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My bet is the government gives cash bonuses for every gender affirming reassignment procedure.

They did that for 50 years to native American women and girls. Need an appendix out? Tubes tied. Tonsils? Tubes tied. Compound fracture? Tubes tied. Numbers thrown around were as much as $10K each.

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” government gives cash “

that’s an interesting angle ...and we do have a history of that sort of thing.
With all the “grant”money that flows around ...somebody needs to do some auditing ...