In a recent Twitter thread, political commentator Matt Walsh outlined work that he and an investigative team uncovered about Vanderbilt University Medical Center’s (VUMC) Clinic for Transgender Health, which provides medical interventions for adults and children.

Opening in 2018, the clinic was “intended as a comprehensive health care provider,” according to reports at the time. The clinic said it offered “primary care, medical specialists, mental health services, hormone therapy, and guidance both before and after transition surgery.”

“This new clinic allows us to meet our patients where they are in their journeys and help them with the resources they need,” said Dr. Shayne Taylor, medical director of the clinic, at the time of the opening.

Despite the warm overtures by Dr. Taylor, a video uncovered by Walsh implies that she and Vanderbilt’s motives for opening the clinic were not wholly altruistic or patient-focused but were instead motivated by profit.

“[We] put down some costs of how much money we think each patient would bring in, and this is only including top surgery; this isn’t including any bottom surgery, and it’s a lot of money,” Taylor said on the video.

Continuing, she reiterated, “These surgeries make a lot of money.”

For example, Taylor said, “female to male chest reconstruction can bring in $40,000.”

Another example was provided. “A patient just on a routine hormone treatment, who I’m only seeing a few times a year, can bring in several thousand dollars.” She said, “It actually makes money for the hospital.”

She referred to numbers she found on the internet from the Philadelphia Center for Transgender Surgery, giving the audience “an idea of how much money these bottom surgeries are making.”

Taylor then went on to report that a vaginoplasty — which according to Boston Children’s Hospital, is the “surgical creation of a vagina” from “existing genital tissue, including the penis” — would bring in $20,000. Taylor said this “has to be a gross underestimate” and could be as low as “10% of it,” all told.

“These are huge money makers,” the doctor proclaimed.

Another video uncovered by Walsh and his team captured Dr. Ellen Clayton speaking directly to those who may take issue with providing these types of surgeries.

“If you are going to assert conscientious objection, you have to realize that that is problematic,” said Dr. Clayton. “I just want you to take home that saying, that you’re not going to do something because of your conscientious — because of your religious beliefs, is not without consequences, and should not be without consequences.”

“If you don’t want to do this kind of work, don’t work at Vanderbilt,” Clayton instructed.

The backlash has been quick and widespread since Walsh revealed these findings. The governor of Tennessee, Bill Lee, has called for an investigation into VUMC’s transgender clinic.

In a recent statement, Lee said, “The ‘pediatric transgender clinic’ at Vanderbilt University Medical Center raises serious moral, ethical, and legal concerns.”

“We should not allow permanent, life-altering decisions that hurt children or policies that suppress religious liberties, all for the purpose of financial gain,” Lee added. “We have to protect Tennessee children, and this warrants a thorough investigation.”

Since Walsh’s investigation broke, the VUMC’s transgender clinic’s website has been pulled offline. However, VUMC has released a statement claiming that Walsh and his team “misrepresent facts about the care” they provide to transgender patients.

Pushing back against the perception that they are motivated by potential profits, VUMC says it “began its Transgender Health Clinic because transgender individuals are a high-risk population for mental and physical health issues and have been consistently underserved by the U.S. health system.”

VUMC also stated that its “policies allow employees to decline to participate in care they find morally objectionable, and do not permit discrimination against employees who choose to do so. This includes employees whose personal or religious beliefs do not support gender-affirming care for transgender persons.”