November 16, 2023

Since his firing from Fox News, former primetime host Tucker Carlson has taken his show on the digital road åüÃÄÖ±²¥” to X, where he has interviewed public figures such as former PresidentÌýÌýand independent presidential candidateÌý.

On Oct. 4, CarlsonÌýÌýan episode titled “Trans, Inc” that focused on gender-affirming health care provided to transgender people.

“Genital mutilation is not just a fad. ItåüÃÄÖ±²¥™s a full-blown industry,” read theÌýÌýon CarlsonåüÃÄÖ±²¥™s X post sharing the episode. The 48-minute video criticized aspects of transgender health care, such as hormones, surgery and social affirmation. It describes “transgenderism” as “unnatural” and “demented,” comparing it with “human sacrifice.” Carlson could not be reached for comment.

In the video, Carlson interviewed Chris Mortiz, whom Carlson introduced as a “policy guy” who has “taken a close forensic look at where the money is coming from.” From his limited online presence, we found that Moritz has worked as a lawyer, investment banker and consultant. Mortiz did not respond to our requests for comment.

The videoÌýÌýÌýÌýÌýÌýÌý. But here are three new assertions involving hormone treatments, gender-affirming surgeries and the trans health care market.

Moritz: “With respect to the transgender pharmaceuticals, there are no long-term studies, peer-reviewed, that show the efficacy or not of taking these very powerful pharmaceuticals.”

MoritzåüÃÄÖ±²¥™s description of a total lack of research is inaccurate. TheÌýÌýstate, “Prior to 1975, few peer-reviewed articles were published concerning endocrine treatment of transgender persons. Since then, more than two thousand articles about various aspects of transgender care have appeared.”

PolitiFact foundÌýÌýÌýand peer-reviewedÌýÌýexamining theÌýÌýÌýand efficacy ofÌýÌýÌýÌýonÌýÌý,Ìýrisk,Ìý,ÌýÌýand more. There is enough research that we foundÌýÌýåüÃÄÖ±²¥” analyses of large numbers of individual research studies åüÃÄÖ±²¥”Ìý onÌýÌýaspects of treatment like bone health.

Although adolescent treatment for gender dysphoria started only in the lateÌý, transgender adults have received hormonal treatment andÌýÌýsince theÌý.

Additionally, people who arenåüÃÄÖ±²¥™t transgender, including men withÌýÌýand women inÌý, sometimes rely on hormone therapy.

“Hormone therapy for transgender males and females confers many of the same risks associated with sex hormone replacement therapy in nontransgender persons,” the Endocrine SocietyåüÃÄÖ±²¥™s Clinical Practice Guidelines say.

The guideline outlines safe dosages and provides guidance for how physicians should monitor for potential adverse effects.

Carlson: “I haven’t heard anybody mention female genital mutilation in the United States in quite some time now. Is that because we now officially engage in it?”

Ìýis a nonconsensual procedure that can include the partial or total removal of the clitoris, labia minora or the narrowing of the vaginal opening. The World Health Organization said it is mostly forced on girls younger than 15. More than 200 million women have been affected in 30 countries in Africa, Asia and the Middle East.

The procedure aims to reduce or eliminate sexual function and pleasure. It is widely considered a human rights violation.

Dr. Marci Bowers, a gynecological surgeon who does gender-affirming genital surgeries and restorative surgeries for female genital mutilation survivors, told PolitiFact that gender-affirming surgeries do not amount to genital mutilation åüÃÄÖ±²¥”Ìýthe two are entirely different.

“Transgender surgery is done with full consent of the individual,” Bowers said.

Female genital mutilation is usually forced on girlsÌýÌýin nonmedical and unsterile conditions. Gender-affirming surgeries, however, are performed in hospitals by trained professionals, and areÌýÌýperformed on people younger than 18, said Bowers, president of the World Professional Association for Transgender Health. When gender-affirming surgery is performed on minors, it is “only under the most severe conditions of gender dysphoria,” she said.

Bowers also noted the difference in how the two procedures affect womenåüÃÄÖ±²¥™s sexual functionality åüÃÄÖ±²¥” such as the ability to have sensation or orgasm. Gender-affirming surgeries “are generally quite elegant surgeries that leave the individual fully functional versus (female genital mutilation), which robs a woman of functionality,” she said.

Mariya Taher, co-founder ofÌý, an organization working in Asia to end female genital mutilation, agreed with Bowers. Taher told PolitiFact her organization “strongly” believes that gender-affirming health care does not equate to genital mutilation.

“We are saddened to see the two issues are being conflated” and that female genital mutilation “is being used as a guise to target and harm trans youth and gender-diverse individuals” Taher said.

Additionally, representatives from the End FGM network in both theÌýÌýandÌýÌýtold PolitiFact that female genital mutilation and gender-affirming surgeries are not the same.

Moritz: “The combined value sales of sex reassignment surgeries and pharmaceutical products in 2018 was $2.94 billion. By 2022, that figure had rose to $4.18 billion.”

We are unsure how Moritz arrived at those numbers; he offered no evidence backing them up and did not answer our inquiries.

We found a few publicly available market research reports, which are often commissioned by investors deciding whether to invest in a given industry. But it is difficult to assess the reliability of these reports without knowing the methodology behind them, and estimates can vary widely, said experts.

Carlson made a broader assertion that profits are driving transgender health care: “Transgenderism, it didn’t happen by accident,” he said. “Some people are profiting from it.”

None of the 2022 reports we found for the U.S. market added up to $4.18 billion, but some got close. Grand View Research, for example, values the U.S. sex reassignment hormone therapy market at $Ìýand the U.S. sex reassignment surgical market at $Ìýin 2022.

These values can be calculated using a combination of insurance data, federal and state data, and information directly from medical providers, explained Stephen Parente, professor of finance at the University of Minnesota Carlson School of Management. But for procedures not reimbursed by insurance, getting accurate estimates might prove more challenging. Coverage of health care services for transgender people can differ by state and health plan, according toÌý.

“Most types of health care, including gender affirming care, involve multiple types of providers of goods and services åüÃÄÖ±²¥” e.g., drugs, visits, procedures, hospital stays, etc.” said Melinda Buntin, health economist and professor at Johns Hopkins Bloomberg School of Public Health. “For this reason, it is hard to assess how much is spent on specific categories of care in sum.”

The market size can vary depending on what is included in a given estimate, said Supriya Munshaw, associate professor at Johns Hopkins Carey School of Business. Is it just surgery or is the hospital stay included? What about complications? How do they determine what mastectomies are gender-affirming and which are done for breast cancer?

“How are you actually calculating the number?” said Munshaw. “It might differ in different research reports.”

The U.S. health care market is large to begin with,ÌýÌýin 2021, according to federal data onÌý. A market of billions is a “sizable market” from an investment perspective, Munshaw said, but “it doesn’t mean that if something is profitable that the healthcare industry is pushing it.”

PolitiFact Researcher Caryn Baird contributed to this report.

This fact check was originally , which is part of the åüÃÄÖ±²¥ Institute. See the sources for this fact check .

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Grace Abels joined PolitiFact in June 2022. She is a senior at Duke University majoring in history and journalism. During the school year, she works…
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