Newly obtained state financial records reveal that the Washington Department of Corrections (DOC) has spent more than $4.8 million on “gender affirming care” for inmates since fiscal year 2019, with costs accelerating sharply in recent years — including hundreds of thousands paid through Medicaid even after Washington Democrats moved to cut Medicaid spending elsewhere.
According to the records obtained by The Ari Hoffman Show on Talk Radio 570 KVI, the DOC itself paid approximately $4.46 million, while Medicaid contributed an additional $394,237 toward procedures and treatments. The largest category of spending was listed as general “procedure/treatment” expenses, totaling more than $3.2 million. Records also show approximately $527,900 spent on bottom surgeries, nearly $586,000 spent on top surgeries, roughly $62,000 spent on laser hair removal services, and more than $67,000 for office visits and consultations.
NEW: The WA Dept of Corrections has spent over $4.8 million on "gender affirming" care for convicted felons in prison since 2019, with costs accelerating sharply in recent years — including nearly $400,000 paid through Medicaid even after WA Democrats moved to cut Medicaid… pic.twitter.com/7XbmJYJOjT
— Ari Hoffman (@thehoffather) May 19, 2026
The fiscal-year breakdown shows relatively low expenditures before 2022 before costs began escalating sharply. By FY2025 alone, annual DOC expenditures exceeded $1.56 million, while projected FY2026 costs are expected to surpass $1.86 million.
The Medicaid portion of the spending comes amid broader controversy over healthcare funding in Washington state. Despite reductions to Medicaid spending and warnings over rising healthcare costs, state records show Medicaid still covered nearly $400,000 in gender affirming care-related expenses connected to incarcerated individuals.
The records add new context to a Daily Wire investigation, which reported that Stiller Aesthetics, a cosmetic surgery practice led by Dr. Geoffrey Stiller, received more than $4.3 million from the Washington State Health Care Authority beginning in July 2019. The outlet noted that the state database did not specify what each payment covered, but said public records it reviewed showed some of the practice’s patients included individuals incarcerated in the Washington Department of Corrections.
The Daily Wire reported that Stiller Aesthetics advertised multiple transgender surgical offerings, including facial feminization, “non-binary” double mastectomy, and bottom surgery, and that payments to Stiller continued after President Donald Trump’s election, including more than $800,000 in 2025 alone.
InvestigateWest separately reported in December 2025 that Stiller had been arrested for driving under the influence in 2021 and had faced multiple medical malpractice lawsuits in recent years. The outlet described allegations from former employees and patients involving ethical lapses, poor recordkeeping, and concerns over oversight in the cosmetic surgery industry.
Separate budget records obtained alongside the expenditure reports show lawmakers approved dedicated “Gender Affirming Services” funding lines within the corrections budget for FY2024 and FY2025. For FY2024, the state appropriated $627,000 for gender affirming services and spent nearly the entire amount on salaries, employee benefits, goods and services, and intra-agency reimbursements.
By FY2025, appropriations increased dramatically to $1.715 million, with actual charges already totaling more than $1.64 million. The state spent heavily across multiple categories tied to “gender affirming” services, including roughly $476,500 for salaries and wages, nearly $139,000 in employee benefits, and more than $364,000 in professional service contracts. Additional taxpayer funds went toward travel expenses, capital outlays, grants, and client services, while intra-agency reimbursements alone exceeded $577,000.
Combined adjusted budgets for FY2024 and FY2025 totaled $2.34 million, while expenditures reached approximately $2.27 million.
