A Chicago health facility diagnoses transgender patients with a vague medical condition to prescribe cross-sex hormones despite growing suspicion that the diagnosis is fraudulent.
The Howard Brown Health Center’s website says it avoids stigmatizing transgender patients on hormones by giving their insurance providers a diagnosis for an unspecified “endocrine disorder,” which typically refers to one’s body having imbalanced hormone levels. HBHC previously expressed concerns it could lose funds under President Donald Trump and scrubbed mentions of child sex changes from its site in 2025, but the diagnosis policy remains public after similar diagnosis methods sparked fraud investigations nationwide, the Washington Examiner found. A senior HBHC staffer is also a scholar for the World Professional Association for Transgender Health, a group facing a Federal Trade Commission lawsuit for allegedly crafting misleading medical guidance to allow for gender-related insurance coverage.
HBCH relies on the widely used International Classification of Diseases, or ICD codes, to document patients’ conditions treated and reviewed by insurance carriers. Transgender people on hormone drugs “will receive a diagnosis of Endocrine Disorder (ICD code 259.9)” instead of the ICD codes representing “Gender Identity Disorder, Gender Dysphoria or Transsexualism,” the facility’s website says. Though Illinois regulations often protect insurance coverage for sex changes, using those diagnoses suggests “that being transgender or gender diverse is a sign of mental illness or a gender identity disorder,” the site argues.
Texas and Tennessee officials have accused other health professionals of fraud for using the endocrine disorder diagnosis for sex changes since 2023, describing it as a misleading tactic to secure insurance or Medicaid funding. Starting in May, Trump’s Centers for Medicare and Medicaid Services and Department of Justice requested coding records from facilities to check whether they provide transgender procedures legally. The coding issue even prompted a July 2025 analysis from the law firm Sheppard, warning that transgender health providers should review whether “suspect diagnosis codes such as endocrine disorder” could bring consequences under the federal False Claims Act.
HBHC and WPATH did not respond to the Washington Examiner’s requests for comment. HBHC is the state’s only “Federally Qualified Health Center” focused on LGBT people and serves more than 28,000 patients per year, according to its website. The Department of Health and Human Services has awarded it more than $100 million since 1998.
“Howard Brown believes that patients who ask for [hormone therapy] are asking for care that will help their bodies match their gender identity,” the webpage on hormone therapy states. “If you currently have a diagnosis of Gender Identity Disorder, Gender Dysphoria or Transsexualism it will be replaced with Endocrine Disorder. If you get [hormone therapy] and use your insurance, your insurance company will see a diagnosis of Endocrine Disorder and will know which hormones or hormone blockers you got.”
That approach seems like a “blatant” violation of the law, Texas surgeon Eithan Haim told the Washington Examiner. Haim sparked a state investigation into Texas Children’s Hospital in 2023 by blowing the whistle on secret child gender transitions. Texas Attorney General Ken Paxton’s office later found the hospital used false diagnosis codes to prescribe sex changes to minors, among other misdeeds.
“So funny. These idiots are admitting to the crime the DOJ is investigating them for,” Haim said regarding HBHC.
A DOJ spokesperson told the Washington Examiner: “This Department of Justice will use every legal and law enforcement tool available to protect innocent children from being mutilated under the guise of ‘care.’
“The Department does not confirm or deny the existence of investigations.”
HBHC’s senior adviser for education and clinical practice, Kelly Ducheny, co-authored WPATH’s latest “Standards of Care.” HBHC also collaborated with WPATH in a 2017 “LGBT Health Summit,” a WPATH report shows. WPATH has publicly encouraged medical professionals to use the ICD code for endocrine disorder to give gender “care” and avoid codes that explicitly describe transgenderism, which it deems “pathologizing.”
The FTC, Texas and other conservative states sued WPATH in June over claims that Ducheny’s team wrote the Standards of Care to make “nearly every” child sex-change procedure insurable by labeling it “medically necessary,” citing WPATH experts’ own statements. The suit alleges dishonest trade practices under federal and state laws.
WPATH called the case “baseless” in a June 17 statement. “The U.S. Federal Trade Commission is not a medical provider and has no place interfering with the process of individualized medical decision-making and the FTC also does not have any jurisdiction over WPATH and its noncommercial speech,” the organization said. “The state claims have similar factual and legal flaws.”
Trump also signed an executive order in January 2025 that declared federal agencies will not “fund, sponsor, promote, assist, or support” child sex-changes and “will rigorously enforce all laws that prohibit or limit” the practice. The bottom of HBHC’s webpage on hormone therapy used to advertise its “Youth Hormone Program” for eligible minors, but HBHC removed the language sometime in 2025, archived webpages show.
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The president’s order “has no immediate impact on our operations,” the page currently says. “We are continuing to provide gender-affirming care to all patients who rely on our services and remain committed to improving the health of trans and gender diverse communities.”
HBHC also deleted a page about the Youth Hormone Program sometime after the DOJ’s July 2025 announcement that it sent subpoenas to pro-transgender doctors and clinics, archives show.