Lucrative “Gender Mutilation” Business Grows at Taxpayer Expense

The Gender Industrial Complex

According to a report from the American Principles Project (APP), the “gender mutilation” surgery market was worth $4.12 billion in 2022 and is projected to grow annually by 8.4 percent through 2030. But unlike abortion, where federal funding is largely restricted by the Hyde Amendment, there is no such prohibition on Medicare and Medicaid (taxpayer dollars) reimbursing the staggering costs of these gender interventions. 

The APP estimated the total cost of full “gender mutilation” procedures to be anywhere from $87,300-410,600 for males and $66,500-605,500 for females. Since many gender interventions create “lifetime, repeat customers,” who can be covered under federally reimbursed medical insurance, the medical organizations that dominate the gender surgery market have a significant financial incentive to promote them.

The APP report, titled “The Gender Industrial Complex,” made a cost list of the most common procedures:

• Phalloplasty, $20,000-150,000
• Facial Feminization Surgery, $20,000-50,000+
• Metoidioplasty, $20,000-30,000
• Mastectomy, $15,000-50,000
• Vaginoplasty, $10,000-40,000
• Hysterectomy, $9,500-22,500
• Augmentation Mammoplasty, $6,000-12,000
• Chest Masculinization Surgery, $6,000-10,000
• Voice Feminization Surgery, $5,000-9,000
• Orchiectomy, $5,000-8,000
• Reduction Thyrochondroplasty, $3,500-7,000
• Scrotoplasty, $4,000-6,000
• Electrolysis, $50-200 (one-hour session)
• Laser Hair Removal, $200-1,000
• Vocal Training, $50-200 per hour

On top of these procedures, medical organizations can expect to bring in $3000-25,000 annually per patient for five years of puberty blockers. In addition, with the average lifetime expectancy of 60 years, annual maintenance with cross-sex hormones can bring in an additional $240-2,400 per year for testosterone and $200-4,200 per year for estrogen.

The APP report currently lists 11 hospital systems accounting for 48.7 percent of the market share, including Cedars Sinai, Mount Sinai, Kaiser Permanente, Mayo Clinic, Cleveland Clinic, and Johns Hopkins. The report also identifies Pfizer, AbbVie, Endo International, Novartis, and Lilly as the top five companies providing hormones and blockers.

Planned Parenthood has become the nation’s second-largest network for gender mutilation 

As for Planned Parenthood, it has become the nation’s second-largest network for gender mutilation since it entered the market in 2016. While the abortion giant raked in record profits with abortions in its 2024-2025 reporting period (up 8 percent from 2023-2024), the company also saw a 40 percent spike in gender services. According to a report by the Concerned Women for America Legislative Action Committee, Planned Parenthood’s gender interventions skyrocketed by 544 percent in 2022 and continues to rise with many of these services involving teenagers.

Research shows that 60 to 95 percent of minors with gender confusion who undergo puberty normally will come to embrace their biological sex, yet 95 percent of children who begin puberty blockers will proceed to cross-sex hormones and surgery. Despite bans on child medical mutilation in 27 states, and several U.S. medical associations recently recommending stopping irreversible genital surgeries for children, these major medical organizations continue to press forward toward huge profit margins from lifelong patients, many who became so as minors and are covered by taxpayer dollars.

However, recent federal action presents a potential direct threat to this revenue stream. The U.S. Department of Health and Human Services (HHS) announced in December 2025 it has begun the federal rulemaking process to end federal funding of these gender interventions on children. Currently, the “Protect Children’s Innocence Act” has passed the U.S. House and has advanced to the Senate, which if passed, would criminalize administering these procedures on minors with gender confusion, with penalties including fines or up to 10 years in prison, or both.

Liberty Counsel Founder and Chairman Mat Staver said, “American taxpayer dollars should not be used to harm and irreversibly mutilate children. All federal reimbursement funding to medical organizations that promote harm and death via gender ideology and abortion should be stopped. The medical community should no longer be allowed to profit from death and destruction.”