Federal Report Denounces Gender Treatments for Adolescents

U.S. public health authorities issued a report on Thursday affirming that the implementation of hormone and surgical therapies for adolescents experiencing gender dysphoria is unsupported by empirical evidence, raising alarms about potential long-term harms. This stance marks a significant shift away from previous agency guidance and the counsel of prominent U.S. medical associations.

Emphasis on Psychotherapy

The report highlights the significance of talk therapy, a contentious approach to managing gender dysphoria that many advocates and physicians compare to controversial conversion practices.

Challenging Gender Identity

Portions of the assessment appear to question the legitimacy of individuals possessing a gender identity that does not correspond with their assigned sex at birth.

Executive Order Background

In January, President Trump issued an executive order titled “Protecting Children from Chemical and Surgical Mutilation,” instructing the Department of Health and Human Services (HHS) to issue a report within 90 days on the optimal practices for treating young individuals who declare their gender does not match their birth sex.

The order underscored the administration’s predetermined perspective on gender transition therapies for minors, describing the “obvious harm inflicted on children” as a “disgrace in our nation’s legacy.”

Report Details

The extensive 400-page report adopted a more measured tone but arrived at a comparable conclusion. Notably, the authors’ identities were withheld pending a post-release evaluation set to commence in the “forthcoming days.”

HHS Response

HHS officials opted not to address questions about the forthcoming assessment process. The department elaborated that the contributors comprised physicians, medical ethicists, and a methodologist, all spanning “a diverse spectrum of political persuasions,” chosen for their dedication to scientific principles.

The Document’s Purpose

The report clarified that the assessment was not intended to establish medical care standards or policy recommendations. It relied predominantly on analyses of scientific studies on puberty blockers, hormone therapies, and surgeries introduced for adolescents over the past few decades.

The evaluation concluded that while the advantages of medical interventions remain uncertain, the potential adverse effects, including infertility, are more evident.

The Current Practice

The report criticized current medical practices in this area as exceptional and worrying, and it denounced American medical groups for cultivating environments where clinicians feel pressured to self-censor.

The Debate on Treatments

The appropriateness of therapies such as puberty suppressants, hormonal treatments, or surgery for young individuals has sparked intense debate.

Several European nations have restricted these treatments recently, following reviews indicating poor evidence quality supporting their benefits and uncertainties regarding long-term risks.

State-level Restrictions

In the United States, 24 states have enacted laws prohibiting physicians from offering such treatments to adolescents.

Academy’s ReviewSome key acronyms are:

• AAP: American Academy of Pediatrics
• HHS: Health and Human Services
• LGBTQ: Lesbian, Gay, Bisexual, Transgender, and Queer/Questioning

The American Academy of Pediatrics is conducting its review of the evidence. The academy, along with most major U.S. medical groups, endorses these treatments as effective in alleviating the psychological anguish many transgender youths encounter.

Criticism from Activists

Gender rights activists have denounced the new assessment, suggesting it aims to cloak an ideological agenda in scientific legitimacy.

Administrative Policies

The administration has attempted to limit transgender identity recognition in public life, threatening to withhold funding from hospitals offering gender-transition treatments to individuals under 19 and barring openly transgender people from military service.

The administration has also moved to house transgender women in federal prisons with men and to discontinue acknowledging transgender individuals’ gender identities on passports.

Critics question whether the administration’s opposition to such medical care is driven by genuine scientific inquiry or by an ideological disapproval of transgender people. The National Center for Lesbian Rights, representing transgender individuals in lawsuits challenging the constitutionality of the administration’s policies, has raised concerns about the report’s motivations. The legal director of the organization, Shannon Minter, has emphasized the need for transparency in the government’s decision-making processes.

Around 3 percent of high school students in the U.S. identify as transgender—a figure that has significantly risen over the last decade. A much smaller fraction of these adolescents pursue medical interventions.

The Supreme Court

The Supreme Court has agreed to hear a First Amendment challenge to a Colorado ban on conversion therapy next term, brought by a licensed professional counselor whose Christian faith includes the belief that “people flourish when they live consistently with God’s design, including their biological sex,” according to court documents.

Other therapists, including Dr. Erica Anderson, have argued that so-called “exploratory” therapy with supportive clinicians can be beneficial in distinguishing mental health issues from gender identity for adolescents.