Pennsylvania Planned Parenthood employees could be fraudulently obtaining coverage for cross-sex hormones using false diagnoses, according to health experts.
Planned Parenthood’s southeastern and western Pennsylvania facilities describe giving insurance providers the billing code for “endocrine disorder, unspecified” when prescribing the transgender drugs. Doctors are sounding the alarm in recent months about clinics misleadingly using the diagnosis to secure Medicaid or insurance coverage for transgender treatments. Alleged false billing codes, including endocrine disorder, have sparked legal action from Republican Texas Attorney General Ken Paxton against sex-change doctors and health institutions in his state since whistleblowers came forward in 2023.
“In order to meet the needs of most insurance companies and patients, we typically use the code E34.9 (endocrine disorder, unspecified) and occasionally will use F64.9 (gender identity disorder, unspecified) if necessary,” Planned Parenthood of Southeastern Pennsylvania’s website says regarding cross-sex hormones. “We recognize that much of the language around billing for gender affirming care is troublesome; we recognize this is medically necessary care and will work to decrease barriers to getting folks the care they need.”
The western Pennsylvania location’s website similarly says it may use either the endocrine disorder code or the explicitly gender identity-related codes. “Note that while we don’t like the wording used in many of these codes, they are used by insurers and medical billers on a national basis and we are unfortunately required to keep the wording the same when using them because of that,” a disclaimer states.
Planned Parenthood of Western Pennsylvania received more than $4.1 million in taxpayer funds between July 2020 and June 2025, while Planned Parenthood of Southeastern Pennsylvania received more than $10.7 million, tax filings show. The endocrine coding guidance has been live on the southeastern facility’s website since at least February 2023 and on the western location’s site since January 2021, archived webpages show. Planned Parenthood did not respond to the Washington Examiner’s requests for comment.
Sex changes for minors are legal in Pennsylvania. The endocrine disorder billing code, E34.9, is from the World Health Organization’s International Classification of Diseases, or ICD, which many insurance providers rely on to determine coverage.
Whistleblowers say that labeling gender dysphoria as an endocrine disease in order to secure insurance coverage for transgender drugs that may not otherwise be covered is a deceptive practice.
“A huge amount of energy has been spent to develop, find which ICD codes can be used that will justify the [gender] interventions under a false pretense without pushback from insurance companies,” said Dr. Eithan Haim, a Texas surgeon who first blew the whistle in 2023 over secret child sex-changes at Texas Children’s Hospital. Paxton’s investigation later found that TCH used false diagnosis codes to transition children, among other legally dubious actions. The hospital entered a civil settlement with the attorney general and the Department of Justice in May.
“They’re actually inducing the disorder that they’re claiming to treat,” Haim told the Washington Examiner regarding Planned Parenthood.
“Once they’re started on hormones and all that s***, they have an endocrine disorder, but it was just one that was given to them by their doctors,” he said.
Other physicians called out Planned Parenthood of Southeastern Pennsylvania over the endocrine disorder code in July 2025 testimony to the Federal Trade Commission and an April report from the medical group Do No Harm. “Utilizing these ‘alternative’ codes is misleading and contrary to the ICD-10-CM Official Guidelines for Coding and Reporting, which requires providers to ‘[c]ode to the highest level of specificity when supported by medical record documentation,’” Dr. Kurt Miceli wrote for Do No Harm.
“These are physically healthy people. They have no medical diagnosis whatsoever,” Dr. Miriam Grossman told the FTC about transgender-identifying patients. “They have a psychiatric diagnosis. But this E34.9 is being used in a fraudulent way, I would say, in order to get payment for the services.”
“Gender activist organizations” openly encourage health providers to use misleading diagnoses to secure coverage, Paxton’s office noted in a December filing against one doctor accused of the behavior. The physician surrendered her license in October.
Facilities such as Texas Children’s Hospital are “lucky” to get civil cases since fraudulent diagnoses and medical billing are often federal crimes, Haim told the Washington Examiner. “Any other specialty in medicine, these people would be going to prison.”
FEDERALLY FUNDED GENDER CENTER ‘UNDER GUISE OF CARE’ USES DUBIOUS DIAGNOSES FOR HORMONE DRUGS
Haim is currently helping government officials investigate this type of fraud in the sex-change industry, he said, adding that he could not yet discuss details.
“When they’re creating the disease that they’re using to justify the hormones and surgeries which created the disease in the first place, it’s like a level of criminality in healthcare fraud that has never been even described,” Haim said.