Inclusion and Gender Equality Means Cisgender Boys and Men are not Allowed.

The Renfrew Center presents itself as an “inclusive” eating disorder treatment system. Its website says eating disorders affect people regardless of gender, describes diversity as something to be celebrated, advertises specialized programming for historically marginalized populations, and tells prospective patients that cost should not prevent access to care.

However, its admissions policy contradicts that message. “Inclusion” ends at the admission door.

Renfrew offers treatment to “cisgender adolescent girls and women,” “transgender adolescents and adults,” and “gender non-binary adolescents and adults.” The missing element? Cisgender boys and men. A biological male who identifies as a woman can qualify for admission, as can a transgender man or nonbinary patient, while a biological male who identifies as a man cannot.

This is not an ambiguity buried in an outdated brochure. Renfrew has defined the categories itself and continues to publish them under the heading “Expert Care for All.” What Renfrew failed to do is to say that its “Expert Care for All” specifically excludes boys and men. Unless of course you are transgender or non-binary. The hypocrisy is appalling.

The Excluded Population Is Substantial

This exclusion cannot be defended as affecting some negligible fraction of the eating disorder population. The American Psychological Association reports that boys and men account for approximately one third of people diagnosed with eating disorders and describes the long history of male patients being overlooked because these illnesses were treated culturally and clinically as diseases of girls and women. Male patients were underrepresented in research, screening instruments frequently reflected female presentations, and diagnostic criteria historically incorporated assumptions tied to female biology.

Renfrew emerged from that history. When it opened in 1985, the organization was built around the treatment of women and girls, a model consistent with the prevailing view of eating disorders at the time. Scientific understanding changed, and Renfrew expanded its admission categories, but it did so without correcting the exclusion of cisgender males.

The resulting policy is more difficult to justify than Renfrew’s original women only model. Renfrew no longer limits treatment to women, nor does it limit admission according to biological sex. Instead, it admits patients across several gender identities while continuing to reject males who identify as male.

That distinction affects a population already harmed by the eating disorder field’s historic failure to recognize them. A boy with anorexia does not have a less serious disease because he identifies as male, and an adult man with bulimia or binge eating disorder does not require less specialized treatment because his biological sex and gender identity correspond. Yet under Renfrew’s published policy, that characteristic excludes him.

If Renfrew contends that its therapeutic model requires a female environment, the admission of transgender women and nonbinary patients defeats that explanation. If biological sex supplies the justification, the admission of transgender women who were born male creates the opposite problem. If gender identity controls, Renfrew is left attempting to defend a policy under which identifying as male becomes the characteristic that closes the door.

Those operational concerns cannot explain the categorical exclusion of cisgender boys and men. Renfrew has already demonstrated that its historical treatment model can be modified to accommodate patients who fall outside the population for which the institution was originally designed. It has chosen not to make that accommodation available to cisgender males.

Financial Inclusion Has Its Own Boundary

Renfrew’s claims about accessibility extend beyond gender. Its website says the cost of care “should never get in the way of quality treatment,” advertises acceptance of more than 400 insurance plans, and prominently identifies Aetna, Blue Cross Blue Shield, Cigna, Optum/United Behavioral Health and Fidelis Care.

Medicare and Medicaid are not specifically identified on that page. Renfrew knows how to tell commercially insured patients that major carriers are accepted, yet patients who depend on the country’s principal public insurance programs receive no comparable statement about access.

The omission is particularly significant because Renfrew may participate in Medicaid managed care in New York. Renfrew publicly states that it is in network with Fidelis Care for all levels of in person and virtual care. The question remains, does the Fidelis relationship include Fidelis Medicaid Managed Care?

That fact changes the character of the inquiry. Medicaid reimbursement is not merely another commercial payment source. It includes federal financial assistance and carries federal civil rights obligations. A provider accepting that funding cannot separate its public claims of “inclusion” from the nondiscrimination requirements attached to participation in federally funded health care.

