By RMV Staff | Rocky Mountain Voice
Assistant Secretary for Health Brian Christine joins Heidi Ganahl on ‘Unleashed’ to discuss a new federal report, detransitioner stories and what the findings could mean for Colorado families
A new report from the U.S. Department of Health and Human Services is putting renewed scrutiny on medical interventions for minors experiencing gender dysphoria — and one of the nation’s top public health officials says accountability may be coming.
Admiral Brian Christine, the 18th Assistant Secretary for Health at HHS, joined Heidi Ganahl on the latest episode of Unleashed to discuss the department’s new report, Wolves in White Coats, which examines medical treatments for minors, financial incentives within gender clinics and potentially improper medical billing.
Christine, a physician who also leads the more than 5,000 members of the U.S. Public Health Service Commissioned Corps, said the report builds upon previous HHS work examining the evidence behind medical interventions for children experiencing gender dysphoria.
The issue has particular significance in Colorado, where lawmakers, parents and activists continue to battle over parental rights, insurance coverage and medical treatment for minors.
HHS turns its attention to the money
According to Christine, the report examines not only the medical consequences of puberty blockers, cross-sex hormones and surgeries, but also the financial structure surrounding the treatment of minors.
Christine said HHS identified more than $120 million spent on what the report calls “sex-rejecting procedures” between 2019 and 2023. He said the department also identified more than 5,500 surgeries and thousands of instances involving hormones or puberty blockers during the period.
“There is a financial incentive,” Christine told Ganahl.
Christine argued that once minors enter a treatment pathway, ongoing prescriptions, laboratory testing and potential surgeries can create long-term revenue for medical providers. The report also raises questions about medical coding practices allegedly used by some providers to obtain insurance reimbursement.
Those concerns are now moving beyond HHS.
Christine said the report has been referred to the Department of Justice and the HHS Office of Inspector General for further review.
HHS says evidence doesn’t support medical interventions
The new report follows an earlier HHS review of gender dysphoria in minors that Christine said examined the scientific evidence surrounding treatment.
According to Christine, that review concluded that available evidence does not support puberty blockers, cross-sex hormones and surgeries for minors experiencing gender dysphoria.
Instead, he said HHS believes children should have access to comprehensive mental health care that investigates underlying emotional, psychological or traumatic factors rather than immediately affirming a child’s stated gender identity and beginning medical intervention.
“The science doesn’t support sex-rejecting procedures on these kids,” Christine said.
The subject remains fiercely disputed within medicine and politics, with professional medical organizations having supported various forms of gender-affirming care. Christine criticized several of those organizations during the interview, arguing that ideology overtook what he described as “gold-standard science.”
The stories behind the statistics
For all the numbers contained in the report, Christine said the most powerful section may be the one focused on people who underwent treatment themselves.
The accompanying HHS documentary features detransitioners and their families describing their experiences with hormones and surgeries, as well as their attempts to reverse course.
Christine spent significant time speaking with detransitioner Clementine Breen.
He said Breen’s account of complications from hormones and surgeries — and her description of feeling abandoned after deciding to detransition — stayed with him.
“These stories are heartbreaking,” Christine said. “They’re horrific in some ways. They’re certainly shocking.”
Christine said similar themes emerged among several of the individuals interviewed for the report. Some described learning about gender dysphoria through social media, schools or adults; others said they believed medical providers failed to adequately investigate psychological issues before recommending medical treatment.
Ganahl said those firsthand accounts could prove particularly important for parents attempting to understand an issue often buried beneath political rhetoric.
What does it mean for Colorado?
The conversation quickly turned to Colorado, where the political environment surrounding gender-related policies has moved sharply in the opposite direction of the Trump administration.
Ganahl pointed specifically to Colorado legislation affecting insurance coverage of gender-related procedures and asked whether federal action could eventually affect policies enacted at the state level.
Christine stopped short of predicting specific federal action against Colorado’s laws, emphasizing that HHS’s immediate role is to bring scientific evidence and potential billing concerns into public view.
Ganahl also cited outside research claiming dozens of Colorado medical facilities billed for gender-related procedures between 2019 and 2023 and asked Christine whether HHS was pursuing specific Colorado hospitals.
Christine said he did not have information about particular Colorado institutions during the interview, although he noted that the HHS report includes hospitals for which the department says it has questions regarding coding practices.
Christine did not identify a Colorado hospital as having committed wrongdoing during the interview.
Colorado voters could have their own say
Beyond federal action, Ganahl pointed to a citizen-led ballot effort expected to put the issue directly before Colorado voters this fall.
She highlighted the work of Colorado parents and activists attempting to change state policy through the initiative process and said one of the proposed measures could restrict surgeries on minors.
For Ganahl, the HHS report arrives at a critical time because it provides parents and voters with additional material to consider before casting their ballots.
“We’ve got to educate people,” Ganahl said, arguing that voters need to understand both the medical evidence and the experiences of young people who regret treatment.
Christine encouraged parents to read the full report and watch its accompanying documentary rather than relying solely on political or social media commentary.
Resources for parents
Ganahl also asked what parents can do when a child begins questioning his or her gender, particularly in politically progressive states like Colorado.
Christine pointed families toward organizations including Do No Harm and Genspect, which oppose or question pediatric medical transition and provide information and resources to parents seeking alternative approaches.
He also cautioned that the issue isn’t confined to blue states.
Christine recalled speaking with a friend in Alabama who encountered transgender resources at her child’s school several years ago despite Alabama’s deeply conservative political environment.
For Christine, that underscores why parents everywhere should pay attention.
“We can’t have blinders on as parents or healthcare professionals or as concerned patriots, American citizens who care about our kids,” he said.
‘Always be willing to stand up for our kids’
Christine believes the political and medical debate surrounding gender dysphoria in children is far from over.
The Trump administration has made the issue a federal priority, while states including Colorado continue pursuing dramatically different policies.
That leaves parents, physicians, lawmakers and ultimately voters confronting competing visions for how children experiencing gender distress should be treated.
Christine’s advice to families is to begin by educating themselves.
“Read the report, watch the video documentary,” he said. “Share this with family, share this with friends, share it with your kids.”
And when doing so brings criticism?
“Always be willing to stand up for our kids,” Christine said.
Ganahl agreed.
Especially when it comes to children, she said, opposition can be “a badge of honor.”
WATCH/LISTEN: Catch the full conversation with Admiral Brian Christine on Unleashed with Heidi Ganahl on YouTube, Rumble and your favorite podcast platform.
READ MORE: Rocky Mountain Voice will continue following Colorado’s citizen-led ballot initiatives and the debate over medical interventions for minors ahead of the November election.