In a recent 20-tweet thread, Matt Walsh revealed how readily healthcare providers are diagnosing patients with gender dysphoria and “rubber-stamping” letters approving sex reassignment surgeries. 

In order for most insurance companies to pay for these surgeries, patients must be diagnosed with gender dysphoria and receive a letter of support from a mental health and/or healthcare provider. Additionally, World Professional Association for Transgender Health (WPATH) standards, which many major hospitals adhere to, require that trans-identified patients are assessed by one medical professional before undergoing surgeries. WPATH recently removed specific age recommendations for minors seeking some sex reassignment surgeries. 

Healthcare workers can provide the diagnosis and letter often needed for a patient’s surgery to be insured. But sometimes healthcare providers may falsely diagnose a patient with gender dysphoria without undergoing a full assessment and when the individual does not really have dysphoria. Folx, a trans telehealth service, even admits this. 

The Daily Wire’s producer, Gregg Re, decided to test this out with one of the largest trans healthcare providers in the country—Plume. 

Re posed as a trans-identified patient who had experienced gender dysphoria before but not for six months or more. According to the current version of DSM-5, he shouldn’t be diagnosed with gender dysphoria. Plume quickly set up a virtual meeting with Re where he acknowledged he didn’t know the effects orchiectomy, a procedure to remove testicles, would have on him, and made clear that he didn’t consider himself gender dysphoric.

And yet, after a 22-minute video call with Plume, the provider sent Re a letter only three days later declaring that he “reports significant, ongoing gender dysphoria” and strongly recommends testicle removal. The letter explicitly mentioned that Re had met WPATH criteria for gender dysphoria and testicle removal.   

Re reached out to Plume after receiving the letter to ask why he was diagnosed with gender dysphoria. He received this response: 

Plume writes letters based on WPATH templates and often has to diagnose patients with gender dysphoria for the surgery to be covered by insurance.

The undercover investigation confirmed Daily Wire’s suspicions: some healthcare providers are diagnosing patients with gender dysphoria who do not truly have dysphoria. And they are doing so in a less than 30-minute video call. The reason? This is usually how surgeries are paid for. 

Plume and Folx are not the only healthcare providers writing letters of approval for sex-reassignment surgeries without careful assessments and accurate diagnoses. 

Licensed clinical social worker Ari Groner recently conducted a trans healthcare training session for doctors at the Juniper Center, which has physical locations across Illinois and teletherapy in Illinois and Indiana. During the training, she described how quickly and easily she writes letters for patients, even suicidal patients: 

Practices by providers like Folx and Plume disregard the experiences of detransitioners, such as Soren, Prisha, Cat, and Daisy. All four women were easily approved for a double mastectomy and continue to suffer life-altering complications. 

To get her double mastectomy covered by insurance, Soren needed a letter from her therapist. Even though her therapist had not been treating her for any gender-related issues and Soren had some hesitation about taking on a male identity, the therapist wrote her the letter. After her surgery, Soren immediately noticed concerning effects that were dismissed by her surgeons. She later experienced severe medical complications—including vaginal atrophy, hormone fluctuations, joint pain, and gastroenterological issues—that will affect her for the rest of her life. 

The Daily Wire’s investigation raises significant concerns about the standards of care used by trans healthcare providers on patients, like Soren, that often have multiple mental health concerns that go unaddressed, and the insurance approval process.