Federal Money Carries Federal Civil Rights Obligations

If Renfrew accepts Fidelis Medicaid Managed Care, it is subject to Section 1557 of the Affordable Care Act, 42 U.S.C. § 18116(a), which prohibits discrimination on grounds incorporated from federal civil rights statutes, including sex discrimination under Title IX, in covered health programs receiving federal financial assistance.

The current regulations reinforce that prohibition. Under 45 C.F.R. § 92.101(a)(1), an individual may not, on the basis of sex, be excluded from participation in, denied the benefits of, or subjected to discrimination under a covered health program or activity. Section 92.4 defines covered health programs broadly and provides that, for an entity principally engaged in providing health care, the relevant program can encompass all of the entity’s operations.

Renfrew’s published policy presents a direct sex discrimination question. A cisgender woman with an eating disorder falls within the population Renfrew says it treats. Transgender and non-binary people are welcomed. But a cisgender man with the same diagnosis falls outside it. The distinction is categorical and precedes any individualized clinical judgment.

The legal claim of a cisgender boy or man does not depend on contested federal protections for transgender status. His complaint is far simpler: he is male, he has an eating disorder Renfrew treats, and on the basis of sex, Renfrew excludes him from eligibility while admitting female patients.

Taken together, those facts present a focused federal question. Sources have said that Renfrew’s New York operation participates in Medicaid managed care, its provider NPI identifies The Renfrew Centers, Inc. as the legal business name, and the organization publishes a categorical admissions policy excluding cisgender boys and men.

If discrimination on the basis of sex is established, and if Renfrew accepts federal funds through Fidelis Medicaid Managed Care, they are subject to federal law. And now they may have a huge issue.

In the event Renfrew does not accept Medicaid funds, it can carte blanche continue with its discriminatory conduct with impunity from the federal government. Renfrew would then merely be hypocritical and beneath contempt. But, it’s conduct would not technically be illegal. But, if it is accepting Medicaid funds …

Meanwhile, additional issues continue internally.

Residential Treatment Forces the Issue Into the Room

Renfrew’s expansion beyond cisgender women also creates practical issues that do not arise in the abstract language of “inclusion.”

Renfrew operates residential treatment facilities in Philadelphia and Coconut Creek, Florida. At its Philadelphia residential campus, Renfrew tells incoming patients that most bedrooms contain two beds and that patients will likely have a roommate. Its published explanation says roommates are “typically paired by age,” separating adolescents from adults. It does not publicly describe gender identity, biological sex, anatomy, trauma history or patient preference as roommate matching criteria. Admitting transgender and nonbinary patients necessarily requires policies governing privacy, trauma histories, roommate assignments and intimate residential settings. Whatever difficulties accompany those decisions, Renfrew has decided they can be managed when the patient is transgender or nonbinary.

If a cisgender adolescent girl may share a bedroom with a transgender adolescent, parents are entitled to know the criteria governing that placement. The same is true for a transgender patient whose trauma history or privacy concerns may make another placement inappropriate. The clinically serious answer cannot be that identity automatically overrides every other consideration.

Those issues demand transparency.

Renfrew’s own educational material says eating disorders do not discriminate. Its “inclusion” campaign recognizes that men have historically been overlooked. Its support programming is organized around populations that have experienced marginalization (except boys and men). Its financial materials say cost should not stand between a patient and quality care. Mere empty words contradicted by its own conduct.

On September 2, 2026, Renfrew is rolling out a new virtual support group, “Sexuality and Gender Equality (SAGE) Support Group.” Gender equality? Renfrew’s hypocrisy cannot be understated. Pontificating on “gender equality” while systemically excluding a population which may consist of up to 1/3 of those afflicted with eating disorders is the height of inane hubris. It would almost  be humorous … if it was not so tone deaf and tragic.

After four decades of very little progress in our understanding of eating disorders, the most excluded patient is not difficult to identify.

He is the boy with anorexia.

He is the male college athlete purging in secrecy.

He is the gay man whose sexuality may place him at elevated eating disorder risk.

He is the middle-aged father with binge eating disorder.

He is the patient the eating disorder field spent years failing to see.

And at Renfrew, he is the patient standing outside … unwanted and ignored.