The Department of Health and Human Services has released a much-anticipated report on the “treatment for pediatric gender dysphoria”—that is, a feeling of distress over one’s biological sex. In a review of studies of how to treat the disorder, the report finds that “the overall quality of evidence concerning the effects of any intervention on psychological outcomes, quality of life, regret, or long-term health, is very low.”
The report, published Thursday, was commissioned by President Donald Trump in one of his early actions as president, a January 28 executive order titled “Protecting Children from Chemical and Surgical Mutilation.”
Don’t let the incendiary title of that order mislead you. It has resulted in a sober and scholarly 409-page document, “Treatment for Pediatric Gender Dysphoria: Review of Evidence and Best Practices,” recalling similar surveys done in other Western countries.
The U.S. report analyzes 17 international reviews of the medical evidence examining social transition, puberty blockers, cross-sex hormones, surgery, and psychotherapy. The reviews reveal “deep uncertainty” about the purported benefits of these interventions, while finding that the risks are substantial and include: “infertility/sterility, sexual dysfunction, impaired bone-density accrual, adverse cognitive impacts, cardiovascular disease and metabolic disorders, psychiatric disorders, surgical complications and regret.”
The report also finds that:
The authors cite throughout the UK’s Cass Review. Conducted by senior British pediatrician Hilary Cass and released in its final form last year, it concluded that there is “remarkably weak evidence” for medical interventions in pediatric gender care. Its findings sparked an overhaul of Britain’s approach to gender-confused youth. Puberty blockers and cross-sex hormones are no longer routinely prescribed to minors across the UK.
But while the HHS report draws conclusions that are similar to major reviews not just in the UK but in Sweden and Finland, it’s caught in the cross fire of an American culture war, so it may be more easily dismissed as a partisan campaign.
The HHS report’s findings are also in keeping with the conclusions of many doctors and practitioners who have warned in these pagesabout the growing power of a gender-medicine orthodoxy.
One Finnish psychiatrist, Riittakerttu Kaltiala described the pressure she faced to “intervene in healthy, functioning bodies simply on the basis of a young person’s shifting feelings about gender.” Gender-clinic whistleblower Jamie Reed—who is cited throughout the HHS report—described one young patient, three months after her double mastectomy, who reverted to feminine pronouns and told the clinic’s nurse, “I want my breasts back.”
The growing international alarm about the harms done by transitioning vulnerable minors has been ignored by much of the legacy press in the U.S. In keeping with this reluctance to acknowledge the harm done by gender transitions, the Associated Press story on the HHS report quotes LGBT activistscomplaining about the “federal government injecting politics and ideology into medical science” and being insufficiently “neutral” without acknowledging the report’s sober evidence review or even the possibility that the field may be politicized by those in favor of medically transitioning minors.
Not helping matters is the fact that the report’s nine authors—which include “medical doctors, medical ethicists, and a methodologist” and, according to HHS, represent “a wide range of political viewpoints and were chosen for their commitment to scientific principles”—remain anonymous.
The government explains that this is “to help maintain the integrity” of the post-publication peer review process, but this anonymity risks becoming a distraction—and an opportunity for critics to undermine the report’s legitimacy. (The Free Press was informed off-the-record of two of the contributors, who are experts on this issue.)
The HHS report notes that major medical associations, the American Academy of Pediatrics, the Endocrine Society, the American Psychological Association, the American Academy of Child and Adolescent Psychiatry, the American Psychiatric Association, all continue to support what is known as “gender affirming care”—that is quick social and medical transitioning of gender dysphoric minors.
The report questions this “apparent consensus.” The authors note this unanimity is “driven primarily by a small number of specialized committees,” adding that “it is not clear that the official views of these associations are shared by the wider medical community, or even by most of their members.” The report also notes that “there is evidence that some medical and mental-health associations have suppressed dissent and stifled debate about this issue among their members.”
In a section titled “Psychotherapy,” the authors examine the need for open-minded psychological support of young people experiencing gender dysphoria. They note that the rise of gender dysphoria is occurring against the backdrop of a broader mental-health crisis affecting adolescents. The report investigates the controversies surrounding suicidal ideation, and examines the “more robust evidence base” in support of psychotherapeutic approaches, rather than pediatric transition, to address symptoms like anxiety and depression.
The report notes critics of such psychological support mischaracterize this approach as “conversion therapy.” This is a reference to the largely historic, and discredited, efforts to force gay people to be straight. But the authors explain that these exploratory therapies in fact seek to reduce a minor’s distress about their body or social role, helping them accept their bodies as they are without imposing any gender stereotypes.
In the HHS report, the authors regret the politicization of the topic. While they do not offer specific policy proposals, they note that other countries have come to the same conclusions and responded with a much-needed course correction.
But the Trump administration is going all-in on the politics of this issue. Last month, Attorney General Pam Bondi announced civiland potentially criminal investigations regarding pediatric gender transition. This includes investigating medical providers and pharmaceutical companies who “mislead the public about the long-term side effects of chemical and surgical mutilation” as well as “all suspected cases of female genital mutilation performed under the banner of so-called ‘gender affirming care’ or otherwise.”
In a memorandum to Department of Justice employees, she instructed them to “enforce rigorous protections and hold accountable those who prey on vulnerable children and their parents.”
