U.S. Health and Human Services deviates from key medical organizations in assessment of pediatric transgender treatments
In a shocking move, the Trump administration's Department of Health and Human Services kicked off a firestorm on Thursday by releasing a scathing review challenging the quality of evidence surrounding transition-related care for minors. The 409-page report claims that U.S. doctors have been putting their patients in harm's way by providing transition-related care, stating, "many U.S. medical professionals and associations have fallen short of their duty to prioritize the health interests of young patients."
The HHS review asserts that the evidence supporting medical interventions for youth with gender dysphoria is disappointingly low, with limited data on psychological outcomes, quality of life, regret, and long-term health. The report also claims that evidence for harms associated with pediatric medical transition is "sparse," but encourages readers to exercise caution due to the absence of studies tracking and reporting harms.
The World Professional Association for Transgender Health (WPATH), an international non-profit organization of medical professionals dedicated to promoting trans health care, took a hit as the HHS review harshly criticized its guidelines as biased and politically motivated. The HHS report alleged that WPATH has influenced U.S. medical associations to create a false perception of consensus regarding transition care for minors despite concerns from whistleblowers and detransitioners (those who no longer identify as trans or regret transition care).
The HHS review casts doubt on the recent increase in studies associating gender dysphoria with suicidal thoughts, as well as those that link access to transition care with improved mental health outcomes for youth. To counterbalance these practices, the report calls for psychotherapy as a "noninvasive alternative to endocrine and surgical interventions for the treatment of pediatric gender dysphoria," and encourages further research on the effects of exploratory psychotherapy for minors.
The controversial review represents the latest escalation in the Trump administration's efforts to restrict access to transition care and other rights for trans people. Since taking office, President Trump issued several executive orders targeting trans people, including one declaring there are only two immutable sexes assigned at birth, another banning trans people from serving or enlisting in the military, and one prohibiting federal funding for hospitals providing transition care to minors.
The administration's Jan. 28 order required the Department of Health and Human Services to publish a review of the existing literature on best practices for promoting the health of children who assert gender dysphoria. The HHS review notes that it is not a clinical practice guideline, but its findings could still affect access to transition care for minors nationwide by fanning the flames of the political debate surrounding the issue.
The review's findings ran counter to the stance of major U.S. medical associations, including the American Medical Association, American Academy of Pediatrics, and American Psychological Association, which support access to transition-related care for minors and oppose restrictions. In response, medical associations and trans activists immediately slammed the review, criticizing its methods and lack of transparency.
Most notably, HHS did not list any of the review's authors, which appears to be a break with protocol, as the names of authors are generally required on any scientific publication. In an effort to explain the omission, a news release from HHS stated, "Chapters of this review were subject to peer review prior to this publication, and a post-publication peer review will begin in the coming days involving stakeholders with different perspectives." Critics argue this practice is highly unusual and raises concerns about the study's credibility.
The report's focus on exploratory psychotherapy featured prominently, as critics equated this approach to conversion therapy rebranding. Concerns abound that the Trump administration's emphasis on psychotherapy could lead to a potential return to discredited practices that aim to change someone's sexual orientation or gender identity. LGBTQ advocacy organizations, medical experts, and patients warn that the administration's actions could endanger evidence-based care and exacerbate the already high suicide rates among LGBTQ youth.
- The HHS review asserts that evidence supporting therapies and treatments for minors with gender dysphoria in the field of health-and-wellness, particularly mental health, is insufficient and needs further exploration.
- The administration's Department of Health and Human Services, through this review, has raised concerns about the overrepresentation of certain policies and legislations in the policy-and-legislation sector that advocates for transition-related care for minors.
- The World Professional Association for Transgender Health (WPATH) criticizes the HHS review for claiming that their guidelines on transition care for minors are biased and politically motivated, impacting its international nonprofit reputation.
- The funding for hospitals providing transition-related care to minors has been restricted by the Trump administration's executive orders, creating a significant barrier for access to such services, as stated in the general news.
- The scientific community, in response to the HHS review, is calling for more studies on the psychological outcomes, quality of life, regret, and long-term health of patients receiving transition-related funding and care.
- The HHS review has been met with criticism for not listing any of its authors, raising questions about the study's credibility and transparency, as this is usually standard practice for scientific publications.
- The controversial review encourages exploration of psychotherapy as a noninvasive alternative to endocrine and surgical interventions for treating pediatric gender dysphoria, sparking concerns among LGBTQ advocacy organizations, medical experts, and patients that it may bring back conversion therapy practices, negatively impacting the health and well-being of minors.
