Taxpayer Philanthropy: Detransitioner suing a surgeon linked to trans-care nonprofit

The state contract was exposed in an investigation by The Center Square earlier this month, raising questions about how the state could spend money on a trans care group after the 2023 law. The nonprofit's website promotes hormone therapies for minors, which the law banned. 

"It's disheartening," Mosley told The Center Square. "It shows that some people put ideology and their own idea of morality above the law. And above victim testimony."

Tami Fitzgerald, executive director of the NC Values Coalition, a conservative Christian nonprofit and lobbying group that invited Mosley to speak to lawmakers, said the nonprofit's connection to the doctor in her case raises more questions about the health department grant.

"I find it really outrageous," Fitzgerald said, "that the state of North Carolina would fund this transgender healthcare group that Dr. Emerson founded, a year after Prisha testified before the General Assembly about the horrific, sex-denying procedures that were done to her that really have mutilated her body and left her as a lifelong patient."

Those procedures were done in North Carolina, and Dr. Emerson is among the defendants in a lawsuit Mosley filed in Gaston County in 2023 that includes claims of fraud, civil conspiracy, medical malpractice and negligent infliction of emotional distress.

Mosley testified that year before the House Health Committee that doctors and counselors set her on a path of medicalization when she was still a minor, convincing her that changing her body through testosterone and surgery to remove her breasts would cure her mental health problems. She described meeting with a surgeon who "expressed eagerness in performing gender-affirming 'top surgery' on me."

"At age 18, my healthy breasts were cut off of my chest and incinerated," Mosley testified. 

A judge dismissed her lawsuit against Emerson and other defendants last year on a procedural basis, ruling that her claims came too late. Mosley has filed an appeal, arguing that the judge ignored a new 2025 state law that extended the statute of limitations to 10 years after discovery of alleged harm from medical gender transition treatments.

Mosley spoke to the General Assembly before they passed that law, too. Again, it took an override of the Democratic governor's veto.

Including North Carolina, 27 states have enacted laws which, to varying degrees, ban or restrict medical gender treatments on youth. North Carolina outlaws puberty blockers, cross-sex hormones and surgeries on anyone younger than 18. 

Mosley has traveled around the country testifying in favor of other bans, estimating she's been to at least 22 states including Florida, Louisiana, Ohio and Texas. 

The $1.28M grant

The Center Square reported earlier this month how North Carolina is paying taxpayer money to the group that Mosley’s surgeon co-founded: Charlotte Transgender Healthcare Group. The nonprofit is a network of doctors, therapists and other healthcare providers dedicated to advancing "health equity for transgender and gender diverse individuals through education, advocacy, and accessible, affirming care," according to its website.

Emerson is one of the 13 founding members listed on the nonprofit’s website.

The site also touts puberty blockers and cross-sex hormones as treatment options for minors under 18. It has a searchable providers directory that includes doctors and therapists claiming to provide "gender-affirming care" for children as young as infants and toddlers. Some of its doctors' listed services include "Hormone Replacement Therapy for Teens" and "Puberty Suppression."

Also known as Charlotte Trans Health, the group received $780,000 in fiscal years 2025 and 2026, and is set for another $500,000 for payment in 2027, Health and Human Services spokesman James Werner told The Center Square by email. The money came out of a pot of federal funds distributed to North Carolina from the U.S. Substance Abuse and Mental Health Services Administration.

The Center Square discovered the payments as part of its "Taxpayer Philanthropy" investigative series, which reported that since 2016, government grants to nonprofits nationwide doubled to $319 billion, and the number of nonprofits that receive tax money doubled to more than 100,000.

Werner said the grant to the Charlotte trans-care group is only for adult mental health services, but the department has not explained how it's ensuring funds aren't intermingled with outreach to children nor produced any oversight records.

The spokesman said the grant complies with North Carolina law and federal laws and regulations, including an executive order from President Donald Trump forbidding federal grants from being used to "promote gender ideology."

"The scope of services provided by Charlotte Transgender Healthcare Group under this contract with the Department is limited," Werner wrote in an emailed statement. "Funds allocated to Charlotte Transgender Healthcare Group are used for adult mental health services including case management, psychotherapy, and linkage to medical services limited to mental health counseling."

Mosley told The Center Square she doesn't accept that explanation. She pointed out that while her surgery happened at 18, doctors began transitioning her at 16 with Depo-Provera to stop menstruation, then put her on testosterone at 17.

"This is something you're groomed into doing, and that's what this website exists to do," Mosley, now 28, said. "To groom people and to raise money to groom people."

Charlotte Trans Health's executive director, psychologist Holly Savoy, has not responded to messages from The Center Square inquiring about the grant.

Mosley vs. Emerson

In a brief phone call, Dr. Emerson told The Center Square he had no comment on the state sending funds to Charlotte Trans Health so soon after lawmakers heard testimony from Prisha Mosley, nor would he talk about the activities of the nonprofit.

"I can't speak for the group," Emerson said. "I'm no longer a member of the group and I've retired."

Asked about the organization during a deposition in the Mosley lawsuit, Emerson said it launched in 2012 but didn’t form as a nonprofit until 2020. The purpose was to "share knowledge" because of a "dearth of information and ability to collaborate with other providers in different specialties to provide the best care for these patients," he said, according to deposition transcript. "It was a fairly casual group that would get together once a month to discuss different parts of care, patients with gender incongruity."

In those intervening years, he operated on Mosley in 2016.

Mosley came to have major regrets.

She told The Center Square how she struggled with mental health issues during a tumultuous childhood. At 14, she said, she became pregnant from a sexual assault and miscarried.

She connected online with trans-identifying adults who she said manipulated her, and doctors and therapists would manipulate both her and her parents, Mosley said. The so-called "gender-affirming care" started after she told a nutritionist that she hated being a girl. One counselor told her she was actually a boy after meeting with her for a matter of minutes, she said. Doctors led her to believe that if she "put on a boy costume, a man costume, a male disguise, I would be safe and happy and healthy and harm would stop coming to me."

"I just became a less healthy, virilized woman who continued to need mental health care and better people around me in my life," she said.

Now living in Michigan, Mosley has a 2-year-old son and said she suffered severe complications from trapped breast milk. She recently posted on X that she's discussing a possible surgery with the Cleveland Clinic to remove more breast tissue so she can have another child without enduring that pain.

She said she eventually wants to have an aesthetic procedure "so I can look and feel normal."

"It doesn't look like a man's chest," she said. "It looks like a mutilated woman's chest, and it's not normal no matter the clothes I wear."