Boston Children’s Hospital was reimbursed $1.4 million by the state of Massachusetts for its “gender transition services” from January 2015 to May 2023, according to documents obtained by the Daily Caller News Foundation through a public records request.

Boston Children’s Hospital, which claims to have created the first pediatric and adolescent transgender health program in the country, was hit with heavy backlash in 2022 for performing gender transition surgeries on minors, including vaginoplasty, phalloplasty, chest reconstruction and breast augmentation, according to a since-deleted website. The Executive Office of Health and Human Services (EOHHS) of Massachusetts told the DCNF on July 25 that it paid the hospital over $1.4 million for “Gender transition services (i.e., physician’s services, inpatient and outpatient, hospital services, surgical services, prescribed drugs, therapies, etc.)” from January 1, 2015, to May 1, 2023.

The hospital performed 204 “gender affirmation” surgeries on minors from 2017 to 2020, the same time as the EOHHS funding, according to a study from the National Institutes of Health. This total included 65 chest surgeries, with the youngest patient being 15 years old.

Boston Children’s “Center for Gender Surgery” web page, which has since been removed, contained dozens of videos discussing gender dysphoria, transgender sex, “top” and “bottom” surgery, and even a how-to guide for talking to friends and family about the subject, according to an archived version of the page. The website stated that “surgery is never the first step in a gender transition” and suggested that newer patients start with socially transitioning and  “supplemental hormones.”

Patients as young as 15 years old could obtain breast or chest augmentation provided they have their parent’s consent and a letter from a “medical doctor or nurse practitioner stating that you have ‘persistent, well documented, gender dysphoria,’” according to the website.

Boston Children’s also offered vaginoplasty surgeries to 17-year-olds without any parental consent, but said that it would only perform a phalloplasty or a metoidioplasty, which are surgeries to construct a penis, on patients 18 years or older, according to its website.

The hospital did not respond to multiple requests for comment regarding whether or not taxpayer funding was used for transgender surgeries for minors. The public records response did not provide any further explanation regarding the specific “gender transition services” for which the state had reimbursed the hospital.

The hospital’s “Gender Multispeciality Service” website explains that it is “committed to providing the best care for ALL of our patients, regardless of their gender identity” and that children should get the support they need to “live, grow and thrive with love and support.”

“We believe in a gender-affirmative model of care, which supports transgender and gender diverse youth in the gender in which they identify,” the hospital wrote. “This is a standard of care grounded in scientific evidence, demonstrating its benefits to the health and well-being of transgender and gender diverse youth.”

The hospital currently offers a “Transgender Reproductive Health” program where patients can get help with menstrual suppression, including egg freezing and sperm banking, and contraception counseling. The program also does “gender-affirming hysterectomies” but only on patients that are 18 and older, according to the website. If a transgender patient has already had a vaginoplasty, the hospital offers “dilation therapy and care of neovaginas” as well.

On a resources page, the hospital suggests that male teenagers can use things like duct tape for “safe tucking” in order to give the appearance of having a vagina. While the hospital notes that tape is not the recommended method, it lays out steps to use it safely and provides images to demonstrate.

The number of U.S. teenagers getting transgender surgeries has increased over the last several years, according to a study published by the JAMA Network, a medical journal. Surgeries for Americans aged 12 to 40 almost tripled between 2016 and 2019 from 4,552 to 13,011, with minors making up 3,678 of the procedures. The study also noted that just over 25% of patients obtaining gender transition procedures did so using state-funded insurance through Medicaid.

Megan Brock and Kate Anderson on October 30, 2023