The U.S. Department of Health and Human Services has released a 400-plus-page report denouncing what is often referred to as “gender-affirming care” for trans-identified children, speaking out against what it says are “invasive” and “usually
irreversible” medical interventions.
Titled “Treatment for Pediatric Gender Dysphoria: Review of Evidence and Best Practices” and released Thursday, the report analyzes the impact of cross-sex hormones, puberty-blocking drugs and cosmetic sex-change surgeries for minors with gender dysphoria.
“These interventions carry risk of significant harms including infertility/sterility, sexual dysfunction, impaired bone density accrual, adverse cognitive impacts, cardiovascular disease and metabolic disorders, psychiatric disorders, surgical complications, and regret,” states the report’s introduction.
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“Meanwhile, systematic reviews of the evidence have revealed deep uncertainty about the purported benefits of these interventions.”
The report stated that it is “not a clinical practice guideline” and that “it does not issue legislative or policy recommendations.” The document is “intended for policymakers, clinicians, therapists, medical organizations and, importantly, patients and their families.”
In the executive summary, the report contends there is “currently no international consensus about best practices for the care of children and adolescents with gender dysphoria.”
“In the U.S., the current approach to treating pediatric gender dysphoria aligns with the ‘gender-affirming’ model of care recommended by the World Professional Association for Transgender Health,” reads the summary.
“This model emphasizes the use of puberty blockers and cross-sex hormones, as well as surgeries, and casts suspicion on psychotherapeutic approaches for management of gender dysphoria.”
The report was critical of WPATH’s approach, noting that a recent “systematic review of international guideline quality” said that they “lack developmental rigour and transparency.”
“Our duty is to protect our nation’s children — not expose them to unproven and irreversible medical interventions,” said National Institutes of Health Director Dr. Jay Bhattacharya in a statement. “We must follow the gold standard of science, not activist agendas.”
The American Academy of Pediatrics, an organization representing around 67,000 primary care pediatricians that has a history of supporting the use of puberty blockers and sex reassignment surgeries for trans-identified youth, denounced the HHS report.
AAP President Dr. Susan J. Kressly said in a statement Thursday that her organization was “deeply alarmed by the report,” claiming that it “misrepresents the current medical consensus and fails to reflect the realities of pediatric care.”
“AAP was not consulted in the development of this report, yet our policy and intentions behind our recommendations were cited throughout in inaccurate and misleading ways. The report prioritizes opinions over dispassionate reviews of evidence,” stated Kressly.
“We urge government officials and policymakers to approach these conversations with care, humility, and a commitment to considering the full breadth of peer-reviewed research.”
In recent years, there has been considerable debate over how to care for children with gender dysphoria, with some medical professionals advocating for surgical and hormonal processes that support the trans ideology of a minor.
For example, the American Medical Association has stated that they support “improving access to gender-affirming care,” claiming it “is an important means of improving health outcomes for the transgender population.”
“Receipt of gender-affirming care has been linked to dramatically reduced rates of suicide attempts, decreased rates of depression and anxiety, decreased substance use, improved HIV medication adherence and reduced rates of harmful self-prescribed hormone use,” the AMA added.
Last December, the United Kingdom’s National Health Service moved to indefinitely ban the use of puberty-blocking drugs on children for the foreseeable future, except for use in clinical trials.
“The Commission on Human Medicines (CHM) has provided independent expert advice that there is currently an unacceptable safety risk in the continued prescription of puberty blockers to children,” announced the U.K. Department of Health and Social Care.
“Puberty blockers for the treatment of gender incongruence and/or gender dysphoria in under 18s were banned temporarily in May 2024 after the Cass Review found there was insufficient evidence to show they were safe. Legislation will be updated today to make the order indefinite and will be reviewed in 2027.”
Commissioned by the NHS in 2020 as a review of its gender identity services for youth, the “Cass Review” found there is “no good evidence on the long-term outcomes of interventions to manage gender-related distress.” Amid an exponential rise in minors being referred to the Tavistock gender clinic in the U.K., the review urged the NHS to adopt a different service model when it comes to treating gender dysphoria.
Hilary Cass, the retired former president of the Royal College of Paediatrics and Child Health, led the review.
The report stated that even though some studies show that the use of puberty blockers for children with gender dysphoria is “beneficial in reducing mental distress and improving the wellbeing of children and young people with gender dysphoria,” the “quality of these studies is poor.”
The HHS report released Thursday offered its support for the Cass Review, but also suggested that providing youth with hormonal and surgical interventions, even in research trials, is unethical “until and unless the state of the evidence suggests a favorable risk/benefit profile for the studied intervention” and “the researchers have wellgrounded confidence that the foreseeable ‘risks and burdens have been adequately assessed and can be satisfactorily managed.'”
“Criticism of the Cass Review appears to stem largely from a U.S.-based group of motivated advocates for the continued legality of [pediatric medical transition]. The critiques are ridden with misrepresentations of the Cass Review and contain multiple factual errors,” the HHS report stated.
“In the UK, the Cass Review has been widely accepted as a foundational document for realigning pediatric gender medicine with the principles of evidence-based medicine and child safeguarding. It has been welcomed by both major political parties in the UK, and was fully accepted by the NHS for implementation, which is well underway.”
In February, the American College of Pediatricians, a 600-member “national organization of pediatricians and other healthcare professionals dedicated to the health and well-being of children,” released a review of dozens of studies and argued that providing gender transition procedures to minors with gender dysphoria does not lead to an improvement in mental health.
The paper contends that parents and health care professionals “who support the transgender ‘transition’ of children and adolescents are, in fact, contributing to increased depression by appearing to validate to the children that ‘something is wrong with their body and biological sex.'”
The report’s author, ACP board member Dr. Jane Anderson, previously told The Christian Post that there is a “high incidence of adolescents who come into this medical care who have a previous history of depression or anxiety or autism or other medical or psychological concerns.”
“And those issues have to be dealt with first,” she added. “It’s just crucial that they receive the mental health services and support that they so desperately need.”
