Beth Ann Rosica: CHOP’s Gender and Sexuality Clinic remains locked in secrecy

Ajay Suresh via Wikimedia Commons Ajay Suresh via Wikimedia Commons

Despite receiving state tax dollars for services related to gender transition and sex reassignment, Children’s Hospital Of Pennsylvania (CHOP) refuses to share annual reports or answer questions while at the same time, tax dollars spent at this clinic and others in the state have rocketed upwards by an astonishing 8000 percent in just nine years.

The practice of providing gender transition services to children has erupted into a national controversy over the past few years, resulting in one of the most polarizing political issues. While many other countries have stopped the use of medical interventions for children with gender dysphoria, the state and federal governments specifically continue to support and encourage the treatments.

Since 2015, Pennsylvania has spent over $23 million of taxpayers dollars on sex reassignment and transition-related services and drugs for minors, according to a response to a Right to Know request filed with the Pennsylvania Department of Human Services by Broad + Liberty.

Of these totals, CHOP has received approximately $175,000 in taxpayer funding since 2015 for gender transition-related services. And a new report published this month by Do No Harm, a nonprofit group of physicians and other medical professionals, shows that CHOP billed over $230,000 through insurance companies from 2019 to 2023 for the same services. These figures do not include out-of-pocket expenses paid by families on behalf of their children.

Of the $230,000 in charges reported by Do No Harm, CHOP provided sex-change services to 122 children, surgery to five children, hormone and puberty blocker medications to 117 children, and prescriptions for 768 children.

However, these dollar amounts pale in comparison with the billing for gender transition-related services at CHOP’s partner, Hospital of the University of Pennsylvania (HUP). According to Stop the Harm, HUP is one of the top ten institutions in the country that have billed for sex change treatments for children. Coming in at eighth in the country, HUP has billed $2,385,988 to insurance companies from 2019 to 2023 for these services. 

Conceivably, given the relationship between CHOP and HUP, it is likely that some or all of the HUP’s patients are treated by or referred from CHOP’s Gender and Sexuality Clinic. However, it is impossible to confirm this as CHOP has been less than transparent about its activities. While I did not specifically ask CHOP about its relationship with HUP in terms of pediatric sex transition services, I did pose other questions about the clinic.

Regardless of multiple requests, CHOP’s Gender and Sexuality Clinic refused to answer questions or provide copies of their annual report —  despite offering to supply the reports if requested, according to their website.

After eight requests were not returned, I finally received a brief email from a CHOP email address. Joey M McCool Ryan said, “we don’t have any experts available to speak with you.”

A listing of all requests for comment to CHOP is as follows:

April 8 — request for comment to gender clinic

April 15 — request for comment to clinic directors

April 16 — request for comment to media person

April 16 — request for annual report

June 3 — request for interview to media person

June 3 — request for comment to the gender clinic and the clinic directors

June 10 — same request for comment as on June 3

June 17 — same request for comment as on June 3

June 18 — response received from CHOP by someone named Ryan

June 18 — request for the annual report from Ryan at CHOP

July 2 — request for the annual report from the media person

The email contains the questions that were posed to the clinic, including queries about the number of patients, the types of treatments administered, and questions about their treatment guidelines. Based on the lack of transparency and responsiveness, I could not confirm exactly what services the clinic is providing. Yet the new database from Stop the Harm was able to confirm through insurance records that CHOP is performing surgeries, in addition to an array of other services, and some of these treatments are funded with taxpayer dollars.

While CHOP has only received approximately $175,000 in Medicaid funding since 2015 for gender transition-related services, Merakey, a non-profit provider of services to children with disabilities, received $432,000 for the same time period. And Geisinger, a large health care provider system, received almost $2 million in taxpayer dollars for gender transition-related services for children since 2015.

Unlike CHOP, both Merakey and Geisinger responded to requests for comments.

Kristen Frank-Dixon MD, MPH from Geisinger said that they do not perform gender transition surgeries for minors. “Primarily we provide psychology and primary care support to adolescents and families with gender diverse children. For adolescents who desire hormonal intervention and have met diagnostic criteria, we do offer puberty blockers and cross sex hormones when it is appropriate. From 2017 – 2022 (5 years), we treated 1,043 minors with Gender Dysphoria and of those, only 28 received puberty blockers.”

