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A
I need to talk to you about the Trans Inc Thing. Yeah, I. I've been dying to talk to you about this since the moment I first saw.
B
And I learned something in. Oh, there's preparing for this interview that I think is actually the most shocking thing.
A
I have my notes. I'm gonna not talk this time.
B
Well, why don't we just rehash a little bit about the. The numbers. So, please, let's do the numbers. So to explain, I. I did a analysis in 2023 of the economics and sort of a market analysis of transgender healthcare in the United States.
A
Okay.
B
So we're looking at market size, market share, players, profitability, all the different segmentation, things like that. But also through the course of that, you also are dealing with policies and the role policies play in creating this industry. And what you come away with, though, for me, was that the trans phenomenon, if you will, like the.
A
This, like the exponential increase.
B
How do you describe, like, this movement? It's not a movement. It's. It's like a. It's like hysteria, you know, back in a hundred years ago.
A
You know, I want to say I'm putting this out there, that I think trans is real. I think for a very small percentage of the, like, whatever's going on for them, I think it's real. I. I think that it. That. And there has inevitably been evidence that for some individuals, transitioning is a game changer for them. And I would never take that away. My. My argument would be, you're an adult.
B
Yeah.
A
If you're an adult, I don't care what you do with your body. I would fight for you to be able to do whatever you want with your body, as long as you're being told the truth about size. As long as repercussions on a child.
B
Yes, yes, yes. Is.
A
It's criminal.
B
So.
A
And. Okay, go.
B
Yeah. So there are 300,000 transgender youth as of 2022. That population has doubled since 2017. There are 17,000 minors on puberty blockers. And the increase in chest surgeries, mastectomies, for minors was 389% between 2016 and 2019.
A
So, you know, the argument is, it's nothing. It's nominal. It's such a small. Who cares? Gavin Newsom has even said that himself. Ah. Why are we litigating this? Such a small amount of people? Like, first of all, any child that you're sterilizing, you're compromising the development of their brain, their bones. You're taking away sexual function for the rest of their lives. One kid too many continents, one incontinent. No incontinence. That's A new one, like one kid is too many. Yes, but they're lying about the numbers. That's what's even crazier odds.
B
So. So let me give you.
A
It's such a small number.
B
It's not a. It's not a small industry. Okay. That in 2022, the market size, this includes the surgeries, revenue from the surgeries and reven. The hormone treatment, was 4.1 billion in 2018. That was in 2022. In 2018, it was 2.94 billion.
A
My God.
B
And by 2030, it is expected to be 7.8 billion. That is a 8.4% compounded annual growth rate that exceeds the health care industry, which is only growing at 5%. Now, here's a. Here's something really shocking. I found. Surgery revenue for transgender surgeries in 2022 was $2.5 billion. Okay. The total cosmetic surgery market in the United States for that year was 16 billion. So trans surgery represents 15% of the revenue for cosmetic surgery in the United States in 2022 too. Despite the fact that trans population is 0.6% of the population.
A
That.
B
Yeah.
A
You know, the reason this is so important, in my opinion, to point out, is because when you sit there and you think, well, why are the numbers exponentially growing? What? It's a huge business.
B
Yes.
A
It's a monster industry. Well, hence the narratives being crafted. But the part that you brought up, Chris, that really disturbed me was this healthcare equity index score.
B
Oh, yeah. Can you.
A
Can you talk about that for a second?
B
I have to refresh on that. But I. It. I. That is. And effectively was a. I forget what organization was putting hrc.
A
The human Rights.
B
That's what I thought it was. That or.
A
Glad it was. Hrc.
B
It's effectively a DEI metric in a similar. Or esg. Excuse me, ESG metric, you know, that big corporations were applying to all sorts of things in. That was in vogue a few years ago. And this is sort of a equivalent to that, but specific to like, trans availability of trans procedures and so forth within hospitals, major institutions, Johns Hopkins, major.
A
Institutions, all of them.
B
And this score does have, like, significant economic ramifications. So it's another fuel, you know, you know, kindling to the fueling of this industry.
A
Right. Because if there were dissenters in the medical community that said we don't think we should be offering, you know, castration drug, chemical castration drugs to kids or off label cancer drugs to kids, they would ding your score.
B
Yeah.
A
And then it had to do with, like, how much grant money you would get and state.
B
Exactly. Grant money and federal money at time under the Biden administration. But here's what I, what, what I, what I discovered kind of reviewing for this interview and that I did not realize at the time of the report. When I wrote this report. Obamacare, the Affordable Care act was passed in March of 2010. In the bill, there is a section called 1557 and it bans like sex discrimination in federally funded health programs. So on the surface that was going to apply to like sexual orientation, but they added to the language gender identity. That is important because it was not until 2013 that the American, the APA, American Psychiatric association reclassified gender identity disorder as gender dysphoria.
