The Center Square) – Three years ago, North Carolina passed a stringent ban against transgender medical interventions on children, outlawing surgical or chemical treatments on anyone under 18.

That same year, the fortunes of the nonprofit Charlotte Transgender Healthcare Group began to soar.

That was when the network of doctors, therapists and other healthcare providers—which openly promotes hormone therapies on minors—landed a lucrative contract with Mecklenburg County to provide no-cost medical and mental health services to "transgender and gender diverse individuals," paid for by federal Covid-19 recovery funds, documents The Center Square obtained through the Public Records Law show.

The first installment paid to the group: $169,500 in March 2023. Federal dollars have poured in ever since, with Charlotte Transgender Healthcare receiving a total $2.6 million—more than double the sum of taxpayer dollars previously reported by The Center Square.

Almost half of the money was designated explicitly to pay for adult mental health services, but for the remaining payments, the contract with Mecklenburg County is ambiguous about whether it's for medical and mental health for adults, minors or both. The nonprofit's website describes puberty blockers and cross-sex hormones as options for minors, even though North Carolina is one of 27 states that have enacted laws banning, to varying degrees, youth access to medical gender treatments.

"When taxpayers fund any nonprofit they become involuntary members of that nonprofit," Ross Marchand, executive director of the Taxpayers Protection Alliance, told The Center Square. "And that pertains to anything, any nonprofit that offers anything."

The alliance, a Washington, D.C.-based nonprofit, advocates for smaller government and lower taxes and opposes compulsory donations to NGOs via taxes.

"Taxpayers unfortunately are kept in the dark about where their money is going," Marchand said, "and we have seen an explosion of dollars flowing to a variety of nonprofits, but especially healthcare nonprofits with next to no accountability."

The Center Square previously reported that the Charlotte group received $1.28 million from SAMHSA, a branch of the U.S. Department of Health and Human Services now overseen by Secretary Robert F. Kennedy Jr. That money came to the group as passthrough funds from the North Carolina Department of Health and Human Services as a grant for adult mental health services.

Tax filings and other public records discovered in a continuing investigation show the nonprofit received an even bigger budget boost from another source of federal money. Payments from the Mecklenburg County contract, paid out of American Rescue Plan Act funds, total $1.34 million. That contract calls for the nonprofit to "address the needs of transgender and gender diverse individuals by providing free medical and mental health services."

Prisha Mosley said she doesn’t want any of her tax dollars going toward that. A former North Carolina resident and an outspoken detransitioner, Mosley testified to the North Carolina General Assembly before it passed the 2023 ban law, telling how doctors and counselors set her on a path of medicalization when she was still a minor, convincing her she was a boy born in the wrong body.

A plastic surgeon removed her breasts at age 18. That doctor, Eric Emerson, is one of the 13 founding members of Charlotte Transgender Healthcare Group.

"Where do I apply for millions of dollars to provide services to those who have been harmed by this path, or are being led down this path?" Mosley, 28, told The Center Square.

But in litigation pending throughout the country, pro-LGBTQ groups have fought to stop the Trump Administration from cutting off federal funding for transgender healthcare and other causes. Days after taking office for his second term, President Trump issued executive orders barring federal funds from being used to promote gender ideology and ending all federal support for gender medical treatments on anyone under age 19.

Omar Gonzalez-Pagan, senior counsel and health care strategist at Lambda Legal, a national legal organization working on behalf of the LGBTQ population, defended the federal funding.

"Trans people are also taxpayers, and they also contribute to the public fisk with their taxes," he told The Center Square.  "We can all agree that nobody should be denied the ability to get a public education, or get mental health services, or get HIV care, or get just general primary care or housing assistance, because of who they are."

Nonprofit's revenues soar

Charlotte Transgender Health's executive director, psychologist Holly Savoy, has not responded to messages from The Center Square over the past seven weeks and did not respond to an email seeking input for this story.

The Center Square contacted Mecklenburg County Board of Commissioners Chairman Mark Jerrell, who put a reporter in touch with county Public Health spokesman Myles Bell to answer questions about the contract. Bell did not respond to the newswire's interview request before deadline.

The money for the trans-care group came out of the $215.6 million awarded to Mecklenburg County from the 2021 American Rescue Plan Act—a stimulus package authorized by President Biden and Congress to speed up the nation's recovery from the Covid pandemic. The Center Square's interview request sought to discuss why so much money was awarded to the group, why the sum of payments since 2023 is $171,000 above the contract amount, and whether any payments are outstanding. The contract's performance period concludes at the end of December. 