Trish Pisauro, the Vice President for Marketing and Communications from Merakey, responded, “while Merakey provides mental health therapy, we do not provide hormones, puberty blockers or surgery.” When asked to confirm that the agency provides therapy for children diagnosed with gender dysphoria, she said, “Like all of our competitors in our space, provide services for ALL mental health issues.” [emphasis original]

Pennsylvania history 

According to Stop the Harm, providers in the state of Pennsylvania have submitted a total of $6,032,103 in charges to insurance companies from 2019 through 2023 for services, treatments, and prescriptions related to children with gender dysphoria. Pennsylvania ranks in the top ten of states in the country for both total procedures performed (sixth highest) and total charges billed (eighth highest). This is not surprising given Pennsylvania’s stance on the issue as far back as ten years ago.

In 2015, then-Governor Tom Wolf appointed Dr. Rachel Levine, a transgender pediatrician, to the role of Physician General for the Commonwealth of Pennsylvania. Two years later, Wolf appointed Levine as the Secretary of Health where she served until 2021 when she assumed the role of U.S. Assistant Secretary of Health.

The amount of tax dollars spent on sex reassignment and transition-related services and drugs for children began to expand exponentially after Levine was appointed to key roles in the Pennsylvania Department of Health. 

Levine and Wolf were big supporters of CHOP’s Gender and Sexuality Clinic. In 2017, one of the co-founders of the CHOP clinic, Dr. Linda Hawkins, was invited by Wolf to the Governor’s residence for an event where Levine was in attendance.

In 2022, the clinic’s other co-founder, Dr. Nadia Dowshen, gave a presentation highlighting the importance of insurance coverage for puberty blockers, rationalizing that preventing a young woman from developing breasts during puberty could eliminate the need for a mastectomy later in life. Dowshen praised Levine as a “really wonderful advocate” who “has been doing amazing work to make sure young people have coverage of these medications.”

As the U.S. Assistant Secretary of Health, Levine has encouraged doctors and medical professionals to serve as “ambassadors for science,”  to “educate the public,” and “to question the assumptions that are underlying these attacks against trans people.” In 2022, she said, “medicine and science are being politically perverted around the country — this destroys human lives.”

Yet, critics say the reverse seems to be true — Levine has acted based on a political agenda that is not rooted in science.

Earlier this year, she was exposed for pressuring the World Professional Association for Transgender Health (WPATH) to rush the development and issuance of updated standards of care. Court documents, based on internal communications to and from Levine, allege that she was acting based on political goals rather than scientific evidence.

According to James Cantor, Ph.D. in his expert report filed with the court in June 2024, 

 “Assistant Secretary Levine also attempted to and did influence the substantive content of SOC-8 [Standards of Care], based on political goals rather than science. Specifically, Assistant Secretary Levine, though a staff member, pressured WPATH to remove recommended minimum ages for medical transition treatments from SOC-8.” [emphasis added]

Levine’s views on medical transition and puberty blockers for children are also in direct conflict with findings from the Cass Review, published in April 2024. Levine is not the only medical professional or organization to refute the Cass Review, which is the most comprehensive review of the evidence (or lack thereof) for the treatment of transgender children. The review found that there is not enough evidence to support these types of treatments for children and they are likely doing more harm than good. 

The review was so unequivocal in its recommendations to end these practices until further studies could be conducted that multiple European countries immediately ended the treatments.

Under the leadership of Governor Josh Shapiro, Pennsylvania continues to support gender transition-related services and medications for children, despite the findings in the Cass Review. 

On May 2, 2024, Shapiro doubled down and issued a press release about five state licensing boards changing their policies so that therapists, nurses, doctors, social workers, psychologists, and psychiatrists could be reported and face disciplinary consequences for engaging in conversion therapy. According to the release, “conversion therapy refers to any practice that seeks or purports to change an individual’s sexual orientation or gender identity.” Shapiro said of the new policies, “this decisive action makes clear that there is no place for the harmful, dangerous practice of conversion therapy here in our Commonwealth.”

