that it too was using code manipulation,” Friday speculated. “After all, gender clinics are significant profit-centers for hospitals provided insurance is paying.”
Source: One Colorado People’s Choice Ally Awards 2016 video, Facebook, Reirden’s 2020 Curriculum Vitae hosted by CU Anschutz
Source: Boe v. Children’s Hospital Colorado Findings of Fact, Conclusion of Law and Order on Class Plaintiff’s Motion for Preliminary Injunction, February 13, 2026.
TRUE Center treatments halted, future uncertain
The number of minors currently being medicalized by Children’s TRUE Center appears to be zero.
The Colorado Sun recently reported that all the Children’s endocrinologists and adolescent specialists who previously treated gender dysphoric children with puberty blockers and hormones are now refusing to provide the controversial medical interventions, citing legal concerns with the possibility of losing their medical licenses or being criminally charged.
After Children’s Hospital suspended the treatments in January 2026, the Colorado Supreme Court ruled 5-2 that the families were likely to succeed on their Colorado Anti-Discrimination Act claim and ordered the hospital to resume what it described as “medically necessary” treatments while the lawsuit continues.
Attorneys for the plaintiff families dispute the hospital’s account, arguing the halt came from its board rather than the individual doctors.
Amidst a nationwide crackdown on deception and fraud related to the treatment of minors with gender dysphoria, the future of Children’s TRUE Center remains uncertain.
“CHC was one of the first hospitals the DOJ subpoenaed,” Morrell said. “If the DOJ is allowed to review charts, then we will find out what’s really going on.”