The Mecklenburg payments appear to be reflected in the healthcare group's most recent available tax records. Its 2024 Form 990 shows that of $737,611 in revenues, $573,234 came from government grants, or 78%.

The year before, no government grants contributed to its $226,000 in revenues. In 2022, revenues totaled just $52,437, with none coming from taxpayers, according to that year’s 990. The nonprofit's 2025 returns are not yet available.

In its 2023 annual impact report, the group, also known as Charlotte Trans Health, described the federal funds from Mecklenburg County as supporting its "biggest program to-date," the Providing Access to Trans Healthcare (PATH) program. It offers "free case management, mental health services, medical care, and limited prescription coverage assistance to trans and gender-diverse members of the Charlotte metro area who are uninsured or underinsured," the annual report said.

The group's 2024 annual report said PATH served 139 people in the Charlotte area, with two full-time case managers added to help meet demand. The 2025 report said PATH served 350 people, with more than $426,000 spent on therapy, $68,000 spent on medical care, and nearly $27,000 spent on psychiatry.

Mosley, the detransitioner who now lives in Michigan, is discussing a possible surgery with the Cleveland Clinic to remove more breast tissue after experiencing severe pain from trapped milk after the birth of her son. She also has a lawsuit pending against Dr. Emerson and other defendants involved in her "gender-affirming care." A judge dismissed her lawsuit last year on a procedural basis, but she filed an appeal, which is pending.

Mosley said state and local governments awarding grant money to a trans healthcare group is "a really easy and pain-free way to virtue signal and avoid conflict with an incredibly mentally ill demographic."

"I think it's egregious. I think it's not the desire of the general public," she told The Center Square. "I think most people agree that this is wrong. It's not healthcare. This money is being taken under a false premise, as if children are able to change sex, or anyone is, and that this leads to better outcomes. And this is false."

Payments continue despite Trump

Under a similar philosophy, President Trump issued executive orders in January 2025 designed to keep federal money away from groups such as Charlotte Trans Health. The Center Square previously reported how the nonprofit's website has a searchable providers directory that includes doctors and therapists claiming to provide "gender-affirming care" for children as young as infants and toddlers, with some of its doctors' listed services including "Hormone Replacement Therapy for Teens" and "Puberty Suppression."

"Under the age of 18," the website says on a page within its "Provider Education" section, "medical providers coordinate care with mental health providers to support youth and families in making decisions about timing, puberty suppression, or initiating hormone therapy.

A spokesman for the North Carolina health department, James Werner, told The Center Square that its $1.28 million grant to the group complies with state and federal laws and regulations, and it only covers services for adults. Charlotte Trans Health received $780,000 from the state in fiscal years 2025 and 2026, and is set for another $500,000 for payment in 2027, Werner said in an email.

A spokesperson for the U.S. Department of Health and Human Services did not respond to emailed questions about the appropriateness of the ongoing grant in light of the president's prohibition against federal funds promoting gender ideology.

"HHS takes seriously the protection of children from sex-rejecting and life-altering interventions. We endeavor to ensure that these interventions are never funded through federal grants or programs," a statement emailed by HHS press secretary Grace Jamison said.

The Charlotte group received its most recent disbursement of American Rescue Plan Act funds, a payment of $81,250, in January, Mecklenburg County records show.

Any clawback attempts of the HHS or Covid recovery money seem unlikely, as the legal validity of Trump’s orders have been called into question in court cases around the country. Judges have issued injunctions in multiple states including Maryland, Rhode Island, California and Washington. At least three of those cases involve Health and Human Services.

"When we look at the patterns, we see that the administration's efforts to retroactively cancel grants have largely been enjoined by courts," Elana Redfield, federal policy director at the Williams Institute at UCLA School of Law, told The Center Square. The Williams Institute studies sexual orientation and gender identity law and public policy, and Redfield co-authored an analysis of the executive order against gender ideology shortly after Trump signed it. 

"We see that there has been a theme of courts saying, well Congress really needs to give the executive the clear power to make these kinds of determinations, particularly if they conflict with an existing congressional objective," she said.

Gonzalez-Pagan, of Lambda Legal, said that executive order "seeks to deny the very existence of transgender people and to coerce recipients of federal funding into doing the same."

"We all know, and I think it's beyond debate, that distress because of the gender incongruence that some people experience between their sex assigned at birth and their gender identity is a real condition," he said. "It is recognized by the medical community, writ large, opponents and supporters of the care alike. And just because you disagree with a course of treatment doesn't mean that that person shouldn't have access to that course of treatment."