What We Found

Project Description

The Stop the Harm Database catalogs sex change treatments performed on minors throughout healthcare facilities in the United States. Do No Harm profiled children’s hospitals in states still allowing sex change treatments on minors, examining their advertised services to determine which medical interventions they provide. Do No Harm analyzed insurance claims data to properly assess which sex change procedures each hospital and healthcare facility administered to minors. We also reviewed claims data at children’s hospitals in states that have passed legislation with age limits on sex change treatments for minors and non-pediatric hospitals and healthcare facilities. Through this tool, Do No Harm is informing the public and shedding light on how prevalent these practices really are.

Project Goals

• Encourage positive change and protect children
• Provide a publicly available online repository of hospitals and healthcare facilities offering sex change treatments to children in the United States
• Inform the public and shed light on the prevalence of these practices
• Provide insight to healthcare providers, policymakers, and researchers to help understand trends, optimize care, and influence health policy

How we chose the “Dirty Dozen”

The “Dirty Dozen” is Do No Harm’s list of the 12 worst-offending children’s hospitals promoting sex change treatments for minors.

To select our list, we identified each pediatric hospital and pediatric facility offering sex change treatments and considered a combination of factors to determine the institution’s engagement in performing and promoting sex change treatments on minors. 

These factors included the number of child patients who underwent sex change interventions in our target period, whether the hospital had a dedicated gender clinic that advertised sex change treatments, which sex change procedures were offered, the hospital’s promotion of sex change treatments in the local community, and the hospital’s activism and public support for gender ideology. The 12 hospitals deemed to best meet these criteria comprised the “Dirty Dozen.”

When considering a pediatric hospital’s level of activism in favor of sex change treatments, we examined public positions taken by the hospital itself, as well as the public statements and behavior of the institution’s leadership and physicians. 

We considered legislative activism, such as explicit policy statements and/or testimony in favor of legislation, in addition to community activism, such as promoting sex change treatments among local schools and youth groups.

When examining the hospital’s insurance claims data, we considered the sheer number of child sex change claims for which the institution billed, the severity of the procedures involved (with surgeries being considered more severe), the number of prescriptions written for cross-sex hormones and puberty blockers, and the cumulative dollar amount of the claims.

No one factor was considered determinative of a hospital’s inclusion on the list. We weighed the factors against one another and determined which institutions, based on these factors, were the worst-offending pediatric hospitals for sex change treatments in minors.