A Charlotte nonprofit that serves transgender adults is using $1.3 million in federal funding as intended for mental health services, WFAE has learned, despite recent reports that suggest the group is improperly providing gender-affirming medical care or services to minors.
The N.C. Department of Health and Human Services awarded Charlotte Trans Health $1.28 million in 2024 through a federal block grant program. The nonprofit connects transgender patients with health care providers and other resources.
Executive Director Holly Savoy said the money supports the organization's PATH program, which helps uninsured and underinsured transgender adults access mental health care.
“Someone may be uninsured, struggling with depression or anxiety, or having difficulty navigating the health care system, and they can work with a case manager, access psychotherapy, get connected with other community resources, and that's really what the grant's supporting,” Savoy said.
The funding has recently come under scrutiny from The Center Square, a national online news organization focused on government accountability. The outlet has published two reports questioning the grant.
The Center Square pointed to Charlotte Trans Health's online provider directory, where some independent providers list services for minors, and questioned how the state ensures federal grant money isn't being used for those services.
But grant documents obtained by WFAE show the funded program is specifically for patients 18 and older. It provides case management, therapy, psychiatric medication management and connections to other medical and social services.
“Charlotte Trans Health is more of a bridge,” Savoy said. “We're not a medical clinic. We're not a mental health practice, and that's an important distinction.”
The funding comes from the federal Substance Abuse and Mental Health Services Administration, or SAMHSA, and is administered by NCDHHS.
North Carolina law prohibits doctors from providing puberty blockers, hormone therapy, or gender-transition surgery to minors, with limited exceptions. It does not prohibit mental health professionals from providing therapy to minors.
Savoy said Charlotte Trans Health's online directory is separate from the grant and that providers listed there are independent of the nonprofit.
“None of this grant funding pays for hormone therapy, puberty blockers, surgery, or other medical transition-related care,” Savoy said. “It funds mental health counseling, case management, and related support services for adults.”
NCDHHS backed up that distinction in a statement to WFAE. The department said the contract does not cover services for children or gender-affirming surgery for either children or adults.
The department said the contract complies with applicable state and federal laws and is subject to its standard administrative and financial oversight. Based on information available through that oversight, NCDHHS said it believes Charlotte Trans Health's use of the funding is consistent with the contract.
David Heinen, vice president for public policy and advocacy at the North Carolina Center for Nonprofits, said government grants typically come with specific guidelines governing how nonprofits can spend the money.
“For the most part, government grants are not general operating support for nonprofits but rather are restricted grants that need to be used for the particular purpose,” Heinen said.
Charlotte Trans Health's contract requires the organization to submit quarterly reports detailing services and outcomes. It is also subject to state and federal reporting requirements, and NCDHHS and the state auditor can access relevant records.
Heinen said an audit that finds a nonprofit spent government money outside the terms of a grant agreement could result in the organization being required to return the funding.
Savoy said the increased scrutiny surrounding transgender health care has created uncertainty for the people Charlotte Trans Health serves.
“People are just trying to understand whether they will continue to have access to health care at any age, whether their insurance will cover it, whether they'll be treated respectfully when they seek care, and even whether it's safe to identify themselves as transgender in healthcare settings,” Savoy said.
Last year, Charlotte Trans Health served more than 170 new clients through its PATH program and provided more than 3,800 hours of therapy.