A
Oh. Oh, I see.
B
So in a sense, Washington had already laid the statutory rails upon which this multi billion dollar transition industry now runs. And they predated healthcare professionals, psychologists.
A
That's insane.
B
Yeah. Now there's other kind of a trail of this that I followed and it is indeed starts with the law. Then there's rules applied to cms, center for Medicaid Services, and it again touches on this gender identity. Gender identity became code for then gender affirming care being mandated by insurance companies. And there was a rule adopted in 2016 to amend the Affordable Care act specifically to address the gender affirming care. But the groundwork had already been laid in 2010, three years before the American Psychiatric association even came to the conclusion that gender dysphoria was a treatable condition with pharmaceuticals and surgery.
A
And the one thing like I, I can't say it out loud because the, the ding on the show will be so impossible. But I would encourage everybody to go to the HRC's page for the HEI score and you'll see who funds it. Yeah, Just go there.
B
Yeah.
A
And look and see who proudly sponsors it. And it'll tell you everything you need to know. And it'll be the same fact industries and companies that have paved the way for this type of legislation.
B
You know why transgender people are so profitable is because they represent recurring revenue.
A
Right. You have to be on the medications.
B
For the rest of your life. So you have all these expensive surgeries, can be hundreds of thousands of dollars, and then you are on pharmaceutical like hormone treatment for the rest of your life and other things because there's complication whatnot.
A
Of course.
B
So it is a recurring customer.
A
People think it's so small. But when you laid this out and the compound annual growth rate and how many billions of dollars and the fact that it goes on in perpetuity for the length of the patient's life and all of a sudden you start to connect the dots.
B
Yeah.
A
And capturing kids who are psychologically vulnerable, it doesn't mean, and again, you know, for you and I, it to like protect us doesn't mean some of them may not grow up to be. And, and should they be. Again, I, I personally couldn't care less what they, I support them, their own freedom to make their own choices. But children, their brain is not developed.
B
In fact, in England there's a case called I think Belvi Talisac. I probably have that wrong, but relates to a clinic in a, a transgender like gender affirming care clinic. It's very famous in England and the, the, the, this particular court found amongst other things, that children do not have the developmental capacity to make a decision relating to gender affirming care.
A
Of course not. Did you see, did you ever look at Shellenberger's WPATH file, Dom?
B
Yeah, yeah.
A
The doctors are admitting in all this leaked footage they're like, ah, Talking to a 14 year old's like talking to a wall. Yeah. They can't wrap their head around any of that. Parents don't really get it either. It's fricking scandalous.
B
Yeah, it's an, it is an, it's an industry. It was created. It was an industry. And I think on the activist NGO side, like personally, I think I'm thinking that as sort of like, as sort of gay rights like peaked and we have gay marriage and like normalization. Well, those entities still need to function. Those pe, those executives of those entities need to make money. They need a new issue.
A
You know what's so funny you say that is I was gonna actually wrap this up by saying to you, the irony is I was at the HRC dinners, I donated to the hrc. I am sure I was involved. And what, you know, I've never been a big gay activist, but I, you know, I wanted equal rights for marriage because it's like comes with a thousand rights. I want to protect my wife, my kids. Yeah, my ex wife. You know, I, I lot of stuff that comes along with this and, and I wanted all of these rights to protect these people that I love. I wanted to adopt kids legally. In fact, like, I didn't come out of the closet until my daughter was adopted because it was illegal to adopt her as a gay person. And I was like, I'm sorry, this is a law worth breaking with with, in my opinion, with that said.
B
Well, gay rights used to be about normalization.
A
And now I'm like this organization is evil.
B
We went from, look what they're doing. We went from banning gay conversion to mandating child biological conversion.
