Planned Parenthood accused of fraud over sex-change care
Medical professionals warn that Pennsylvania Planned Parenthood facilities may be using misleading diagnostic codes to secure insurance coverage for cross-sex hormones, similar to practices under investigation in Texas.
According to Washington Examiner, Planned Parenthood centers in southeastern and western Pennsylvania are submitting the billing code for “endocrine disorder, unspecified” when prescribing transgender drugs to patients. Medical experts have raised serious concerns in recent months about clinics improperly applying this diagnosis to obtain Medicaid or private insurance reimbursement for transgender interventions.
The practice mirrors allegations that triggered legal action in Texas, where Republican Attorney General Ken Paxton launched investigations into sex-change doctors and healthcare institutions after whistleblowers came forward in 2023 reporting similar fraudulent billing schemes.
The southeastern Pennsylvania Planned Parenthood facility explicitly states on its website that it typically uses code E34.9, designated for “endocrine disorder, unspecified,” and occasionally employs F64.9 for “gender identity disorder, unspecified” when prescribing cross-sex hormones. The organization acknowledges discomfort with the coding language but claims the practice helps overcome barriers to what it considers medically necessary care.
The western Pennsylvania location maintains a similar policy, using either the endocrine disorder code or explicitly gender identity-related codes for billing purposes. A disclaimer on the facility’s website concedes dissatisfaction with the wording of these codes but states they are required to maintain consistency with national insurance and medical billing standards.
Taxpayer funding to these facilities has been substantial. Between July 2020 and June 2025, Planned Parenthood of Western Pennsylvania received over $4.1 million in public funds, while the southeastern Pennsylvania branch collected more than $10.7 million, according to tax filings. The controversial endocrine coding guidance has been available on the southeastern facility’s website since at least February 2023, and on the western location’s site since January 2021, archived records confirm.
Planned Parenthood did not respond to requests for comment from Washington Examiner.
Pennsylvania law currently permits sex-change procedures for minors. The E34.9 endocrine disorder billing code originates from the World Health Organization’s International Classification of Diseases system, which insurance providers commonly use to determine coverage eligibility.
Whistleblowers characterize the practice of labeling gender dysphoria as an endocrine disease to obtain insurance coverage for transgender drugs as fundamentally deceptive.
Dr. Eithan Haim, a Texas surgeon who first exposed secret child sex-change operations at Texas Children’s Hospital in 2023, told Washington Examiner that considerable effort has been devoted to identifying ICD codes that can justify gender interventions under false pretenses without triggering insurance company scrutiny. Paxton’s investigation subsequently found that Texas Children’s Hospital used false diagnosis codes to transition children, among other legally questionable actions. The hospital reached a civil settlement with the attorney general and the Department of Justice in May.
Haim explained that medical providers are effectively creating the very disorder they claim to treat. Patients develop endocrine disorders only after doctors administer hormones, he noted.
Other physicians have publicly criticized Planned Parenthood of Southeastern Pennsylvania over the endocrine disorder code in July 2025 testimony to the Federal Trade Commission and in an April report from the medical advocacy group Do No Harm.
Dr. Kurt Miceli wrote for Do No Harm that utilizing alternative codes is misleading and violates ICD-10-CM Official Guidelines for Coding and Reporting, which require providers to code to the highest level of specificity when medical record documentation supports it.
Dr. Miriam Grossman testified to the FTC that transgender-identifying patients are physically healthy individuals with no medical diagnosis whatsoever. They have psychiatric diagnoses, she stated, but the E34.9 code is being used fraudulently to obtain payment for services.
Paxton’s office noted in a December filing against one accused physician that gender activist organizations openly encourage health providers to use misleading diagnoses to secure insurance coverage. That physician surrendered her medical license in October 2025.
With information from Washington Examiner
