Major HHS Report Cites Lack of Evidence Supporting ‘Gender-Affirming Care,’ Failure of Medical Establishment

A comprehensive new report from the U.S. Department of Health and Human Services (HHS) has concluded that there is no strong evidence to support “gender-affirming” procedures that block puberty, mutilate the sexual organs of, and sterilize children for life. Experts say the report is a welcome affirmation of the grievous harms that gender transition procedures inflict on minors — which much of Europe has already acknowledged, marking a stark reversal of the pro-gender transitions for minors position of the previous Biden administration.

The five-part, 409-page report, entitled “Treatment for Pediatric Gender Dysphoria: Review of Evidence and Best Practices,” presents an exhaustive study of the issues surrounding diagnosing children with gender dysphoria and subjecting them to gender transition procedures. The first part covers the background, noting that medical treatments are typically “first established as safe and effective in adults before being extended to pediatric populations. In this case, however, the opposite occurred: clinician-researchers developed the pediatric medical transition protocol in response to disappointing psychosocial outcomes in adults who underwent medical transition.”

The report went on to note that gender transition protocols were “adopted internationally” before proper studies were conducted to examine the health outcomes of pediatric patients. But after evidence of outcomes began accumulating, “health authorities in an increasing number of countries have restricted access to puberty blockers and cross-sex hormones, and, in the rare cases where they were offered, surgeries for minors. These authorities now recommend psychosocial approaches, rather than hormonal or surgical interventions, as the primary treatment.”

The second part of the report highlighted a general lack of reliable evidence analyzing the effects of gender transition procedures. However, it emphasized that the risks of the procedures that have been established “include infertility/sterility, sexual dysfunction, impaired bone density accrual, adverse cognitive impacts, cardiovascular disease and metabolic disorders, psychiatric disorders, surgical complications, and regret.”

Despite these documented risks, the report’s third part noted that the most influential U.S. bodies for recommending health protocols for gender transition procedures, the World Professional Association for Transgender Health (WPATH) and the Endocrine Society, went ahead with guidelines recommending the procedures for children, which were characterized by international reviewers as “lack[ing] developmental rigour and transparency.” The report pointed to countries like Sweden, Finland, and the U.K. who are encouraging mental health approaches over medical interventions.

The authors (whose names have not yet been released) further observe that the “‘gender-affirming’ model of care, as practiced in U.S. clinics, is characterized by a child-led process in which comprehensive mental health assessments are often minimized or omitted.” In addition, the concerns of whistleblowers and detransitioners “have been discounted, dismissed, or ignored by prominent advocates and practitioners of pediatric medical transition.”

The report goes on to detail the ethical concerns involved in establishing protocols for gender transition procedures without sufficient clinical evidence to support them, as well as ethical concerns about involving children in “randomized controlled trials on pubertal suppression or hormone therapy.” The final part points out that behavioral comorbidities such as suicidal ideation associated with gender dysphoria in children “have known psychotherapeutic management strategies.” The report argues for more research to be conducted on psychotherapy as a way to treat gender dysphoria, since psychotherapy “is a noninvasive alternative to endocrine and surgical interventions for the treatment of pediatric gender dysphoria.”

The HHS report concludes by stating that “[w]hile no clinician or medical association intends to fail their patients — particularly those who are most vulnerable — the preceding chapters demonstrate that this is precisely what has occurred.”

Clinical experts like Dr. Jennifer Bauwens, who serves as director of the Center for Family Studies at Family Research Council, say the new HHS report is a welcome change in direction away from the blind promotion of gender transition procedures for minors that occurred under the previous administration.

“[O]ur government under the Biden administration was falsely using research to scaffold the ‘gender-affirming care,’” she pointed out during Thursday’s “Washington Watch.” “And really, what this report showed in the bottom line is [that] basically everything that has come from Europe and what we have been talking about, that the science is just not there to support it. And in fact, it’s quite the opposite. It says, ‘Run from these procedures and … protect children.’”

Bauwens, a clinical psychologist and licensed therapist who has provided trauma-focused treatment to children, went on to highlight how the new report delved into data coming out of Europe on mental health outcomes of children who have undergone transgender procedures, including the U.K.’s groundbreaking Cass Review.

“[W]hat it found [after] looking at the science, just the methods … used to cause a reduction in distress, is [there’s] no question you have to scrap this so-called ‘intervention’ because it’s not making a difference in what it purports to do,” she explained. “It’s not causing psychological distress to be reduced. In some cases, as other reports have found in Sweden, the rate of suicide was much higher.”

Bauwens concluded by expressing gratitude to the Trump administration for taking an ideology-free approach to the issue of gender transition procedures for minors.

“I’m so grateful that we are living during an administration that has courage and is doing what they said they would do, looking at all of the science but also looking at the ideology and saying, ‘How can someone suddenly claim to be … the opposite sex?’ They’re looking at it with common sense, and that’s really the heart behind this administration. … And I think we can get a lot done by just adhering to those basic principles.”

AUTHOR

Dan Hart

Dan Hart is senior editor at The Washington Stand.

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