Subsequently in July 2024, the Pennsylvania Psychological Association (PPA) outlawed discussion of the Cass Review on their member listserv, stating that it did not meet their organization’s standards for research and that the discussion was “disheartening, hurtful, and unprofessional.” Despite a mission to “support lifelong learning of competent and ethical psychologists” and to “foster a community of professional psychologists”, the PPA was more concerned about the Cass Review’s impact on their transgender members than the actual review of science.

The only indication that the U.S. may begin to change direction on this issue comes from the American Society of Plastic Surgeons who spoke out in July 2024. City Journal reported that the Society is the first major medical association to challenge the consensus of gender-affirming care for minors.

“The American Society of Plastic Surgeons, a major medical association representing 11,000 members and over 90 percent of the field in the U.S. and Canada, told me that it ‘has not endorsed any organization’s practice recommendations for the treatment of adolescents with gender dysphoria.’ ASPS acknowledged that there is ‘considerable uncertainty as to the long-term efficacy for the use of chest and genital surgical interventions’ and that ‘the existing evidence base is viewed as low quality/low certainty.’”

CHOP’s unwillingness to discuss the number of patients it serves and the types of treatment they receive raises questions and ethical issues. The Gender and Sexuality Clinic allegedly produces an annual report but they refused to share it when requested. Yet, CHOP regularly sends out unsolicited reports like this one.

CHOP’s clinic clearly has support from the governor’s office and the U.S. Department of Health. They appear to be working together to ensure gender transition and sex reassignment services are readily available for children and may be paid for, at least in part, with taxpayer dollars. 

The clinic’s founders are uninterested in discussing science or even providing a rational explanation as to why they have not re-evaluated their practices. By continuing to ignore questions, their actions give reason for pause. As a leading provider of pediatric services, CHOP has an ethical responsibility to be transparent about its treatment methodologies, and they must be willing to defend them. 

CHOP is one of the most highly rated children’s hospitals in the country. U.S. News and World Report first published rankings in 2007, and CHOP has consistently been at the top of the list, including 2024-2025. The Department of Pediatrics at the University of Pennsylvania’s Perelman School of Medicine, located at CHOP, has been ranked as the number one Department of Pediatrics in the country by U.S. News for ten consecutive years.

It is simply unconscionable that organizations as large and well-respected as CHOP and Penn Medicine refuse to provide information or answer any questions about their services and treatments. Given the controversial and political nature of these services across the globe, it is imperative that CHOP and Penn Medicine be transparent about their services. Absent that, we are left wondering what they are hiding and why.

Beth Ann Rosica resides in West Chester, has a Ph.D. in Education, and has dedicated her career to advocating on behalf of at-risk children and families. She covers education issues for Broad + Liberty. Contact her at barosica@broadandliberty.com.

email icon

Subscribe to our mailing list:

3 thoughts on “Beth Ann Rosica: CHOP’s Gender and Sexuality Clinic remains locked in secrecy”

  1. Dr Rosica does it again. The words unconscionable and unethical are perfectly selected and accurate. Where are the ethical pediatricians who swore to uphold and protect children?

  2. Ms. Rosica, who is an educator and not a medical doctor does it again. Once again she tries to insert herself into an area she is not trained in. The process of physically transitioning takes years and involves the consensus of multiple medical doctors and mental health experts. This is a decision that is made by the patient, their family, and their doctors. As Ms. Rosica disagrees with this process she should not let her children undergo it.

    Until Ms. Rosica and her supporters are prepared to share the results of their gynecologic exams and other health records for a random person to make treatment decisions, you need to mind their own business. I would not trust Ms. Rosica to make medical decisions anymore than I would trust an auto mechanic to determine a schools curriculum.

  3. “The church as the community of Jesus Christ is meant to be a refuge and place of hope, care, and understanding to all who are perplexed, suffering, struggling, and lonely…. All people are invited to attend the Seventh-day Adventist Church and enjoy the fellowship of its believers.”
    Dr. Rosica, Andrews University

Leave a (Respectful) Comment

Your email address will not be published. Required fields are marked *