A
When I started the fitnessapp.com I had a really clear vision. But what I didn't realize was how much goes into building and scaling a business. I mean, it's not just about having a great product or a great service. It's about reaching people, managing growth, and doing it all without burning out. That's why I use Shopify. Shopify gives me the tools to run my business seamlessly. Whether it's managing online sales, tracking inventory, connecting with customers in a way that feels personal, it's all in one place and that's what makes it so powerful. And even as an established business, Shopify continues to be the backbone that lets me focus on what I do best. Creating products and offering services that actually help people. It takes the overwhelm out of the back end so I can put my energy into the front end. So whether you're just getting started or you're ready to scale, Shopify is the platform that makes it possible. Shopify is the commerce platform behind millions of businesses around the world and 10% of all e commerce in the U.S. now what if you can't design a website? Shopify's got you from the get go with beautiful ready to go templates that are ready to match your brand style. What if you need a hands? You can get help with everyday tasks like enhancing product images, writing product descriptions, or generating discount codes with Shopify's AI tools that are created for commerce. What if people haven't heard about your brand? Shopify even helps you find your customers with easy to run email and social media campaigns. And if you get stuck, Shopify is always around to share advice with their award winning 247 customer support. So turn those dreams into and get give those dreams the best shot at success with Shopify. Sign up for your $1 per month trial and start selling today at shopify.com Jillian Go to shopify.com Jillian that's shopify.com Jillian all right, let's be real for a second. Bras and underwear have always been a pain point, right? I mean they dig in, they don't stay put, they never feel as good as they look. And this is one of the reasons that I love skims. I think the first piece that I fell in love with was the Fits everybody T shirt bra. I mean it's seamless, it's supportive without being restrictive. And honestly, it kind of feels like you're not wearing Anything. But it still gives you the shape you want and the lift maybe you need. I'll speak for myself. I mean I reach for it every single day because it just works with everything in my wardrobe. And then there are the fits everybody boy shorts. And I cannot tell you how many times I've dealt with underwear rolling into places I don't want it or showing lines under clothes I know you know what I'm talking about. These issues are completely solved. They're buttery, soft, they don't move around. They're so comfortable I forget I'm even wearing them. Skims nailed it. Period. And it's the first brand that feels like it was designed for real bodies, real comfort and real life. And I would recommend it to anyone because once you try it, you're never going to want to go back. So shop my favorite bras and underwear@skims.com after you place your order, be sure to let them know that I sent you select podcast in the survey and be sure to select my show in the dropdown menu that follows. Fall is in full swing and it's the perfect time to refresh your wardrobe with pieces that feel just as good as they look. And this is why I am obsessed with quints. They make it easy to look polished, stay warm and save big without ever compromising on quality. Quince has all the elevated essentials for fall. 100% Mongolian cashmere starting at just 50 bucks. Washable silk tops and skirts. Perfectly tailored denim. Honestly, the prices feel too good to be true. I mean right now I'm loving their wool coats. They look totally designer but cost a fraction of the price and the quality. I mean it's just as good if not better. And here's how they do it. Quint's partners directly with ethical top tier factories and and they cut out the middlemen. And that means that you get luxury quality pieces at half the price of similar brands. So again for me my go to has got to be the wool coats are the cashmere sweaters are fantastic. I mean keep it classic and cozy this fall with long lasting staples from Quince. Just go to quince.com/jillian for free shipping on your order and 365 day returns. Which is bananas. That's quince.com/jillian Q U I N C E.com/jillian to get free shipping and 365 day returns. Quintcom Jillian I mean a crew neck, a coat. I make it your staple for fall. I find myself reaching for it again and again. So if you're ready for a smart, stylish, effortless wardrobe. Guys, upgrade and check out quints. What is it the same thing that happened to California?
B
I mean, there are laws we didn't get to. I'll tell you about some other time, but there are laws that are specifically incorporate some of these, like gender identity issues related to the criminal justice system. So for instance, there is.
A
I was going to say get to one there.
B
Okay, there is. There, there. Okay. There's a really shocking. There's a really shocking law. I think it's SB3 57 maybe.
A
I love that you can remember this. I'm like, it's very hard to remember.
B
It was passed in 2020 and it had to do with juries. And the law said that if you belong to a protected class, and that includes, of course, race, gender, gender identity, sexual orientation, everyone but you basically perceived membership in a protected class.
A
Wait, hold on. Does that mean if someone perceives that you're trans but you're not.
B
Who knows? It's so ambiguous.
A
Oh, by design. I see.
B
And basically, it means that if a prosecutor makes a peremptory challenge, which is to basically throw out the juror from the pool to one of these protected class, there is a presumption of bias and the. And the prosecutor then has to show why that decision, why that peremptory challenge was not biased.
A
My God.
B
And it gets worse from there. But basically it's. It's the prosecutors I know say, like, this is result. Oh, oh, yeah. This is. This is another thing. If a. This is not related to trans. But if someone says like, I hate cops. I was like, my brother was shot by a cop. Like something like that. That used to be. That was considered race neutral. And you could throw. You could challenge that juror's position on the jury as a prosecutor and have them dismissed. Now, that is considered presumptively biased. And so.
A
Hold on. Yeah, so if I'm. If I'm.
B
You can't do it at all if I'm black.
A
Okay, wait. If I'm a person of color and I say I hate cops and I'm defending a cop as an attorney, I'm like, okay, that person's off the drip.
B
You can't do it.
A
No, that's crazy.
B
I know. And the prosecutors I talked to say it's resulting.
A
California.
B
California, yeah. We also passed a law in the same year, the Racial Justice Act. That is. I mean, it's. It's bonkers. Like, it, it basically meant that if there is any. If there was any inference of racial bias From a juror, from a clerk, from a police officer. It could be, it could be demonstrated through statistical evidence at that particular jurisdiction that maybe there was increase more convictions or arrests of blacks in this particular jurisdiction. That statistical evidence could be entered into consideration for mitigation or even, you know, outright like throwing out a conviction and it's retroactive.