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The report, published Thursday, was commissioned by President Donald Trump in one of his early actions as president, a January 28 executive order titled “Protecting Children from Chemical and Surgical Mutilation.”
Don’t let the incendiary title of that order mislead you. It has resulted in a sober and scholarly 409-page document, “Treatment for Pediatric Gender Dysphoria: Review of Evidence and Best Practices,” recalling similar surveys done in other Western countries.
The U.S. report analyzes 17 international reviews of the medical evidence examining social transition, puberty blockers, cross-sex hormones, surgery, and psychotherapy. The reviews reveal “deep uncertainty” about the purported benefits of these interventions, while finding that the risks are substantial and include: “infertility/sterility, sexual dysfunction, impaired bone-density accrual, adverse cognitive impacts, cardiovascular disease and metabolic disorders, psychiatric disorders, surgical complications and regret.”
The report also finds that:
- Many of the studies done in the U.S. in support of transitioning minors suffer from serious methodological flaws.
- U.S. medical associations create a perception of consensus in favor of pediatric medical transitions that does not exist and even suppress dissent and debate.
- There is “no evidence that pediatric medical transition reduces the incidence of suicide, which remains, fortunately, very low.”
The authors cite throughout the UK’s Cass Review. Conducted by senior British pediatrician Hilary Cass and released in its final form last year, it concluded that there is “remarkably weak evidence” for medical interventions in pediatric gender care. Its findings sparked an overhaul of Britain’s approach to gender-confused youth. Puberty blockers and cross-sex hormones are no longer routinely prescribed to minors across the UK.
But while the HHS report draws conclusions that are similar to major reviews not just in the UK but in Sweden and Finland, it’s caught in the cross fire of an American culture war, so it may be more easily dismissed as a partisan campaign.
The HHS report’s findings are also in keeping with the conclusions of many doctors and practitioners who have warned in these pagesabout the growing power of a gender-medicine orthodoxy.
One Finnish psychiatrist, Riittakerttu Kaltiala described the pressure she faced to “intervene in healthy, functioning bodies simply on the basis of a young person’s shifting feelings about gender.” Gender-clinic whistleblower Jamie Reed—who is cited throughout the HHS report—described one young patient, three months after her double mastectomy, who reverted to feminine pronouns and told the clinic’s nurse, “I want my breasts back.”
The growing international alarm about the harms done by transitioning vulnerable minors has been ignored by much of the legacy press in the U.S. In keeping with this reluctance to acknowledge the harm done by gender transitions, the Associated Press story on the HHS report quotes LGBT activistscomplaining about the “federal government injecting politics and ideology into medical science” and being insufficiently “neutral” without acknowledging the report’s sober evidence review or even the possibility that the field may be politicized by those in favor of medically transitioning minors.
Not helping matters is the fact that the report’s nine authors—which include “medical doctors, medical ethicists, and a methodologist” and, according to HHS, represent “a wide range of political viewpoints and were chosen for their commitment to scientific principles”—remain anonymous.
The government explains that this is “to help maintain the integrity” of the post-publication peer review process, but this anonymity risks becoming a distraction—and an opportunity for critics to undermine the report’s legitimacy. (The Free Press was informed off-the-record of two of the contributors, who are experts on this issue.)
The HHS report notes that major medical associations, the American Academy of Pediatrics, the Endocrine Society, the American Psychological Association, the American Academy of Child and Adolescent Psychiatry, the American Psychiatric Association, all continue to support what is known as “gender affirming care”—that is quick social and medical transitioning of gender dysphoric minors.
The report questions this “apparent consensus.” The authors note this unanimity is “driven primarily by a small number of specialized committees,” adding that “it is not clear that the official views of these associations are shared by the wider medical community, or even by most of their members.” The report also notes that “there is evidence that some medical and mental-health associations have suppressed dissent and stifled debate about this issue among their members.”
In a section titled “Psychotherapy,” the authors examine the need for open-minded psychological support of young people experiencing gender dysphoria. They note that the rise of gender dysphoria is occurring against the backdrop of a broader mental-health crisis affecting adolescents. The report investigates the controversies surrounding suicidal ideation, and examines the “more robust evidence base” in support of psychotherapeutic approaches, rather than pediatric transition, to address symptoms like anxiety and depression.
The report notes critics of such psychological support mischaracterize this approach as “conversion therapy.” This is a reference to the largely historic, and discredited, efforts to force gay people to be straight. But the authors explain that these exploratory therapies in fact seek to reduce a minor’s distress about their body or social role, helping them accept their bodies as they are without imposing any gender stereotypes.
In the HHS report, the authors regret the politicization of the topic. While they do not offer specific policy proposals, they note that other countries have come to the same conclusions and responded with a much-needed course correction.
But the Trump administration is going all-in on the politics of this issue. Last month, Attorney General Pam Bondi announced civiland potentially criminal investigations regarding pediatric gender transition. This includes investigating medical providers and pharmaceutical companies who “mislead the public about the long-term side effects of chemical and surgical mutilation” as well as “all suspected cases of female genital mutilation performed under the banner of so-called ‘gender affirming care’ or otherwise.”
In a memorandum to Department of Justice employees, she instructed them to “enforce rigorous protections and hold accountable those who prey on vulnerable children and their parents.”
Article (Paywalled)
Archive