A
So if, if the person who committed the crime is of color.
B
Yes, they can, they're now can argue a racial bias under the Racial justice act and have their case thrown out or mitigated. And. But basically it's creating.
A
Because in that area more people of color have been convicted of crimes.
B
Right. So like that's statistical evidence. And look, it doesn't have to have any bearing on the case. It has no bearing on the facts of the case. It could be completely unrelated.
A
So if, if a person of color rapes me on camera, but in that jurisdiction, more people of that ethnicity have been convicted of crimes over the past decade or what have you, then it could be thrown out on that.
B
They could argue that it had some kind of influence on the case or the jury or a, or anything or community is biased. All it's doing is creating a flurry of litigation. Right. It's, it's creating court backlog. And the prosecutors are all terrified of every time they, you know, are going up against a minority defendant, the defense is going to claim Racial Justice Act.
A
Yeah, they use that in my line of work all the time. Yeah. So if you try to get soda off of snaps and the first one to really put this front and center to make people aware of it, even though it's been going on for such a long time, was really cali means. But they'll call you racist and they'll imply that you're racist. And it's. They then give money.
B
Yeah.
A
To the NAACP or the Hispanic Freedom League.
B
Well, that's a shakedown. Yeah, that's just a shake.
A
They give them money.
B
Like don't Al Sharpton, Jesse Jackson were doing that? Like 80s. That's like old style racial Shakespeare.
A
It's crazy.
B
California's taking it to a new level. Like California's like invalidated the jury system, which we've had, you know, since Magna Carta. So that's why I say like California has effectively rejected the Social Contract. And the Social Contract, it's an enlightenment concept whereby we enter into society into a government system from the state of nature and we enter into a transaction with the government and the government is to provide protection against the violence of the state of nature. And the anarchy of the state of nature. And therefore we give up certain rights in exchange. But in California and tax dollars, the government. Well, of course in California, that transaction, that contract has been broken. And when you. When the social contract is just dismissed, like the government doesn't have legitimacy.
A
Chris, I literally could talk to you for hours.
B
Same.
A
Okay. The. The book Failed State A Portrait of California in the Twilight of an Empire. Available everywhere. I mean, where do we get more from you?
B
You can follow me on X. Chrisg Moritz and that's probably the best place.
A
Thank you for all, all the things you're doing. I mean, I know you have a day job.
B
You know, California matters.
A
Everything you're talking about matters.
B
California matters. And the trans issue matters like kids are getting hurt.
A
You're wonderful.
B
Thank you.
A
I appreciate you. I look forward to many more conversations.
B
It was really, really wonderful. Thank you, Julian.
Episode Title: Follow the Money. Inside the Trans Industry Machine
Host: Jillian Michaels
Guest: Chris Moritz (author, analyst)
Date: September 3, 2025
This episode features a candid, data-driven discussion between host Jillian Michaels and guest Chris Moritz exploring the business, policy, and societal aspects of the burgeoning transgender healthcare industry in the United States. The conversation scrutinizes the exponential financial growth of the industry, examines the evolution of related laws and policies, and voices concerns about the medicalization of youth. The episode also touches on broader implications for healthcare equity, legal changes in California, and the moral responsibilities of both policymakers and the medical establishment.
Jillian Michaels (on youth transition):
"First of all, any child that you're sterilizing, you're compromising the development of their brain, their bones. You're taking away sexual function for the rest of their lives. One kid too many…one kid is too many." (04:58)
Chris Moritz:
"Trans surgery represents 15% of the revenue for cosmetic surgery in the United States in 2022, despite the fact that trans population is 0.6%." (06:03)
Jillian Michaels (on institutional incentives):
"If there were dissenters in the medical community that said we don't think we should be offering… chemical castration drugs to kids…they would ding your score…grant money and federal money at time under the Biden administration." (08:25–08:45)
Chris Moritz:
"Washington had already laid the statutory rails upon which this multi billion dollar transition industry now runs…and they predated healthcare professionals, psychologists." (10:02–10:18)
Jillian Michaels (reflecting on LGBTQ activism):
"The irony is I was at the HRC dinners, I donated to the HRC…Now I'm like this organization is evil." (15:15)
Chris Moritz (on shifts in the gay rights movement):
"We went from banning gay conversion to mandating child biological conversion." (15:17)
Jillian Michaels (on California legal reforms):
"If a person of color rapes me on camera, but in that jurisdiction, more people of that ethnicity have been convicted of crimes...it could be thrown out..." (24:06–24:22)
Further Reading & Resources
*Follow the guests:
Chris Moritz on X: @chrisgmoritz